Frequently Asked Questions of PREP

Q: Who is PREP for?
PREP is designed to serve people who are within two years of their first psychotic break or first episode psychosis. PREP services help the individual struggling with these issues, and his or her “family.”

Q: How does PREP define “family?”
In PREP family is defined as supportive individuals who may or may not be actual relatives, but who can to commit to supporting the client.

Q: What is psychosis?
Psychosis describes the experience of some loss of contact with reality.  While perspectives on what reality is can vary between individuals, people experiencing psychosis may encounter sounds or see things that others do not. Psychotic episodes are periods of time when symptoms of psychosis are strong and interfere with regular life. The lengths of these episodes vary from person to person and may last between a few hours or days, or for weeks, months or even years. Psychosis can be substance induced or due to a general medical condition, and can be experienced briefly or chronically. PREP serves people in early psychosis due to a mental health condition. The terms "early psychosis" or "first episode psychosis" mean that an individual is experiencing psychosis for the first time. Individuals experiencing psychosis may have very different symptoms.  Please see our "What is Psychosis?" section for more information.

Q: What is a chronic psychotic disorder?
The common types of chronic psychosis are schizophrenia, schizophreniform, and schizoaffective disorder.  These terms are often misused in the popular press and even sometimes by doctors.  They do not refer to a split personality or to someone who is always confused or disoriented.  These disorders instead refer to a prolonged period of frequent psychosis in the context of a prolonged period of functional impairment which typically involves problems with attention, concentration, memory and communication ability.  Schizoaffective disorder additionally involves depressed or manic episodes.

Q: How do I know if it’s a chronic psychotic disorder?
Everyone’s experience of psychosis is different and attaching a specific name or label to the experience is not always easy or even useful in the early stages. A diagnosis will depend on what brought on the illness and how long the symptoms last. It can be particularly difficult to diagnose early psychosis, which is why PREP uses the most current research-based tools for a thorough and comprehensive diagnosis and assessment.

Q: When does chronic psychosis tend to start?
Early signs of these disorders most often begin in adolescence or young adulthood (ages 12-35).

Q: Why try to catch psychosis early?
It has been shown in many scientific studies that early intervention with appropriate treatment can prevent or reverse the impairments associated with schizophrenia and schizoaffective disorder (reviewed by Marshall in Archives of General Psychiatry, 2005, pages 975-983).  Our goal is to provide accurate assessment, evidence-based treatment and appropriate referral as early as possible.

Q: How long do PREP services last?
PREP services are designed to last two years, after which time clients may have an opportunity to continue with some services and supports.

Q: What if the person has been suffering from psychosis for several years already?
PREP is designed for early psychosis, so if the person has been experiencing symptoms for several years, he or she is unlikely to qualify for PREP services, but may be able to benefit from other services offered through FSA-SF and UCSF’s Langley Porter. See below for individuals who do not qualify for PREP.

Q: What if I don’t qualify for PREP, but I would still like services?
If you do not qualify for the PREP program, there are a number of other programs that can help you, based on your specific needs. The PREP advice line will conduct a free, confidential telephone screening to see if you qualify for PREP, and offer you specific referrals or a list of resources if it is determined that PREP is not a fit for your needs. You can also obtain referrals from the Mental Health Association of Alameda County (MHAAC). Also, the Family Service Agency of San Francisco (FSA-SF) offers a host of high-quality behavioral health, social service and family support programs at low or no cost.

Frequently Asked Questions about Recovery

The pattern of recovery varies from person to person.  The important thing to remember is that psychosis is treatable.  Most people recover from psychosis to lead satisfying and productive lives.  "Recovery is Real."

Q: What do I do when my son/daughter is released from the hospital?

• Before your loved one is released, make sure there are written instruction for treatment, e.g., what medications should be taken and when, who to see for follow-up care and when, and what professionals are available in case of emergency. 

• Believe in your loved one’s ability to recover.  Show support by being kind, available and dependable. 

• Ask what your loved one needs.  Ask if you can help with daily tasks and go to appointments with them.  Respect their boundaries and be patient.  It may take some time for them to feel better. 

• Remember to take care of yourself!

Q: My son/daughter is over the age of 18 and the doctors won’t share information with me regarding their treatment.  What can I do?

Doctors and nurses "BY LAW" are not allowed to talk to you about the situation and are required by law to tell the patient if they talk with you.  If the patient is 18 or over, confidentiality laws protect his/her right to privacy. This means that your relative, partner or friend must authorize the treatment facility to contact or disclose information to you before they are allowed to involve you in these ways.  A separate Release of Confidential Information form must be signed for each admission, and for each individual seeking to be involved in the care. Ask your loved one if they will add you to their list of individuals authorized to speak to their providers.  Staff at the nurse’s station has this form in your loved one's files.  See the Family Education and Resource Center (FERC) website for more information.   

Q: What are the chances of relapse?

Early warning signs of a relapse vary, and sometimes do not come with any warning.  You should schedule a family meeting to come up with a plan of action in the event of relapse.  In the meeting discuss relapses and try to find out what may trigger a relapse.  Remember that stopping treatment is usually followed by a relapse. People with schizophrenia can be affected by arguments, criticism, and sudden increased responsibilities. Come up with some ways to alleviate stress for both you, and your loved one.

Q: How do I explain this condition to family members/friends?

Remember that it's natural to feel embarrassment or shame.  Find people, friends or professionals, who can understand and sympathize. There are many people out there that can and will support you in this struggle.

Q: What do I do if my son/daughter is arrested?

The FERC Website offers specific information regarding on what to do.  If you find yourself in this situation, please read FERC's, "My Family Member Has Been Arrested - What Do I Do?" for more information. 

Q: I’ve read horror stories about people with schizophrenia hurting others.  Is my son/daughter dangerous?  Should I be afraid?

The majority of people who have mental health issues are no more violent than anyone else. You may know someone with a mental illness and not even realize it.

Q: What are the chances that my other children will experience psychosis?While a person may have some of the genes that are associated with increased risk of mental illness - research suggests that only if a person is exposed to specific environmental factors and perceived stresses do the genes become active and thereby further increase the risk for, or trigger, the illness. There is no specific amount of genetic or environmental input that has been identified that will ensure someone will or will not develop schizophrenia.