First Episode Psychosis Program (FEPP)

The First Episode Psychosis Program (FEPP) is intended for people 12 to 35 years of age presenting with the symptoms of a psychotic disorder. It offers intensive interdisciplinary follow-up care. It combines medical treatment for psychosis and psychosocial counselling.

To benefit from the FEPP, young people must never have been treated for psychosis or treated for one or more periods totalling no more than 12 months.

This specialty program is designed to decrease the duration of untreated psychosis and to reduce its impact to a minimum. The aim is to allow young people to resume their normal development and to find the best way to maintain long-term recovery.

FEPP staff members offer personalized support that takes into account all of the needs of young people and their family/social circles. These team members also offer awareness-raising activities on the early detection of psychosis to partners and the general public.

All Québec residents insured by the Régie de l’assurance maladie du Québec (RAMQ) can access the FEPP free of charge. People covered by private insurance, such as foreign students, are also eligible for the services in this program.

Psychosis is defined as a break with reality. It is a serious mental disorder that impairs daily functioning and leads to significant distress for the person and the people in their lives. Psychosis appears mainly between the ages of 16 and 35 and comes in many forms.

Psychosis is divided into three phases during which symptoms manifest differently.

• During the first phase, the prodrome, the person presents with non-specific symptoms (e.g., sleep disturbances) and sometimes with mild or transient psychotic symptoms.
• During the acute phase, psychotic symptoms are more defined. These may involve delusional thinking, hallucinations, disorganized speech and behaviour, and negative symptoms (e.g., lack of motivation and energy, social withdrawal).
• Lastly, during the recovery phase, which encompasses the two years following the start of treatment, the symptoms reduce in intensity.

Recovery for a person presenting with psychosis is closely tied to the duration of untreated psychosis, symptom reduction, maintenance treatment and improved functioning during the critical period of the first two to five years.

The development of a program for early detection and early intervention with regard to the signs and symptoms of psychosis was therefore crucial. The FEPP also aims to ensure young people’s full engagement in being involved in their follow-up care.

For more information on the signs and symptoms of psychotic disorders, see the Psychotic Disorders page.

All the regions of Québec offer services for young people presenting with a first episode of psychosis. To access these program services, you need only contact the “First Episode of Psychosis” team in your local area.

You do not need a medical referral. If you do not have the contact information for your local clinic, contact the psychosocial department of your CLSC or call Info-Social 811. They will put you in touch with the persons who can respond to your request.

All service requests are analyzed by a program team member within 24 to 72 hours. You will therefore be contacted promptly to determine whether the program is the service that best meets your needs.

The FEPP has a psychiatrist who will guide the young person through the psychosis treatment. The program also includes a team composed of diversified care providers (nurse, occupational therapist, social worker, psycho-educator, psychologist). All these care providers are specialized in interventions with young people experiencing their first episode of psychosis: they will be there to guide and support them. A team member will be assigned to the young person’s follow-up care as a patient navigator.

Various interventions are offered. The patient navigator will offer psychosocial counselling tailored to the phase of the psychosis and to the young person’s recovery. The intervention will take place in the setting that best meets the young person’s needs: the team’s offices, a public place, or the young person’s home, etc. The frequency of the follow-up care will also be adapted to their needs, ranging from a few times a week to a few times a year.

The interventions focus on:

• returning to school or work (or maintaining these activities);
• arranging for pharmacological treatment;
• raising awareness about psychosis, treatment and relapse prevention;
• developing coping strategies (healthy lifestyle, stress-management and problem-solving tools, etc.);
• monitoring physical health;
• monitoring other mental health issues, including substance abuse, if any.

Team members also offer support to the young person’s family and friends, in accordance with the rules of confidentiality.