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Young people and psychosis : getting the help you need

If you are suffering from psychotic symptoms, it can be daunting to figure out how to get the appropriate help. I’m going to describe what these symptoms might feel like and discuss the importance of getting help right away. Then I’ll let you know how to get the help you need in Montreal.

Many people describe their psychotic experience as being unsure about what is real and what is not. You may hear voices or see things that others cannot. Often, you just don’t feel “right”, or feel “different”. Even thinking might be difficult and confused. Your thoughts can seem to speed up or slow down. You may have bizarre preoccupations or feel worried that others are reading your mind. You may feel extremely hopeless, anxious, sad and afraid. Suicidal thoughts are common too. You may feel and act differently that you normally would.

Remember, we’re talking about symptoms of psychosis, not about a specific illness. Often, these symptoms occur during a stressful period in your life. They can be associated with mental and physical disorders such as depression, brief reactive psychosis, bipolar disorder, organic psychoses, delusional disorder, drug-induced psychosis, schizophrenia, schizophreniform disorder, and schizoaffective disorder.

Timing is very important.

If you suspect that you have psychotic symptoms, getting help early can greatly increase your chances of preventing a recurrence and ensuring a complete recovery, no matter what type of illness. Before you begin to worry about the possible mental or physical disorder that you may or may not have, get help to deal with the symptoms now.  One of the problems with psychosis is that the more episodes that you suffer, the greater the hit to your self esteem and self-confidence, which can lead to depression. Another problem is that a psychotic episode can leave you frightened and isolated from friends and family. Psychotic symptoms often first appear in your late teens and early 20s- a critical period in the development of your identity. You may be considering your future career path, or moving out for the first time, or starting to figure out who you really are. Having to deal with psychotic symptoms at this time of your life is extremely disruptive. For this reason, there are several services targeting youth who are at risk or who have had their first episode of psychosis. Accessing these services is the best way to keep you on the path to a healthy and productive future.

Early intervention prevents disruptions in family, friends, school and work. This is not to say that recovery is not possible at a later stage, it’s just becomes more difficult down the road because of the impact of your symptoms on these different areas of your life; identity, psychological health, social world, employment, etc.

The good news is that with the appropriate early treatment, most people recover very well. If you are a teenager or young adult, (usually between 14 and 30) and you are experiencing psychotic symptoms for the first time, you should get help at one of Montreal’s first episode clinics. There is a basic protocol for getting into the right clinic for you, and a few alternative routes which I will discuss later. Here is what you need to know:

(Note that, if you are in the midst of an episode and urgently need help right now, you can call 911 or go to the emergency at your nearest hospital.)

  1. Set up an appointment with a first line health care provider. This can be your family doctor, psychiatrist, social worker, or therapist. It can also be your local CLSSS or CLSC (health centres). To find the CLSC in your neighbourhood, click here:
  1. Describe your symptoms to the health care provider. They will evaluate you. Ask for access to a First Episode Clinic – part of second line health care – which is more specialized and best suited to your needs as a young adult who has recently experienced psychotic symptoms. The first line provider will fill out one of these forms:[1]
        • Note that steps 1 and 2 are usually the most time consuming part. It can take a while to get an appointment, and even then you may find it difficult to talk about your symptoms, or the doctor might be too rushed to evaluate you properly. To facilitate the process, I suggest that you print out the appropriate form above and bring it with you to your appointment.  (Some health care people are not up to date on the system). You could even print out this article, to help stimulate discussion. Your provider will then fax the request for second line services to the:
  2. Central guichet d’acess en santé mentale (Entry point into mental health).
        • This is the person or team that receives all requests for mental health help, prioritizes the requests, and evaluates what kind of psychosocial services are needed based on the needs of each individual. In your case, depending on where in Montreal you live, a request for consultation will be sent to the appropriate program in your area. Each first episode clinic is responsible for a specific area.
        • You can take a look at a list of most of the clinics in Montreal here:
          • http://www.aqppep.com/cliniques.htm
  3. Once your referral gets sent to the appropriate program/clinic, this clinic will embark on it’s own procedure, but it’s usually a very quick and easy process at this point. You will be assessed and then oriented towards the appropriate help. For example, here is what happens if the Guichet sends your request to the
    • PEP Maisonneuve-Rosement:
      • The liaison nurse in the psychiatric departement will receive the request from the guichet and orient you to the PEP program or even to another program if necessary (if your case doesn’t meet the criteria and your needs might be better met elsewhere). Within one week you will be able to be assessed by PEP team member and accepted into their program.

 

Now just to complicate things a little bit, despite the city’s efforts to centralize and expedite access to second line health care, each clinic has a slightly different admission protocol. Even though all of the clinics are accessible through the main system, the following clinics that can be also be contacted directly, (without a referral), which might be easier than going through the first line provider. The reason is that they also have a research mandate, and therefore are not limited to the public health procedures. You have to live in the eligible area. If you are unsure, give them a call to see if you live in the eligible area.

  • Clinique JAP at the CHUM-Hôpital Notre-Dame:

If you live in the CSSS Jeanne-Mance area, you, your friends or even your family members can call the clinic directly.

 

  • The PEPP Program at the Douglas Hospital

You can contact them directly, if you live in LaSalle, Verdun, Saint-Henri, Pointe Saint-Charles, Côte-Des-Neiges, Lachine, NDG/Montréal-Ouest, Ville Émard / Côte Saint-Paul, or Westmount.

 

  • The FEPP program at the Jewish General Hospital

This program serves NDG, Cote St Luc, and the area around the Jewish General Hospital. They cannot be accessed through the guichet d’acces. You must call them  directly:

 

  • Early Psychosis Intervention Clinic (EPIC) at the Royal Victoria Hospital

This program can also only be accessed by calling directly. I had difficulty finding information about this program, unfortunately. I am not sure about the eligibility criteria.

    • Contact: Rhona
    • Telephone: 514-934-1934 x36178

I have spoken with a few of the clinics and everyone has been very warm and respectful and easy to talk to. There are a few steps to getting the help that you need, but rest assured that it is there, it’s confidential and it works.

If you have any comments, suggestions, questions, or would like to share your own experience with First Episode Clinics in Montreal, please comment on this article. Or, you can email me directly at starr@cpfdesjardins.com. I look forward to hearing from you.

 

Links about psychosis that may helpful to you:

Get Help Early

Mind Your Mind (MYM)

http://www.psychosissucks.ca/

 


[1] If the first line provider (doctor, social worker, therapist, etc.) is unable to evaluate your symptoms, or does not refer you, then I recommend that you consult the first line people at your CLSC.

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