The RAP Program: Early Intervention for Serious Mental Illness

By AIM Youth Board Advisory Member
AIM Youth Advisory Board Member

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By Sydney Stilwell

Severe anxiety fills you with fear and dread. It makes you doubt yourself. It seeps into the dark nooks and crannies of your psyche to feed you intrusive thoughts that make you worry you are losing your mind. 

Most often, the first instances of anxiety will occur in someone’s life around the ages of 18-24 – the college years. While the first semester of college represents a societal narrative of newfound freedom, for others, it marks the terrifying beginnings of not beginning to trust yourself. 

young girl with psychosisFor Sarah, a 17-year old residing in New York, her first semester of college marked a time of such severe anxiety that she began missing classes out of fear that she would have an anxiety attack during a lecture. Yet, as she withdrew from class and isolated herself, her fears intensified thus creating the likelihood that those attacks would indeed occur. She began to experience anxiety attacks regularly. In fact, her anxiety became so paralyzing, she dropped out within that first semester. 

Dropping out of college only increased Sarah’s already debilitating anxiety, adding to her list of worries that if her mental health continued this way, she could develop more serious symptoms like psychosis. According to the NIMH, an estimated 32% of youth have an anxiety disorder, with 8.3% having severe impairment. Sarah is part of that 8.3% – with anxiety so severe she is high-risk for developing psychosis or schizophrenia later in life. 

Motivated to manage her anxiety, Sarah joined over 800 young people between the ages of 12-22 in participating in the New York based Recognition and Prevention (RAP) program; where AIM-funded researcher and director of the RAP program, Dr. Barbara Cornblatt, is working to determine the predictors of serious mental illnesses (like psychosis and schizophrenia) and prevent their development earlier on.

Programs like Dr. Cornblatt’s are some of the most important research being done. Early Intervention treatments like the RAP program approach mental health as a help-first system, in order to engage individuals – to arm them with the tools, techniques, and the language to understand their mental health – before the development of serious mental illness. 

Dr. Cornblatt’s RAP program has been a leader in prevention research for twenty years. However, despite the research’s long standing significance, funding still remains scarce as a result of the stigma surrounding mental health. Dr. Cornblatt shares, “as we were on the brink of a new prevention study [the very study Sarah was enrolled in], gaps in funding forced our research program to come to a halt. But not so fast, AIM stepped in and saved the day!” As a result of AIM’s emergency funding, the RAP program was able to move forward and put those twenty years of findings to good immediate use. It is expected that from this research, Dr. Cornblatt can establish a fully automated platform to deliver an intervention package to youth struggling with severe mental health challenges. This would allow for at-risk youth across the nation to lower their vulnerability to developing a serious mental illness later in life. 

Reflecting on the program, Sarah shares, “It was very beneficial for my overall thinking, reaction skills, and other facets of daily life. How I react in other situations and how I make decisions in situations. I’m more considerate now…I consider other options, perspectives, and think more critically…and have a bigger picture mindset, I believe.” 

As a result of RAP’s continuous programming, Sarah was able to learn tools to manage her anxiety. She approached RAP’s brain training tasks as a distraction, but also as a proactive tool to strengthen her cognitive abilities and rebuild her confidence. With these improvements and the knowledge of how to work on herself moving forward, Sarah lowered her risk for developing psychosis later in life. She opened the door to her education again. She now has a hopeful glimpse into all her future has in store for her. 

“We now have great expectations that we will contribute substantially to understanding of the causes of [serious mental illness] and to preventive treatment in at-risk teens as a result of AIM support at just the right time,” says Dr. Cornblatt. “It is likely from this pilot study that Sarah and many other youths will benefit from a longer-term intervention of this kind.”

*Dr. Barbara Cornblatt is a member of AIM’s esteemed Scientific Advisory Board.

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