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Educator Toolkit: Introduction

Welcome to the EPC Educator Toolkit!

Missouri’s Early Psychosis Care Center (EPC) has prepared this toolkit for educators of middle school, high school, and college students. It contains information, resources for families, and classroom materials surrounding psychosis. We hope you will find it useful!

When educators hear “intervention,” they often think about treatment, which is generally outside their scope of practice. The attached EPC Educator Toolkit is a resource designed to help educators understand, accommodate, and support students who may be experiencing psychosis. Developed by Missouri’s Early Psychosis Care Center (EPC) Youth Advisory Council (YAC)—a group of young adults (ages 15-35) with personal lived experience—this toolkit provides essential information about early warning signs, classroom accommodations, stigma reduction, and connecting students to care.

Educators spend significant time with students and play a key role in early identification, support, and intervention. Since psychosis often first appears in adolescence or early adulthood, teachers who recognize the signs and encourage access to care can make a profound difference in a student’s life. Additionally, educators influence how mental health is discussed in schools. By providing stigma-reducing information, this toolkit helps foster positive, informed conversations about psychosis, promoting a more supportive and inclusive learning environment.

This resource aligns with EPC YAC’s mission to reduce stigma, raise awareness, and improve access to care for young people experiencing psychosis. With the right knowledge and tools, educators can create a learning environment where all students feel supported and empowered to succeed.

For more information, visit epcmissouri.org or email us at contact@epcmissouri.org.

Frequently Asked Questions About Psychosis for Educators

What is psychosis?
Psychosis is when a person has trouble distinguishing what’s real and what’s not. They might experience things which others don’t see or hear.
Symptoms may vary, but common signs include seeing or hearing things which aren’t there, delusional or confused thinking, appearing distracted by mild stimuli (such as lights), and sudden changes in behavior. Severity and symptom profile does not appear to vary by age, but a first episode of psychosis most often emerges in the late teens or early adulthood.
Early signs may include withdrawal, changes in academic performance, and talking about unusual experiences.
Show care and concern. Share your observations with the school’s support team and seek guidance from the student and/or their family.
While prevention isn’t always possible, fostering a supportive and understanding environment can positively impact students’ well-being. Encouraging the student or their family to seek treatment may help shorten the duration and severity of an episode.
Stay calm, ensure the safety of the student and their classmates, and seek assistance from the school’s support team, first responders, or a mental health professional.
Having psychosis doesn’t automatically make someone dangerous, and most individuals with psychosis are not violent. In fact, individuals who experience psychosis are more likely than others to be victims of violence. In some cases, an individual experiencing psychosis may behave in confusing or unpredictable ways, and this can result in harm to themselves and others. Treatment can reduce this risk, so it is important for the individual to seek care as soon as possible.
Diagnosis is performed by medical and behavioral health professionals who evaluate the student’s symptoms and experiences.
Avoid stigma or judgment, use active listening skills, and prioritize empathy and understanding.
Yes, with appropriate support, many students with psychosis can succeed academically and socially.
Symptoms can impact concentration and focus. Providing support and accommodations can help students succeed.
Accommodations may include a quiet space, flexible deadlines, note-taking assistance, extra time for exams, and medication accommodations. Work with your student, their family, and the school’s support team to determine which accommodations will work best for your student’s needs.
Mental health nonprofits and government mental health organizations can be useful sources of information for students and families. Examples include the National Alliance on Mental Illness (NAMI), the National Institute of Mental Health (NIMH), and the Missouri State Department of Mental Health (DMH). For individuals looking for care, the Missouri Behavioral Health Council (MOBHC) Treatment Locator can show them behavioral healthcare available in their area.
Show understanding, maintain open communication, and collaborate with the student’s support team.
Advocate for accessible mental health services, address stigma when you encounter it, seek training on supporting individuals who experience psychosis, and promote understanding and empathy in your community.
Establish support systems, collaborate with mental health professionals, and offer resources to connect students with help.
Develop comprehensive support plans, involve families, and offer staff training on supporting students with mental health challenges. Remain up to date on professional development relating to academic accommodations.
Collaborate with parents to create a supportive environment, and ensure information shared is respectful and appropriate. Emphasize to other students that stigma and judgement are not welcome in the classroom.
Encourage open conversations about mental health and emphasize inclusivity and support for all students.

What questions can I ask a student who is experiencing psychosis to better understand what they are experiencing?

