William McFarlane, MD

Dr. William McFarlane, “father” of the Portland Identification and Early Treatment (PIER) program, has a long history of advocating early intervention treatment for youth with mental illness. The PIER program and its subsequent implementation throughout the U.S. is a great source of pride for him – and understandably so (see Now is The Time).  It began almost 40 years ago when a teen he hired to do some construction had difficulty hammering nails. “He also exhibited behaviors associated with early onset schizophrenia like difficulty concentrating, recalling instructions and responding to things that weren’t there,” Dr. McFarlane explained. “Unfortunately, he did have a full-blown psychotic event a few years later. I’ll never forget him.  He was the inspiration for our work on preventing the first episode.”

Decades later, Dr. McFarlane became the lead investigator for the Mental Health Attitudes of Youth (MAY) study with some exciting initial results to report. Early analysis, reflecting over half the sample (120 out of 200), supports the notion that the subject’s awareness of symptoms (internal stigma) has more impact than the “labeling” they experience from those around them. Their internal struggles with memory loss or even mild hallucinations can make them think they’re defective and become stigmatizing. Despite being scared, they are still at an earlier stage where psychosis has not set in, so they are able to respond to early treatment.

More importantly, they are able to engage in that treatment, as they are hopeful to reverse what is happening to them. Early intervention means both the subject and family members have not become exhausted by the illness. Everyone — including parents, school staff, family members and clinicians — can work together to reduce the symptoms sooner.

“The good news”, said Dr. McFarlane is that “the relationships between shame, stigma and symptoms may be affected by therapy. We believe that when the symptoms are treated, the shame and stigma will go away.”