Sarah McIlwaine

What Do Young People At Risk For Psychosis Need?

Introduction: Some young people who seek mental health services are deemed to be at clinical high risk for psychosis (CHR): a term used to summarize experiences of low-level psychotic symptoms (e.g. hearing noises instead of voices). Increasingly, specialized services are being created to prevent or reduce the risk of transition from CHR to a full-blown first episode of psychosis. However, many youth at CHR also experience low mood or anxiety, as well as problems with school, work, friends or family; issues that persist regardless of whether psychosis develops or not. And since only 20-40% of youth at CHR will develop psychosis, it remains unclear whether specialized services should be designed based on psychosis prevention, whether the needs of these youth are in some ways distinct from those who have experienced a first psychotic episode, and indeed, what the service needs of youth at CHR actually are.
Aims/Objectives: Although many of the interventions offered to youth at CHR are symptom-based, there is a movement towards tailoring these services to not only address symptoms, but to also address needs that are defined by service users themselves. Yet clear gaps exist in our knowledge surrounding the lived experiences of youth at CHR, highlighting a stark need to examine the subjective experiences of such youth, the appropriateness of current interventions for CHR states, and to hear directly from the youth themselves about what their service needs are.
Methods: Our project aims to address these gaps in our current knowledge through individual interviews with youth attending the Clinic for the Assessment of Youth at Risk (CAYR) in Montreal, Quebec.
Potential Outcomes: This presentation will critically explore the terminology currently used to describe the CHR state (e.g. converter versus non-converter) and how it is identified and defined, discuss whether psychosis prevention is a useful intervention goal in this group, and where research on the subjective experience of CHR should go from here. The results of this project will potentially help clarify these concepts and bring to light current issues surrounding the conceptualization of the CHR experience, as well as the kinds of services that are being delivered to these young people.
Discussion/Implications: Given what we know surrounding the CHR experience, it would appear that the model of care currently prescribed for youth at CHR may not necessarily match what they actually want and need from services. However, we cannot know what we do not inquire about. Understanding the lived experience and needs of youth at CHR should therefore be integrated into the design and development of specialized services targeting this vulnerable population.