$2.6 million federal grant will fund a first-of-its-kind countywide program to catch early warning signs in Orange County youth
By Mimi Ko Cruz
Before a first episode of psychosis fully takes hold, there is a window — narrow, easy to miss, and for some teenagers and young adults, an extremely consequential moment in their lives.
UC Irvine researchers are determined to engage and partner with some of these youth before that window closes.
Backed by a $2.6 million grant from the Substance Abuse and Mental Health Services Administration, UCI this month will launch a countywide system of care designed to do exactly that.
The four-year initiative brings together UCI faculty, clinicians, students, researchers, and community partners to identify youth and young adults — ages 15 to 25 — who are showing early warning signs of psychosis, connect them with support and intervene before a first episode ever occurs.
“Research suggests that approximately 2-4% of young people meet criteria for clinical high risk for psychosis,” said Jason Schiffman, UCI professor of psychology and associate dean for research and faculty welfare for the School of Social Ecology, who is co-leading the effort with Dr. Cameron S. Carter, UCI Distinguished Professor and chair of psychiatry and human behavior in the School of Medicine. “Applied broadly to a county our size, that suggests thousands of young people could benefit from specialized assessment and support.”
Over the four-year grant period, the program aims to provide treatment and coordinated care to more than 150 young people. An additional 500 to 600 brief screenings are expected each year, with outreach extending to families, schools, health care providers and community organizations.
Disorders involving psychosis, which can include hallucinations, delusions and disorganized thinking, often first emerge during adolescence and young adulthood, Schiffman noted, adding that researchers have more recently recognized that a critical period exists before a first full episode, when symptoms are developing but haven’t yet crossed a clinical threshold.
Reaching young people during that window has historically been the hard part.
“Early signs can be subtle and overlap with concerns such as anxiety, depression, trauma or sleep problems,” Schiffman said. “A young person may recognize that something feels different but have trouble explaining it, or worry about how people will react. Even when someone recognizes the concern, stigma runs deep and available services have often been fragmented.”
What’s at stake is more than symptom management, he said. Adolescence is when friendships form, degrees are earned and careers begin, and psychosis risk can quietly erode those milestones long before a formal episode.
“We have an opportunity to address distress, support families and help young people stay engaged in their lives in ways that are consistent with their own values and passions,” Schiffman said. “If psychosis does develop, we want specialized treatment to begin promptly.”
Carter concurred.
“This is a unique collaboration between experts in the psychological assessment and management of youth in a risk state and psychiatrists and psychologists with expertise in treating more intense and potentially progressive symptoms, including the full onset of serious mental illness,” Carter said. “It is a unique new program that ensures that youth identified in the community can be linked to the right level and intensity of care.”
How it works
The program is designed to meet young people where they are, starting with the adults already in their lives. A school counselor who notices a student growing withdrawn, or a pediatrician whose patient's grades have inexplicably collapsed, can now initiate a referral into a clear, connected system.
After a referral, a brief screening questionnaire is administered. A positive result triggers a structured clinical interview with a trained UCI clinician.
From there, the young person is matched to care — cognitive behavioral therapy for many, psychiatric consultation for those with more severe symptoms, and supported education and employment programs for anyone interested in that level of support.
The initiative draws on three complementary partners: UCI Psychiatry’s iEDAPT early psychosis clinic, UCI Psychology’s Together Clinic, led by Naomi Tabak, Ph.D., who directs the Psychological Services Center within the Department of Psychology, and Thrive Together OC, a county-supported nonprofit co-founded by Schiffman. Together they form a continuum from community identification through treatment and ongoing support.
For parents who have noticed something off such as a teenager who has become inexplicably withdrawn or who has started describing experiences that don't quite make sense, Schiffman advises:
“You can ask for help before you’re certain of what’s happening. You don’t need to diagnose your child or wait for a crisis to seek an assessment. Being at elevated risk doesn’t mean psychosis is inevitable. Most young people identified as being at clinical high risk don’t develop a disorder related to psychosis. Still, many are experiencing real distress and deserve support now. We’re here to help.”
For those who do go on to experience psychosis, the connection to specialty care is already built in, Schiffman and Carter point out.
“If a first episode of psychosis occurs, the team is already there to help coordinate that transition,” Schiffman explained. “We’ll also try to connect families with others going through similar experiences to remind folks that they’re not alone.”
For Schiffman, who co-founded Thrive Together OC in 2021 and has personally trained more than 1,000 Orange County providers, the grant formalizes years of groundwork.
“When we encourage a family to reach out, we want to have a clear, helpful next step for them,” he said. “This funding gives us a much stronger ability to offer that, and to build services we hope will last beyond the grant.”
Schiffman already is looking toward the future.
He noted that UCI’s own research has already shaped the way the country approaches early psychosis intervention, informing national guidelines that are now influencing programs beyond Orange County.
The challenge, he said, isn’t a shortage of resources — most communities already have schools, primary care providers, therapists and community organizations that can play a role. What has been missing is the connective tissue: clear referral pathways, shared training and the kind of coordination that turns a loose network of services into a system that actually works.
“We believe,” Schiffman added, “in helping to support everyone to be able to live a life of their own choosing.”