BANGOR, Maine — In the world of mental illness and brain-related disorders, the term “psychosis” is associated with the most severe and intractable cases. Characterized by a devastating loss of contact with reality, false beliefs about what is going on, and hearing and seeing things that are not there, psychosis is linked with diagnoses such as schizophrenia, bipolar disorder and deep, clinical depression.
But long before full-blown psychosis makes its appearance, some people — most often teens and young adults — experience early warning signs. A new mental health practice in Bangor, with its roots at The Acadia Hospital, seeks to identify those who are experiencing these warning signs and help them steer clear of the shattering experience of a full psychotic episode.
People experiencing the warning signs of psychosis feel alone in the world and find it hard to discuss their frightening symptoms with friends, family members, teachers or others, said psychologist Jessica Pollard, founder of the Aware Center for Early Intervention. But in fact, their experiences tend to move along similar pathways and can be assessed by well-trained mental health professionals, she said in a recent interview.
For example, these individuals may have a heightened sense of suspicion about other people and the world around them, Pollard said. They may find themselves thinking that they are being watched or recorded. They might see flashing lights, spy shadowy figures at the edge of their vision or hear someone calling their name when they know no one is there.
The key, Pollard said, is that these people have not yet crossed the line into believing their distorted perceptions of the world.
“They know it’s an odd way to think,” Pollard said. “It can be a real relief when they have a chance to talk to someone about it.” And, she said, a combination of individual and group therapy, lifestyle changes, stress management and the judicious use of medications can effectively ward off the disabling cascade of brain activity that typifies a true psychotic episode.
In January, Pollard opened her private practice on Main Street, along with her business and clinical partner Katrina Benjamin, who is a clinical social worker. Before striking out on their own, both women were working at The Acadia Hospital in Bangor, a 100-bed psychiatric facility where Pollard in 2008 first developed the Aware program with the support of then president and CEO Dottie Hill and then chief medical officer Dr. Paul Tisher.
“We pretty quickly realized that we needed a specialized treatment team,” Pollard said, and she went about seeking funding and training for a cadre of dedicated staff for the Aware program.
But subsequent changes at Acadia, including Hill’s retirement, Tisher’s departure and a major turnover in other administrators and clinical staff, left the hospital’s Aware program without the support it needed to function effectively, Pollard said Wednesday, although a hospital official says the program is still up and running.
“We were trying to keep people trained, but with all the turnover, it was impossible,” Pollard said. In addition, it seemed that many of the Aware center’s young and relatively functional clients were uncomfortable being treated in the acute-care setting of a major psychiatric center, when their own symptoms were still relatively mild, Pollard said.
Pollard, who had been at The Acadia Hospital for three and a half years, decided to leave and set up in private practice, building on her work at Acadia. Benjamin, a 12-year Acadia employee, made the move with her, along with receptionist Kim Welch, who had worked at Acadia for three and half years. Recently, they were joined by psychiatric nurse practitioner Stephanie Lanham, who left Acadia last June — after 17 years — due to the stress of the administrative and clinical changes there.
Pollard said most of the Aware program’s clients from Acadia made the transition with her, despite the hospital’s efforts to retain them. There has been some legal wrangling over the name of her practice, she said, but overall the move has been a positive one.
At The Acadia Hospital, Director of Psychology David Prescott said Wednesday that the hospital continues to offer its Aware program, though staffing is diminished and some elements, including a research component Pollard built into the program, are not currently operational. Prescott said the program is successful at preventing, delaying and minimizing the onset of full-blown psychosis in some clients, and that being treated at the hospital is not a drawback for most clients.
Prescott said he did not know the standing of legal concerns regarding Pollard’s use of the Aware program’s name.
Earlier this month, after months of public controversy, Acadia’s former CEO and president David Proffitt resigned the position he had held since the fall of 2008. Brewer-based Eastern Maine Health Care Systems, the hospital’s corporate parent, is currently seeking a replacement.