Usually first occurring in teen and young adult years, psychosis temporarily impairs the brain’s ability to decipher reality. Psychosis is an underlying condition that occurs in some illnesses such as schizophrenia and bipolar disorder, a temporary result of drug use, and a number of other medical issues.
Psychosis exists along a continuum, with a wide range of health impacts and persistence. Everyone’s experience is unique, but typical early symptoms include:
Changes in how things sound, look, taste, smell or feel
Suspiciousness or paranoia
Problems with sleep, concentrating or processing thoughts
Contrary to common assumptions, psychosis doesn’t have to be forever. And it doesn’t mean you can’t lead the life you’ve envisioned. Psychosis, especially in its earliest stages, can be effectively treated. Without treatment and support, however, psychosis can be extremely disruptive to your life and health, so it’s important to get help early.
Who is affected?
Serious mental illnesses affects roughly 3%, or 9 million Americans.
Approximately 100,000 young people in the United States experience first episode psychosis each year.
75% of chronic mental illness begins by age 24.
3.5 million people with serious mental illness remain untreated–a population equal to Los Angeles, the second largest city in the U.S.
The human costs are unforgivable.
The impact of psychosis on a young person's health can lead to social, academic, and vocational challenges - setbacks that can interrupt the formation of personal independence, identity and values.
Seen through this lens, preventing the progression of adolescent mental health conditions is a lynchpin to solving a myriad of thorny social, economic and health problems. Click each tile to learn more.
Unemployment for persons with serious mental illness is estimated to be 80%. Psychiatric illnesses are the third leading cause of disability in the United States.
(Crowther et al, NIMH)
Ten times more people with serious mental illnesses are in state prisons and county jails than there are in state mental hospitals. In 44 states, the largest single “public mental institution” is a prison or jail. 20%-40% of jail and prison inmates suffer from serious mental illness, at a cost of $10 billion per year. 90% of people referred to public psychiatric hospitals in California come from the criminal justice system – not the mental health system.
30% of our nation’s homeless population – more than 200,000 people – lives with mental illness.
(Treatment Advocacy Center)
The highest risk of violence at the hands of someone with psychosis is suicide: roughly 10% of people with schizophrenia die by suicide, as compared to 1% for the general population.
Suicide is the third leading cause of death among mid-adolescents.
Over 90% of children and adolescents who die by suicide have a mental health condition.
(WHO, Meltzer, NAMI)
Research shows that as many as half of persons with schizophrenia suffer from coexisting drug or alcohol disorder. At greatest risk are young males with lower educational attainment.
Addiction puts a person at greater risk for earlier onset of psychosis, and is associated with poorer outcomes, including increased psychotic symptoms, poor treatment adherence, violence, homelessness, medical problems (including HIV), and greater use of costly crisis-oriented services.
For all of these reasons, it is imperative that substance abuse and mental health treatment go hand-in-hand to effectively treat psychosis.
Persons with schizophrenia die 15-20 years younger than the general population. The leading cause of death is heart disease and cancer, for which people with schizophrenia have a lower rate of survival.
(Crump et al)
The prevalence of diabetes among people with psychosis is 1.5-2 times greater than average. The rate of undiagnosed diabetes is also remarkably high (10%+) among this population, making regular screening as a part of the standard of care for psychosis extremely important.
(Bauer et al)
Studies indicate a strong linkage between psychosis and tobacco use as compared to healthy controls. Its prevalence has implications for smoking cessation programs and efforts to reduce the many known health risks of smoking among people with mental illness.
One study showed that the prevalence for high school drop-out for students who had experienced a first episode of psychosis was remarkably high – roughly three times the local census data for the same period. This points to the need for an integrated treatment approach that includes supported education.
The majority of persons with mental illnesses are not violent. In fact, a person with serious mental illness is 11 times more likely to be a victim of violent crime than the general population. A news investigation found that half of the estimated 375 to 500 people shot and killed by police nationwide each year suffer from mental illness.
While suicide and mental illness are strongly correlated, homicide and mental illness generally are not. According to the research, the biggest predictor of gun violence is a history of violence, followed by substance use/abuse and poverty. A small minority - just 4% - of violence in the U.S. is attributable to mental illnesses, making the issue of mass shootings more nuanced than many believe.Untreated psychosis, especially when combined with alcohol or substance abuse, does increase the risk of violence, according to research. These violent acts tend to be non-life threatening, and are rarely against an unknown person.
For those insistent upon tying gun violence solely to mental health concerns, it is worth noting that every country in the world has about the same incidence rate of psychosis, yet the U.S. stands out in its gun ownership and mass violence rates, pointing to a more complex set of causal factors.
Surveys of US employers show that 50% are reluctant to hire someone with past psychiatric history. Approximately 70% are reluctant to hire someone currently taking antipsychotic medication.
The mortality rate for people with schizophrenia and bipolar disorder is double that of the general population.
Three barriers stand in the way of progress.
$$$$. Lack of funding for prevention and recovery-based research.
Community-based treatment programs were intended to replace psychiatric hospitals in the mid-20th century. Instead, one inhumane system was replaced by another: the criminal justice system.
Stigma. The U.S. Department of Health and Human Services labeled stigma “the most formidable obstacle to future progress in the arena of mental illness and health.” Why?
Today, we have the tools to begin to alleviate the personal and societal toll of psychosis through early detection and treatment.
With a scientifically-tested treatment model that is changing futures for young people facing early stage psychosis, we can no longer allow treatable conditions to escalate into personal devastation because we feel silenced or because specialized care is unavailable.
Treatment is aimed at helping a person reach their life goals, and may include cognitive behavioral therapy or another form of structured talk therapy, cognitive training exercises, family therapy, supported education/employment and low-dose medication.