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Dr. Bill McFarlane '65, far right, is the founder of the Early Detection, Intervention, and Prevention of Psychosis Program (EDIPPP).

Alumnus pioneering early detection treatment for schizophrenia

May 23, 2016

An emerging treatment for schizophrenia pioneered by Dr. Bill McFarlane ’65 offers hope for earlier detection and treatment before psychosis even occurs.

“The premise of this program is to identify a young person earlier in the progression, before the psychosis becomes severe and disabling,” McFarlane says. “Right from the start, we’ve had strong community support and referrals, as well as very positive outcomes. Our patients can now hold down jobs, stay in school, get their degrees and go on to live much more fulfilled and happier lives.”

McFarlane, a psychiatrist and professor at the Maine Medical Center in Portland and Tufts University School of Medicine, is the founder of the Early Detection, Intervention, and Prevention of Psychosis Program (EDIPPP).  His work has been heralded as a “promising new approach” by the Washington Post to improve mental health treatment and curb the expense of homelessness, law enforcement and unemployment benefits.

EDIPPP began as a community program in Portland in the late 1990s with funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) and a major grant by the Robert Wood Johnson Foundation and the National Institute of Mental Health (NIMH). The first clinic opened under the name of the Portland Identification and Early Referral (PIER) program in May 2001.

Five additional research sites have joined with the PIER program to use evidence-based interventions to treat early warning signs of serious mental illness in young people.  Since the completion of the national research study, six other counties in California have developed these programs, as have Philadelphia, Delaware and Ogden, Utah.

“We’ve seen impact in all of the major population centers who have adapted this approach,” McFarlane says. “The results are fairly consistent. We are very happy.”

While the work has spread further south in the eastern United States and Utah, EDIPPP has also been met by some controversy in the medical community though Congress is considering funding several more sites in the current 2017 budget to promote adoption nationwide.

McFarlane started treating schizophrenia in a multiple family group setting in a clinic he started in the south Bronx, the last such center established with funding from the Kennedy Act. After the Reagan administration discontinued funding for mental health centers, he successfully developed a modified version of that approach at Columbia University, College of Physicians and Surgeons (P&S). 

However, an encounter with a local teenager who he had hired to help him with some carpentry projects and later had a psychotic episode turned his attention elsewhere.

“What if we could reach a young person earlier in the progression?” McFarlane wondered. “We could know what to do for the patient and family — and that might be enough to head off a psychotic episode.”

PIER/EDIPPP’s protocols include a research-certified list of early warning signs of potential psychosis, which helps adults who are around teens and young adults — teachers, parents and school nurses — provide help early. Symptoms may include memory problems, feelings of confusion or odd and distracting thoughts.

Throughout McFarlane’s career, a network of Earlhamites have supported and strengthened his work.

They include:

  • Ellen (Pennell) Lukens ’69 and Bruce Link ’71 were co-investigators at Columbia P&S on a clinical trial of the multifamily group treatment for schizophrenia and Link continues to work with McFarlane on a study of the stigma of psychotic disorders;
  • Willie Kai Yee ’65 was the psychiatrist for multifamily clinical trials
  • Ben Levine ’66 McFarlane’s roommate freshman year, was the videographer who created informational videos for clinicians and educational videos on schizophrenia for families and patients;
  • Francie Swan ’64 was an early adopter of the multifamily group model as a nurse in Maryland, independent of McFarlane’s work at Columbia in New York;
  • John Daniel Ragland ’84 was the Deputy Site Director of the University of California at Davis in the national Robert Wood Johnson effectiveness trial of early intervention prior to onset of psychosis;
  • Anne Mathews-Younes ’68 was the project liaison for grants from the SAMHSA; and
  • Richard Nakamura ’68 was Acting Director of NIMH and was the final approver of McFarlane’s first clinical trial grant testing the early intervention (pre-psychotic) in psychosis.

McFarlane says the number of Earlhamites he’s reconnected with in the field does not surprise him.

“Earlham is a fabulous pre-medical college,” McFarlane says. “I think our careers reflect quite powerfully on what Earlham, almost uniquely, does for its students over the long haul.

“I chose Earlham because it felt good and I liked the people I met,” he says. “Fifty years later I still have that sense.”

— EC —

Earlham College, a national liberal arts college located in Richmond, Indiana, is a "College That Changes Lives." We expect our students to be fully present: to think rigorously, value directness and genuineness, and actively seek insights from differing perspectives. The values we practice at Earlham are rooted in centuries of Quaker tradition, but they also constitute the ideal toolkit for contemporary success. Earlham is one of only 40 national liberal arts colleges ranked among U.S. News and World Reports' "Great Schools at a Great Price."

 Brian Zimmerman is director of media relations at Earlham College. He can be reached at (765) 983-1256 and zimmebr@earlham.edu.

 

 

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