One in three young people who request mental health services show symptoms that mental health professionals say indicate a high risk of psychosis.

The symptoms range from cognitive difficulties, struggles with concentration, planning and organizing thoughts, withdrawal from the outside world, verbal and visual hallucinations, and false beliefs or delusions.

Youth with these symptoms could have a 15% to 20% chance of converting to a psychotic disorder like schizophrenia within two to five years.

“With our clientele we do see quite a bit of youth who are experiencing these symptoms, and oftentimes they go under treated or without treatment at all,” said Fay Hartje, a clinician at Hanna Center, a mental health resource hub in Sonoma.

The center just received a $1.9 million grant to open an early intervention program for Sonoma County youth and young adults aged 12-25. When the program launches in August, it will be the sole intervention program in the city of Sonoma, and one of only two programs in the county.

“This funding will empower the Community Mental Health Hub to provide much-needed support to our community members,” said Cameron Safarloo, Hanna Center CEO. “Individuals who need, or are showing signs that they will need a higher level of mental health support, will be able to access it. The goal of this funding is to provide preemptive care in an attempt to avoid crisis and emergency visits.”

It’s a need Hanna Center has long hoped to fill, he added.

“Hanna did a community-needs assessment early on while developing the new strategic plan, and as we continue our mission to support youth who have experienced trauma and adversity, we recognized this type of care is missing and difficult to access by those who need it,” Safarloo said.

The program has a “wraparound services model,” Hartje said, meaning Hanna clinicians can collaborate to not only directly address symptoms but to ensure individualized support for the youth and their family.

“It allows us to offer specialized care, so, using cognitive behavioral therapy for psychosis coupled with peer support, family support specialist and psychiatry services,” Hartje said.

When a youth enters Hanna Center to request services and presents some of the high-risk symptoms, they can be triaged at Hanna Center without referrals.

While some symptoms — like cognitive difficulties or struggles with concentration, planning and organizing thoughts — may be common in youth with mental health concerns, there are less common symptoms that require a more complex treatment plan.

Feelings of suspiciousness or mistrust, visual or verbal hallucinations coupled with false beliefs or delusion — thinking that certain things have special meaning only to them — or developing some kind of obsession around religion outside of cultural beliefs, or obsession about magic things can all be examples.

Visual hallucinations can include seeing light beams and shadows in the peripheral vision.

“A lot of people assume that someone who experiences clinical high-risk symptoms — that it’s biological or it’s hereditary, but ultimately it’s a mixture of different things,” Hartje said.

Youth who’ve experienced childhood trauma, are in unstable home environments or were exposed to stress in their community may also be at risk for developing these symptoms.

“When somebody has an episode or uptick in symptoms, it’s a huge protective factor for the client and the family to know what they’re experiencing,” Hartje said.

All on-site youth enrolled in the new program will have access to a clinical supervisor; two mental health therapists who deliver specialized therapy; a child psychiatrist; and a psychiatric nurse practitioner. They will also have access to a family support therapist to educate the family on how to protect their child; and a peer support therapist to help the youth integrate their symptoms into their every day life.

The program would be free for families without insurance.

“If (an episode or uptick in symptoms) were to happen, that client has the tools and ability to function and understand what the trajectory of someone’s life would be if they were living with a psychotic disorder,” Hartje said.

Currently, Hanna Center clinicians refer high-risk youth to Santa Rosa mental health center’s Aldea Children and Family Services, which houses the county’s only other early intervention program.

Kerry Ahern, Aldea’s CEO, said there are 20 youth at any given time enrolled in their Supportive Outreach and Access to Resources program in Santa Rosa.

She anticipated that there may be more youth who require these kinds of services but shy away because of the stigma around psychosis and psychotic disorders.

“There’s a lack of knowledge in our field and in education where people aren’t quite aware of early signs of psychosis and what that looks like,” Ahern said.

Ahern said that she will reach out to Hanna Center to find ways the two programs can support one another.

Providing a wraparound model in one facility eases stress on a family and their child, both Ahern and Hartje agreed.

Hanna Center clinicians now refer clients out of county to intervention programs at the University of San Francisco, UC Davis or Stanford University. This will slow down as in-house services ramp up, but Hanna will keep a partnership with the universities, who will aid with training clinicians on the specific intervention care.

“The downside of that is their care is kind of spread out all over the place,” Hartje said. “Individuals and families who are experiencing these symptoms; it’s a lot to manage. Having everything in-house was really our goal in applying for funding.”

The funding was provided by the Mental Health Services Oversight and Accountability Commission in partnership with the Department of Health Care Services as part of Gov. Gavin Newsom’s Master Plan for Kids’ Mental Health.

Ultimately, Hartje hopes that this program helps to destigmatize how people view psychosis syndrome and psychotic disorders.

“A lot of people think that people who experience these symptoms are going to become institutionalized or that it’s so rare for somebody to experience these symptoms, which is not the case,” Hartje said. “In fact, even if someone experiences these symptoms one time or experiences them throughout their lives, they’re very manageable symptoms, with the right care and the right tools.”

Report For America corps member Adriana Gutierrez covers education and child welfare issues for The Press Democrat. You can reach her at


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