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Summer 2009 | Vol 12 No 4

Focus

First steps through psychosis

A journey through early intervention to lasting recovery

By Elizabeth Scott

CAPTION: Rob vividly captures the chaos of psychosis.

At age 17, Rob Neville appeared to be living a regular teenage life. He had always been somewhat of a loner, so no one took much notice when he started to talk less, and then grew silent altogether. What others couldn’t see, however, were the disturbing voices running through his head and his overwhelming anxiety and panic.

“My heart was racing, I was gasping for breath, I couldn’t sit still, I started seeing things,” he says. “Strange and severe headaches, paranoia and delusions occurred,” he continues, reading from a story he has written about the experience. “To avoid the painful voices, I would wear music headphones to drown them out. I was crying out for help and pushing people away at the same time.” Rob tried to deal with the chaos on his own, turning to alcohol and other drugs.

Eventually, however, his world came crashing in. A few false starts later, Rob became a participant in the Early Psychosis Prevention and Intervention Service (EPPIS), a program of the Manitoba Adolescent Treatment Centre in Winnipeg. Today, six years later, Rob credits the program for his recovery, one that has banished his debilitating symptoms and has restored a relatively calm mind and a meaningful life.

That renewed sense of meaning motivated Rob to give back to his community and society in general. He has become a public speaker about mental illness and shares his story with schools, police, family support groups and at mental health events. When one clinician noted Rob’s talent for articulating his experience, the team encouraged him to become involved in educating people about schizophrenia – the challenges, issues, hopes and barriers he and others face. Rob hopes to help others understand what psychosis is and why it can be hard to treat – but that recovery is possible. “There are a lot of misperceptions out there,” he tells me quietly over the phone.

Rob found valuable support through the early intervention program: “I believe my success is a result of the knowledge and education that was poured into me,” says Rob, who is now 25. “The dedication of a few people who refused to give up on me played a large part.”

At EPPIS, a psychiatrist and mental health clinician work with clients to evaluate their situation and develop an action plan that includes establishing goals and strategies to pave the road to recovery. Over two years, clients learn about their illness and develop skills to take care of themselves. In addition to learning skills of daily living, they participate in recreational days and social events, such as going to a baseball game or to the gym, which provide an opportunity to apply the strategies they have learned to deal with stress. For Rob, each small step brought him closer to his goals – long-term stabilization, independence and a sense of positive self-worth.

Rob’s mother, who recently passed away, also played a vital role in his early recovery. During the six months he was in hospital, she drove from one end of Winnipeg to the other to visit him: “She would actually come to see me every other day,” says Rob with a note of pride. In the six years since Rob finished the program, supports there continue to play a role in his life: “I’ve had many more obstacles in my way and my worker has supported me through them all,” says Rob.

Strong supports have not only helped Rob in his recovery and encouraged his participation as a speaker and educator; they have also helped him realize his artistic talent. He joined Artbeat Studio in Winnipeg, which accommodates artists with mental health issues, and got funding for art supplies from the First Episode Family Support Group, part of EPPIS. “Creating art has always been very big in my recovery, mostly because it has always been one of the ways I could express myself,” says Rob.

Creativity also played a role in the relapse prevention plan that Rob developed with EPPIS. “I still had symptoms, such as hallucinations, anxiety and panic, so we created a plan that would consider those factors – symptom triggers, daily triggers and stressors and stable medications.” After finding the right medication – Rob suffered an acute dystonic reaction early on from the wrong one – Rob has remained committed to taking his medication and has never had a relapse.

Another key to relapse prevention and recovery – appropriate housing – often remains elusive to people in recovery. Rob’s mother helped him find housing. He has been living on his own in an apartment since he finished the EPPIS program, and although he has moved several times since his initial discharge, he has always found a place to live within the same block. “I have a good landlord,” he says, knowing that this is often not the case for people with mental illness.

Considering the challenges strewn along the recovery path, Rob’s story attests to the importance of patience, consistent support, knowledge sharing and comprehensive treatment. When I ask Rob whether early intervention made a difference to his recovery experience, his answer is simple but resounding, “Oh yeah. Definitely, yeah.”