This means that different treatment approaches are required than those used for people with well-established illness, who are usually older. Young people in the early stages of a serious mental illness most often present with a complex mix of relatively non-specific, but distressing, symptoms that wax and wane and develop further over time. Moreover, for those who do experience a first episode of psychosis, treatment is no longer aimed at simply controlling their symptoms, but also at helping maintain or regain their developmental trajectory so they can make the best possible social and vocational recovery and enjoy a productive and meaningful life. Appropriate care to reinforce functioning and prevent symptom deterioration for these 'at clinical high risk' individuals may potentially prevent the onset of psychosis, or minimize the devastating consequences which come when individuals lose touch with reality in a first episode of psychosis. It is now possible to identify young people with early symptoms which are beginning to impact their functioning but which are not yet severe enough to prevent them from distinguishing reality. This is why early intervention is so important. We now know that much of the disability associated with psychotic illness develops during this pre-onset period, well before the first episode, 1 and that the most important risk factor for a poor outcome is a long duration of untreated illness.

Eventually, the psychotic symptoms increase to the point that a first psychotic episode occurs in which the person loses touch with reality. Over time, these symptoms slowly intensify low-grade psychotic symptoms such as visual distortions, hallucinations, and early delusional thought processes appear and the young person's ability to function in daily life is increasingly affected.

Long-term studies have shown that schizophrenia almost always follows a long period of increasingly distressing symptoms, such as poor concentration, disturbed sleep, lack of energy, social withdrawal, depression, and anxiety. Understanding How Illness Develops, and How Best to Treat it If the illness is untreated, or poorly treated, this disruption can lead to long-term and even life-long disability. Disrupting life during this crucial transitional period can be devastating to young people's normal development process of finishing theirĮducation and beginning their working lives, developing intimate relationships, and establishing themselves as independent adults. This is particularly important for psychosis, since one of the main reasons why these illnesses can be so devastating is that they typically appear during late adolescence and early adulthood. The key aims of early intervention are to prevent illness, or when illness occurs, to minimize its impact. This has led to a radical shift in our approach to the care of those living with psychosis: instead of simply managing symptoms, the focus of treatment is now intervening early with a strong emphasis on promoting recovery to enable the young person to live a meaningful and contributing life within the community.

Or at the very least reduce, the negative effects of these illnesses. Instead, timely and appropriate early intervention has the potential to eliminate, We now know that experiencing a psychotic illness like schizophrenia does not inevitably lead to a lifetime of disability and dependence. Clinical research has led to the development of services specifically designed around the unique needs of these vulnerable young people. Since then, we have learned much about how these illnesses evolve and their neurobiology, which has allowed the development of better medical treatments. Interest expanded rapidly around the world in understanding the biological and social factors that underpin psychotic illnesses, and in better ways to treat them. During the 1980s, the first clinical studies highlighting the special needs of young people experiencing a first episode of psychosis caught the attention of clinicians and researchers, beginning with our research group here in Australia. He outlook for a young person in the early stages of a psychotic illness today can – and should – be very different from that of just three decades ago.

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