In any given year, some 3 million adults in the U.S. are affected by schizophrenia, a serious mental illness that hinders the ability to think clearly and relate to other people. People with the disorder, which is characterized by hallucinations, delusions and other erratic behavior, often have a hard time keeping a job or caring for themselves and end up dependent on others.

But it doesn’t have to be that way. A program that began at Maine Medical Center has demonstrated that people who have a serious mental illness – including not only schizophrenia but also major depression and bipolar disorder – can live normal lives if their illness is diagnosed and treated early.

In fact, the Portland Identification and Early Referral program has become a national model – and the state should give those behind the initiative the funding they need to help at-risk Mainers become productive and fulfilled members of the community.

Schizophrenia often appears in adults in their 20s but starts affecting the brain in the middle to late teens. So the PIER program works by developing a network of people who have a lot of contact with adolescents – high school principals, college administrators, school nurses, guidance counselors and family doctors – and asking them to identify young people at risk.

Those identified are then connected with a range of services, including counseling, medication and education about mental illness.

Tiffany Martinez is one PIER success story. As a University of Southern Maine freshman, she was referred to the program by friends and school counselors who noticed alarming signs, including unexplained fears, social isolation and a decline in functioning (falling grades, in her case).


She was diagnosed with early onset of psychosis, the loss of contact with reality that characterizes schizophrenia and some forms of depression and bipolar disorder. Then she was prescribed medication and took part in talk therapy, completing the program in five years.

Now 27, Martinez, who says she could have developed schizophrenia without early treatment, has a master’s degree and a job in Portland as a psychiatric nurse practitioner.

The National Alliance on Mental Illness supports PIER’s methods. So does the U.S. Substance Abuse and Mental Health Services Administration. Similar programs are being tried in Michigan, New Mexico, New York, Oregon and California.

And a study published last fall has found that the number of people hospitalized for first psychotic breaks fell 26 percent in the Portland area after the PIER program was launched there but rose 8 percent in other parts of Maine, where the program wasn’t in place.

About a third of young people with symptoms like the ones Martinez had develop full-blown psychosis within two years, driving up their risk of becoming caught in the spiral of decline associated with schizophrenia: homelessness, unemployment, hospitalization and suicide. Indeed, the cost of schizophrenia in the U.S. has been estimated at $63 billion a year.

Science, humanity and common sense all point to the need to intervene early, before serious mental illnesses like schizophrenia become intractable. The state should support PIER’s application for a five-year, $1.4 million grant that would allow the program to relaunch this spring and give more Maine young people the chance to keep their lives on track.

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