You start hearing voices. Suddenly, you’re seeing, tasting, and feeling things that no one else is experiencing. You can’t get rid of these persistent odd or strange thoughts. You’re not making sense to others when speaking and you can’t focus. Your global functioning has deteriorated to the point that work, school, and relationships have become difficult or impossible to maintain and it feels that everything has unraveled. 

It’s hard to imagine the fear and confusion that grips someone when they are experiencing their first episode of psychosis. Luckily, there is an excellent team in place at UNLV Health Mojave Counseling to help these individuals try to get back to the life they had before this episode. They are staff of the first episode psychosis (FEP) program.

David Stoebling, FEP program director, said that it’s at this first episode when someone’s life really starts to change and becomes increasingly difficult. That’s where the FEP program can step in and make a difference.

“Psychosis refers to a set of symptoms that are associated with a psychotic disorder,” said Stoebling. “Symptoms of psychosis refer to hallucinations, delusions, disorganized thought, disorganized speech, disorganized behavior, and negative psychotic features.”

Psychosis often begins when a person is in his or her late teens to mid-20s. There are about 100,000 new cases of psychosis each year in the U.S. Nevada averages a little more than 300 first episode cases every year split between Northern and Southern Nevada in the cities with the highest populations (Las Vegas, Reno/Sparks, and Carson City). 

The causes of psychotic disorders are suspected to be attributable to genetics and environmental factors. Individuals who experience psychosis may have family histories of psychosis or other mental health issues. An individual predisposed to psychosis may experience a psychotic episode in their lifetime after experiencing an environmental stressor (large or small) such as a break-up, losing a job, failing an exam, using drugs or alcohol, or just about anything.  

Eligibility

Before acceptance into the FEP program, certain eligibility requirements must be met. Individuals must:

• Be in the age range of 15-44
• Meet the DSM-5 (the standard classification of mental disorders used in the U.S.) for schizophrenia spectrum and other psychotic disorders
• Have onset of psychotic symptoms less than five years in duration at the time of enrollment
• Not have been treated with antipsychotic medication(s) for more than 12 months in their lifetime
• Have an IQ of 80 or greater and not have a developmental and/or intellectual disability
• Reside in the Clark Behavioral Health Region in Southern Nevada

Certain other DSM-5 diagnoses are excluded from the program. Complete details of eligibility requirements and exclusions can be found on the FEP website. 

Treatment Approach

The backbone of treatment for FEP is medication management, as the goal is to stabilize the patient’s symptoms as soon as possible. Once symptoms are stabilized with anti-psychotic medications, they can begin the two components of therapy: family and individual resiliency training.

Along with medication and therapy, the “wrap around” program of services provided by the FEP program also includes case management to access community resources and supported employment and education (SEE) services to assist individuals with employment and education opportunities.

The FEP program began development at Mojave in January 2020 and saw its first patient in May 2020. Since it is a two-year program, it had its very first graduate this month and three other patients will graduate this year. As the program focuses on reducing incarcerations and psychiatric hospitalizations, Stoebling pointed to success with this first group of graduates, as they are practically at zero for both.

Overcoming Challenges

One of the main challenges inherent with a psychotic disorder is that individuals at times can lack insight. They don’t understand they have the disorder or even believe they have it, so why take medication? In general, psychotic disorders are typically lifelong, chronic conditions and are treated with continuous multi-disciplinary care with psychiatry, psychotherapy, and case management. The goal is to help individuals achieve their goals, have good relationships with family and friends, and have a good quality of life. 

“This team is very passionate about what it does,” said Stoebling. “…We will provide this population our very best.”

First Episode Psychosis Program Contact

If you know someone who may be suffering from a first episode of psychosis, email David Stoebling, FEP program director, or call 702-968-4032.