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  • Pathways to early care

    Veteran Specialists & Psychosis

    Psychosis in the Veteran population

    Individuals who serve the Veteran population are in a position to help end the stigma associated with reaching out for mental health support. Early identification and treatment of psychosis symptoms (for example, shortly after discharge) tends to lead to better long-term outcomes.

    The Veteran's network

    According to the National Center for Veterans Analysis and Statistics, as of 2019 the projected U.S Veteran population is 19.2 million. Many Veterans enlist in service during their young adult years, which is a time of life when psychosis symptoms frequently first emerge (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, 2013).

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    According to the US Department of Veteran Affairs, in fiscal year 2018 more than 1.7 million Veterans received treatment in a VA mental health specialty program meant to support recovery and enable Veterans who experience mental health problems to live meaningful lives. As of a 2014 study approximately 120,000 Veterans receiving VA health care experienced symptoms of schizophrenia, a chronic mental illness associated with psychosis symptoms.

    Through education and intervention you can help Veterans who may be suffering from early psychosis long before they find themselves in a crisis. This help is often in the form of recognizing possible mental illness, knowing how to engage with that person and knowing the best resources in your area to access for care. As a trusted member of a Veteran’s network, you are poised to help a Veteran learn about available resources and connect with care, either within or outside of the Veterans Health Administration.

    What is psychosis?

    The word psychosis pertains to a variety of symptoms that affect the mind. Characterized by noticeable changes in behaviors, perceptions, thoughts and beliefs, a Veteran with psychosis is sometimes unable to distinguish what is real and what is not.

    What are the symptoms of psychosis?

    These experiences will vary from person to person. Symptoms may be frightening and seem very real to the person having them.

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    Voices or auditory hallucinations

    Hearing single or multiple voices, which can be simple or complex, abusive, neutral or soothing. People may hear whispers or clear/distinct voices; they may describe changes in their hearing acuity (e.g., hearing things from another room); they may describe indistinct or clear noises or sounds (e.g., buzzing/ringing) which are new/distressing. They may tell you directly that they are experiencing these perceptions, or you may notice cues in their behavior such as: they may appear to be talking to themselves, looking somewhere and you don’t know why, or focusing on certain body parts.


    Tactile or somatic sensations or hallucinations

    Body sensations or feelings that are new and strange. These are sometimes described as electrical charges or feeling something crawling on a body part. People sometimes feel that a part of their body has changed in some significant and troublesome way (e.g., bigger/smaller).


    Unusual or delusional thinking

    Persistent beliefs not shared by others. A person may report thinking other people are watching them or that they are under surveillance, feeling very good at certain tasks, having a connection to a famous person, or any number of thoughts that are different and unusual. They sometimes report that television, music or other media are communicating directly to them. You may also notice they seem uneasy with others, or make comments indicating suspiciousness about others’ intentions.


    Depersonalization / Derealization

    Feeling they are an outside observer of their own thoughts, feelings, and actions. Examples are feeling that their speech or movements are uncontrollable or controlled by outside forces, that parts of their body are distorted, or feel their memories are not their own. They may feel alienated from their surroundings or disconnected from people (as if they were separated by a glass wall). Their surroundings may seem distorted, colorless, two-dimensional or artificial and they may have misperceptions of time and space.


    Cognitive disorganization

    A person’s speech and writing may become disorganized and/or tangential. They may draw connections between words or terms that seem illogical or non-sensical, or they may have more difficulty than usual following conversations. Slowing of speech, movement and motivation A young person may demonstrate changes in the amount, tone, rate, pitch, or rhythm of speech. Psychosis may slow people down and significantly lower one’s motivational energy.


    Depression and demoralization

    Many individuals with psychosis experience significant depression and/or demoralization.


    A person with psychosis may experience all or only a few of the above symptoms.
    The intensity and impact of symptoms can also vary enormously from one individual to another.

    A pathway towards rtecovery

    The path to appropriate treatment for a young person is not always linear, but as awareness and treatment options for early psychosis continue to grow, we can work together to streamline connections to the best treatment as early as possible. As with most issues, the earlier someone gets help, the better.

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    It is important to seek help as soon as you are concerned. There are many resources available within the Veterans Health Administration (VHA, The First Episode Psychosis (FEP) centers that HeadsUp represents are outside of the VHA system.

    Sometimes Veterans prefer to receive mental health treatment at outside organizations, and sometimes it is helpful to speak with an FEP center near you to find out more about available services. The care received at an FEP (First Episode Psychosis) center is designed with each individual in mind and involves many types of trained, caring people who will collaborate with the individual and their family to plan a path towards recovery.


    Coordinated Specialty Care

    Our programs and first episode psychosis programs across the country typically offer a team of people who will help. Each program is a little different but will often include:


    Psychotherapy Talk therapy to help build personal skills of resiliency, management, and coping.

    Supported Employment & Education Assistance with continuing to engage in or adjust to school and work goals while receiving care.

    Medication Management As necessary, finding the best medications at the lowest possible dose.

    Peer Support Guidance from those currently on their own recovery paths.

    Case Management Skills and support to organize the practical issues presented during treatment. This includes communication with other team members.

    Family Support and Education Tools designed to keep family members engaged and informed.

    Avenues of collaboration

    There are many ways HeadsUp can work with you to ensure we are finding appropriate care for people who may need it.

    • Facilitating referrals
    • Education and training for you and your staff members on the mental health needs of the Veteran population
    • Utilize your facilities and outreach platforms to promote the availability of mental health supports

    Resources for Veterans

    HeadsUp Animated “What is Psychosis Video”

    A simple, short educational video to use and share.

    "What is Psychosis?" Video

    HeadsUp Animated Video “What is Coordinated Specialty Care?”

    A brief educational video from HeadsUp about Coordinated Specialty Care which is the type of care someone receives at a Pennsylvania First Episode Psychosis (FEP) Center.  It is available for use to help spread information about psychosis to those who may need support.

    What is Coordinated Specialty Care?

    Mind Apps-Health Index & Navigation Database

    “There are an estimated ten thousand mental health apps available today, offering a range of possibilities from connection with a clinicain to symptom monitoring. Apps can be useful in care, but it’s important to be cautious about choosing a suitable app. The goal of this database is to equip users with the information necessary to make a decision based on the app characteristics that matter most to them.”



    Provided by the National Institutes of Health this document highlights the history and important milestones of the early intervention model (providing effective care within the first few months of illness) for young people with schizophrenia. Now a national mental health care priority, Coordinated Speciality Care (CSC) enhances work and school participation and supports recovery.