Photo of Dr. Carter UC Davis psychiatrist Cameron Carter will lead an innovative program to help young adults at risk for psychosis avoid the onset and consequences of serious mental illness.

Jarad was about 19 years old when he started to hear voices of people who weren't there. Soon after, birds and animals began talking to him "about totally random things."

As he struggled to make sense of what was happening to him, Jarad convinced himself that the sun had grown larger, introducing a new frequency of sound waves that allowed him to hear these new voices. His torment was about to end when he imagined his mother handing him a gun, telling him he would know what to do with it. Although he says he realized the gun was imaginary, he still believed his mother had told him to kill himself.

So, he found a rope and went into the woods to hang himself. "Just as I was passing out, I realized that this wasn't right, this wasn't the way I wanted go," says Jarad. He quickly scrambled up the rope and the tree branch and went home.

Time to seek help

With the bruises around his neck still fresh, Jarad and his family finally sought help. When he was diagnosed with schizophrenia, he says he felt oddly relieved.

"My psychiatrist understood what I was going through and I didn't feel so alone anymore," he says.

Jarad is now 23 and just graduated from college with a bachelor's degree. He is on medication and doing well in therapy, says his psychiatrist, UC Davis professor Cameron Carter. But Carter wants to prevent other young people from having to experience a life-threatening event like Jarad's.

"My psychiatrist understood what I was going through and I didn't feel so alone anymore."
A new $2 million grant from the Robert Wood Johnson Foundation will help Carter in his prevention efforts.

The funding launches a communitywide research initiative, called the Early Detection and Intervention for the Prevention of Psychosis Program. The goal is to identify young people who show early signs of psychosis and prevent the onset and consequences of serious mental illness.

One of four sites

UC Davis is one of only four sites selected from a limited number of organizations across the country qualified to do this type of work.

"This project is really about creating a paradigm shift in how we think about treating mental illness in which we move from a palliative-care model to prevention," says Carter, who will direct the new program.

"Instead of a picking-up-the-pieces approach in treating serious and debilitating mental illnesses, such as schizophrenia, we will work to preserve function and maintain social, occupational and academic development in teens and young adults," he says. "Our expectation is that we can avoid what is now considered the standard outcome for these youth — school failure, occupational failure, social isolation, homelessness, incarceration, hospitalization and devastating events like Virginia Tech."

The program seeks to replicate an innovative and highly promising approach to psychosis prevention developed in Portland, Maine. There, approximately 86 percent of at-risk young people who enrolled in the Portland Identification and Early Referral program did not experience a full-blown psychotic episode a year later. According to experts, the expected rate would be 50 to 60 percent for that group of young people.

Community participation

More than 15 community organizations in the Sacramento area, ranging from the African-American Mental Health Providers to the La Familia Counseling Center and the Hmong Women's Heritage Association, are partnering with UC Davis in this effort to educate others who interact with youths regularly to recognize the early signs of psychotic illness.

The program will focus on youths, ages 12 to 25, who show early symptoms of psychotic illness but do not yet have the disease. Young people at higher risk and their families will receive evidenced-based, psychosocial support and education, treatment, and medication. Those with a much lower risk will receive careful monitoring, support and referrals for further treatment, as needed.

Private funding of this project was critical, Carter says: "A project on this scale would not have received funding without the support of the Robert Wood Johnson Foundation, which believes that what we are doing will have a quick impact on policy and contribute to a fundamental change in addressing the needs of this population."