Probing psychosis risk

Jason Schiffman

Jason Schiffman is professor of psychological science, director of the clinical psychology program and co-founder of Thrive Together OC. Photo by Han Parker

Professor Schiffman seeks early identification of mental health challenges

Jason Schiffman is on a mission to connect with people at risk of developing psychosis.

“If we can find folks early in their mental health struggles, we can partner with them, work with them to help them gain skills and wrap them with supports, then we can potentially alter their trajectories in really positive ways,” the professor of psychological science says.

Those positive ways could produce outcomes such as educational and employment opportunities and better social life and functioning in the community, Schiffman explains. “Fewer symptoms and better functioning lead to a more meaningful, happy, and abundant life. ”

Psychosis, as defined by the National Alliance on Mental Illness, is characterized as disruptions to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t. Psychotic illnesses, which impact 3% of individuals worldwide, have long been considered the least understood, most stigmatized, and most impairing mental health diagnoses. Schizophrenia alone is associated with an estimated $155 billion in annual healthcare costs. 

“People with psychosis often have symptoms such as hearing or seeing things that aren’t there, or having unusual thoughts or ideas despite contrary evidence,” Schiffman shares. “These experiences can significantly interfere with a person’s ability to connect with others, contribute to society, and make the most of their lives.”

Schiffman’s research focuses on refining the identification of young people at risk for psychotic disorders, better understanding the effects of psychosocial interventions for adolescents at risk for psychosis, uncovering mechanisms that can reduce stigma against people with serious mental health concerns, and addressing issues of racial inequity and health disparities for those in the early phases of psychosis.

With $1.38 million in funding this year alone from the National Institute of Mental Health, Charitable Ventures of Orange County, Yale University, and the University of Maryland, Baltimore, Schiffman is investigating ways to help people who may develop psychosis through myriad research projects and service contracts.

Highlighting the urgency to identify people earlier, Schiffman notes that effective treatment for most people with psychosis doesn’t tend to start until nearly two years after they have developed psychosis.

So, Schiffman’s goal is to find people before they develop a psychotic episode and connect them with services.

“If we find people during the risk phase and work with them, we can avoid many of the negative consequences associated with long durations of untreated psychosis,” he says. “My students, staff, and I are passionate about this pursuit.”

During a recent national webinar training session hosted by the Mental Health Technology Transfer Center Network, Schiffman suggested the importance of partnering with schools, as the onset of psychosis generally occurs in people between the ages of 15 and 25.

“Nearly all youth who are at risk are in schools,” he points out. “In one study, 87% of school providers reported involvement with a youth with psychosis. Nonetheless, it can be challenging to engage with schools, so it’s critical that we nurture these connections.” 

Schiffman actively partners with school personnel at local and national levels to sensitize educators and families to the signs of early psychosis and how to help. However, according to Schiffman, school personnel are not the only ones who benefit from understanding more about risk for psychosis. As a result, he actively engages the broader community to educate as many people as he can on risk factors and symptoms.

For instance, he partners with Elizabeth Cauffman, professor of psychological science and a pioneer in supporting justice-involved youths, in supporting incarcerated youths with signs of psychosis. 

“Together with our graduate students, staff, undergrads, and colleagues, we are pioneering new research that uncovers addressable barriers to care, especially for people from marginalized communities,” Schiffman says.

Making a Difference

“There is solid evidence suggesting that if we connect with schools and the community more broadly, create less stigmatizing environments, and increase knowledge, we can really make a difference,” he says.

To that end, Schiffman’s projects aim to reduce and aspirationally eliminate the risk of psychosis and associated challenges.

For example, his Youth-nominated Support Team (YST) project targets suicide prevention in young people who are at risk of psychosis, a common concern for this population.

“For youth who are at risk for psychosis, the risk for suicide is quite high. For some, there’s a feeling as if they’re ‘losing their mind,’ maybe losing grasp of reality. These feelings can lead to a sense of hopelessness, fear, and worry about what’s to come next,” Schiffman says.

The main ingredient in his YST project is social connection. The YST model engages natural supports, such as family members and mentors, into the treatment team, equipping them with resources for when their loved one reaches out for help. The project is similar in spirit to another intervention Schiffman is working on under the stewardship of his colleague Elizabeth Martin, associate professor of psychological science, where their collective team is finding ways to increase social skills for people at risk for psychosis so that they can have a richer social network and fuller life. 

With federal funding from the National Institute of Mental Health across several studies, Schiffman and his team are also partnering with UCI Psychiatry as well as universities across the world to identify biological and psychosocial indicators of risk. From experiences of discrimination to fMRI neuroimaging and everything in between, the team is determined to uncover social and biological determinants of risk. 

Schiffman’s work is not limited to research, however. In the spirit of transforming his science to solutions for the community, Schiffman co-founded the Orange County nonprofit organization Thrive Together OC. Through Thrive Together, his team offers free clinical services to youth and families in Southern California.

Gold Standard

Schiffman, who has a Ph.D. in clinical psychology from USC, is one of only three certified trainers in the U.S. of the gold standard instrument for assessing psychosis risk. Because of this status and his past experience establishing centers of excellence in early psychosis, Schiffman’s training expertise is in high demand nationwide. 

Schiffman and colleagues’ work in the early identification and prevention of psychosis is being described as “on the cusp of a revolution,” and as a result, Schiffman consults and trains scores of community programs and hundreds of clinicians across the country.

“When I started as an undergrad 28 years ago, there was no talk of identifying people before developing psychosis, much less forestalling its development or preventing it,” Schiffman says.

“With my many partners and friends, we’re generating new knowledge and then training the workforce with this knowledge to be a part of this revolution,” he says. “I think research to the community through training is vital as mental health providers and the services they offer are the gateways to helping this vulnerable group of people. As we bring science to the streets, we know that the right care, from the right person, at the right time can make all the difference.”

In addition to his research in the early identification and treatment of psychosis, Schiffman is the director of UCI’s Clinical Psychology program, which welcomed its first students in 2021. Schiffman and colleagues in the Department of Psychological Science are training tomorrow’s clinical scientists in the scholarship and practice of clinical psychology.

Students in the Ph.D. program will be equipped to serve the community by helping to meet society's growing mental health needs, including but not limited to psychosis, through science and leadership.

Whether in the context of his work preventing psychosis or his leadership in bringing to life a Clinical Psychology Ph.D. program, Schiffman is passionate about improving the mental health and well-being of others. With his colleagues and students, he clearly brings science and real-world applicability together to create optimism and hope for some of the community’s most vulnerable members.

“We firmly believe that an ounce of prevention is worth a pound of cure for many mental health challenges, including psychosis and schizophrenia,” he says. “Prevention is possible.”

Mimi Ko Cruz