First Episode Center In Avondale Is Trying To Catch Psychosis Early
On Hudson Meek’s 20th birthday, he got just the cake he wanted: vanilla, lots of frosting, and cream in the middle. Thing is, ahead of the celebration, his mom, Christy Meek, noticed one piece missing.
“He got home from work late last night,” she recounted. “He was like, ‘It was after midnight so…’ He had a little piece before he went to bed last night!” She had missed her chance to take a cake picture.
On this day, the family shares a laugh and a piece of cake before Hudson heads to work. One of life’s familiar joys. But around this time last year, the family was dealing with something completely unfamiliar: Hudson’s psychosis.
Psychosis is symptom of a mental illness like schizophrenia where a person can’t easily distinguish what’s real and what isn’t.
Looking back, Hudson thinks the first major sign came when he was living in Hawaii and quit his job there.
“I felt out of control. I was just saying random stuff. It was just coming out,” he said.
He got back home to Gilbert and was uncharacteristically argumentative and obsessively watched religious videos. Then one night, he woke up his mother, brother and neighbors with his first psychotic break. He yelled that the rapture was coming. He was physical with his mom.
When police opened the door to their apartment, light spilled in from the hallway, and Hudson charged in that direction.
“He could’ve been shot right then and there,” Christy said. “There was one guy that had a taser, so they [tased] him instead.” She said Hudson was naked, so the police could tell he wasn’t armed. Still, the taser had to be used several times.
She gestured to the hallway. “I could still hear him out there singing Jesus songs.”
Many health conditions start with a crisis, and then get managed over time. A heart attack, for example, might put you in the hospital at first, but then you leave with a plan to prevent the next one. A special kind of mental health center in the West Valley is trying to do the same for young people with psychosis: the First Episode Center.
After a few short stays in psychiatric facilities, a caseworker recommended the First Episode Center to Hudson. Part of the Maricopa Integrated Health System, it’s an outpatient center in Avondale for young people across the valley who are experiencing their first episode of psychosis.
“Their first episode, [the] treatment they get is hospitalization," said Dr. Alicia Cowdrey, a psychiatrist at the First Episode Center. “That’s not where we wanna be, but that’s unfortunately where the system of care is at this juncture.”
Cowdrey has to do a lot of community outreach to find young people who need this help.
“Do we just say, ‘Oh, you had a heart attack, here’s a list of the best treatments, see ya later. Here’s some cardiologists’? No,” she said to a small audience of health care workers at a recent conference. “You’re going to lose weight, you’re going work out, you’re going to follow up with a dietician, you’re going to do all of these things. We need to do the same thing with psychosis.”
At the First Episode Center, a care plan includes medication but also therapy and help with getting back into school or work. It has an after-hours number for enrollees. They’ll even go to court with a person like Hudson Meek, who’s break entangled him in the criminal justice system.
Dr. Sophia Murphy works at a Phoenix clinic that offers both primary care and behavioral health. After hearing Dr. Cowdrey’s presentation, she could think of plenty of young people who could benefit from this kind of treatment.
“Do we just say, ‘Oh, you had a heart attack, here’s a list of the best treatments, see ya later?' ... No."
— Dr. Alicia Cowdrey
“We’re getting an influx of young, young kids, 12, 13 having a first psychotic episode,” she said. “Being kicked out of school, getting into aggressive encounters with law enforcement. And we don’t know where to send them to the best care. So they end up at inpatient at someplace.”
Twelve and 13 is still too young for the First Episode Center and the Epicenter, a similar place near downtown Phoenix. They both accept kids starting at 15.
According to the National Institute of Mental Health and the National Alliance on Mental Illness, about 100,000 U.S. teens and young adults experience their first psychotic episode each year. Treating it early can forestall worse damage from future breaks, which can ultimately save dollars down the road.
It’s a new model of delivering mental health care. Lisa Dixon, director of Behavioral Health Services and Policy Research, said many factors will determine the model’s success: proper funding, a skilled workforce and community awareness.
“Getting the community not only to understand what this is but to demand it,” she said. “Just the way you would demand cancer treatment that is gonna give you a better chance of recovery.”
Hudson Meek now visits the First Episode Center about once a month. He takes his medication, works his job at Target and pursues his passion with an internship on a farm. His duties include harvesting and planting vegetables.
“Not driving the tractor yet but hopefully soon,” he said.
He’s happily pursuing his goals. Just like any other 20-year-old.