Frequently Asked Questions
Frequently asked questions from other parents
What can I expect for my child’s future?
No one can say precisely how an individual’s symptoms are going to develop over time. Part of the problem is that while researchers suspect risk factors for psychosis (certain genes, genetic mutations, prenatal and perinatal events, and human behaviors such as heavy teenage marijuana use), we still do not know what exactly causes psychosis and therefore cannot predict what will happen in the future. The good news is that there are some things that individuals and families can do to modify their way of life that will reduce the likelihood that symptoms will occur or reoccur. In the end, it is more productive to focus on what one can do to feel better and stronger than to try and predict what exactly will happen.
Is this going to get worse?
Once again, no one is yet able to say with certainty that your child’s symptoms are going to improve, worsen, or remain unchanged. However, clinical researchers can say with confidence that you can improve the probability of a better future if you engage in treatment that educates your family about psychosis and provides counseling to help you come to terms, manage symptoms, promote recovery, and plan for the future. Treatment should also offer the option of a psychiatric referral and medication if needed. If the young person, her family and the doctor agree that medication is worth trying, it should be taken consistently and as prescribed so that main effects and side effects can be documented for follow-up med checks.
The earlier you begin treatment, the more swift your child’s recovery is likely to be. Once you are in treatment, attend consistently, be patient, and remember that each individual is unique and will improve their functioning at the rate that their body allows them.
What do I say to relatives? Neighbors?
Mental illness is a sensitive topic, but keep in mind that you are under no obligation to share all or any details about your child’s mental health with any family members or neighbors if you do not feel comfortable doing so. If you are considering telling someone who is currently unaware of your child’s issues, it can be wise to first test the waters by discussing, for example, a recently read news article on mental illness. This indirect approach gives you an opportunity to gauge someone attitudes towards people with mental illness or public stigma about mental illness. By selectively sharing the challenges you face with others, you and your child stand to benefit from the support of people who understand you, are open to learning more, and have you and your family’s best interest at heart.
Will my child be able to get and keep a job?
Most employed young people who are at risk for developing psychosis or have recently recovered from their first hospitalization continue to work and have plans to continue working in the future. In a recent study of youth ages 12-25 who were in treatment for signs of early psychosis, more than 4 out of 5 were in school or working jobs. Studies that track these young people over time find that those who stay employed tend to manage their symptoms more successfully and stay socially connected to people outside their families. There is a growing consensus that having meaningful work in one’s life is not just a byproduct of recovery, it is an integral part of it. Employment provides a structure and a setting in where people can connect. It is critical that youth know that they have certain rights in the workplace under the Americans with Disabilities Act. To exercise those rights, it helps to link up with a counselor with expertise in supported employment who can help the youth adjust to the realities of the workplace and seek accommodations from employers when needed.
What treatment options are there for my child? Will my child have to take medicine?
The good news here is that there are more effective options for the treatment of psychosis than existed 10 years ago. One treatment approach, called the PIER model, is designed for youth and young adults and combines several of these effective treatment options into a single intervention. Basic elements of the intervention include: family engagement, education about psychosis (i.e., information about psychosis), group counseling, and consultation to assist with plans for education and employment. When needed, other therapies can be added to these basic elements including: testing to evaluate aptitude and functional readiness, occupational therapy, or substance abuse counseling. While not everyone needs or wants medication, psychiatric support remains in the PIER model as an option for reducing acute symptoms like hallucinations (i.e., sensing things that are not there), elevating mood, or improving motivation. In the PIER model, prescribed medications are frequently reviewed for main effects and side-effects. Moreover, medicine is always looked upon as one single part of an overall strategy and never a standalone treatment.
Is my child likely to be hospitalized or re-hospitalized?
Most people with mental illnesses do not need hospitalization, but it is important to keep in mind the reasons that it may be necessary. Reasons for hospitalization include thoughts of hurting oneself or others, the need to adjust medications for greater stability, or a temporary worsening of symptoms.
As a parent, there are 4 steps you can take to help reduce the possibility that your child will need to be hospitalized in the future. First, do not wait until symptoms become disruptive to get your child assessed for mental health problems. Assess early so that you can address problems before they become big problems. Second, engage your child and any other family members that are being affected by the illness with appropriate treatment that combines visits to the doctor with opportunities for individual, family, or group counseling. Third, attend treatment consistently and over a prolonged period of time. A year is considered a reasonable period of time in which to get information about the illness, give your child time to recover, learn how to track symptoms, implement stress management skills at home, and consolidate plans for education or employment. Fourth, if medicine is prescribed by your child’s doctor, encourage your child to take it consistently and as prescribed. Document any results and side effects so that you can report back to your physician at follow-up visits.
Does insurance cover this?
The treatment program featured in this website (Delaware CORE, Community Outreach, Referral and Early Intervention) is a federally funded program, and is available to the general public at no cost. If your child qualifies for CORE, neither you nor your insurance will be billed. If your child does not qualify for CORE, you and your child will be referred for treatment to another provider. Any fees you incur from attending another treatment program will depend on the type of insurance coverage you and your family have. If you are referred to a program other than CORE, we recommend that you contact your insurance provider to inquire about costs associated with mental or behavioral health treatment for your child.
Will my child be able to continue attending the same school? What should I tell my child’s school?
Because the onset of severe mental illness often occurs during late adolescence and early adulthood, it is not unexpected that a mental illness may interfere with your child’s education. You may notice a change in your child’s ability to concentrate, as well as a change in their socialization patterns, moods, and/or behaviors, all of which influence a child’s academic performance. However, keeping educational goals in the forefront of our minds is of great value. Continuing to pursue one’s education has many positive effects on one’s recovery from mental illness, including: improved self-esteem, a feeling of being productive, opportunities to socialize, and renewed faith in one’s ability to achieve future goals and find employment.
There are several options for continuing academic learning during any stage of your child’s recovery. However, making the right decision can be intimidating, and it is worth the time spent to find someone that has expertise in supportive education.
In some cases, you may consider looking into educational accommodations at your child’s current school, which requires communication with your child’s teachers, academic advisor, and/or guidance counselors. Some teachers are more accommodating than others, so reaching out to the counseling services at the school for support is wise. Also, if you feel a greater accommodation is necessary, you may decide to look into special education or alternative schools, or getting a GED or high school equivalency. By law, primary and secondary schools are required to provide free and appropriate education for all students.
Seeking accommodations from a college or university is more complicated and subject to the policies of a particular learning institution. Common examples of accommodations made to help students succeed include: more time to complete tests and assignments, having a student aide to assist with taking notes, or a reduced course load. Every school has its own policies for academic adjustment. These can usually be found by either going to the school’s website or contacting an admissions counselor.
You may need a document from a doctor or counselor proving your child’s need for accommodation. If you feel that your child is being discriminated against, follow the school’s reporting and grievance procedure. There should be staff assigned to ensure compliance with the laws and policies pertaining to disability and education.