While each individual’s experiences will vary, it is generally helpful to ask open-ended questions to learn more about their experience and how you can assist them best. Here are some potential questions to get you started:


“Can you tell me what you’re experiencing right now?”
“How can I support you right now?”
“Are you feeling scared or overwhelmed?”
“Is there anything specific that caused these feelings or thoughts?”
“Is there anyone or anything that helps you feel calmer or safer?”
“Would you like me to call someone you trust to be with you right now?”
“Do you have any concerns or worries that you’d like to discuss?”
“Can you tell me more about the voices or things you see that others might not?”
“Would you like me to help you find a quiet and safe place?”
“Have you experienced anything like this before, and if so, what has helped in the past?”

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Student Mental Health:
First Episode Psychosis

What Is First Episode Psychosis (FEP)?

A first episode of psychosis (FEP) involves experiencing a disconnection from reality, which can manifest in various ways. FEP typically emerges during late adolescence or early adulthood, making high school and college students a vulnerable demographic.

What Are the Signs and Symptoms of FEP?

Hallucinations
People experiencing FEP may hear sounds and voices or see things that others do not. These experiences can be confusing and distressing.
People experiencing FEP may hear sounds and voices or see things that others do not. These experiences can be confusing and distressing.
People experiencing FEP may hear sounds and voices or see things that others do not. These experiences can be confusing and distressing.
People experiencing FEP may hear sounds and voices or see things that others do not. These experiences can be confusing and distressing.
People experiencing FEP may hear sounds and voices or see things that others do not. These experiences can be confusing and distressing.
People experiencing FEP may hear sounds and voices or see things that others do not. These experiences can be confusing and distressing.

How Do I Identify a Student Who Might Be Experiencing FEP?

Notice Changes:
People experiencing FEP may hear sounds and voices or see things that others do not. These experiences can be confusing and distressing.
People experiencing FEP may hear sounds and voices or see things that others do not. These experiences can be confusing and distressing.

What questions can I ask a student who is experiencing psychosis to better understand what they are experiencing?

“Can you tell me what you’re experiencing right now?”
“How can I support you right now?”
“Are you feeling scared or overwhelmed?”
“Is there anything specific that caused these feelings or thoughts?”
“Is there anyone or anything that helps you feel calmer or safer?”
“Would you like me to call someone you trust to be with you right now?”
“Do you have any concerns or worries that you’d like to discuss?”
“Can you tell me more about the voices or things you see that others might not?”
“Would you like me to help you find a quiet and safe place?”
“Have you experienced anything like this before, and if so, what has helped in the past?”

How do I Support Students Who Might Be Experiencing FEP?

Engage with Empathy
People experiencing FEP may hear sounds and voices or see things that others do not. These experiences can be confusing and distressing.

Where Can I Learn More?

Coordinated Specialty Care in Missouri

What is CSC-FEP?

Coordinated Specialty Care for First Episode Psychosis (CSC-FEP) is a specialized approach to provide care for individuals experiencing a first episode of psychosis (FEP). While psychosis can affect those of any age, the first episode most often occurs between the ages of 16 and 25.

CSC-FEP involves a team of experts dedicated to supporting the individual’s recovery. This team includes professionals with expertise in disciplines such as psychiatry, social work, psychology, substance use treatment, lived experience, and supported employment.

In Missouri, CSC-FEP provides key services including case management, psychotherapy, medication management, family education and support, individual resiliency training, supported employment and education, and peer support.

Why CSC-FEP?

The CSC-FEP team works closely with the individual and their support system, which may include family, friends, and other members of the community. Services are individualized and comprehensive to ensure the highest quality of care.

Research shows that CSC-FEP can lead to a reduction in psychosis symptoms, improved daily functioning, fewer hospitalizations, reduced trauma, and an enhanced quality of life.

Programs

There are 4 CSC-FEP programs in the state of Missouri, located in Kansas City, St.
Charles, and Odessa, and St. Louis.

For more information, contact the Early Psychosis Care Center at
contact@epcmissouri.org

Middle School Classroom Accommodations

Accommodations for Middle Schoolers

Below are a series of accommodations that may be appropriate for middle school students experiencing psychosis. Some, all, or none of these may be suitable for a given student—it’s best to collaborate with the student, their family, teachers, school or district administration, and other support staff to find the best solutions for each individual.

Extended Time on Tests – Additional time to complete exams and assignments to accommodate processing speed and reduce anxiety.

Preferential Seating – Seating arrangements close to the teacher or away from distractions to enhance focus.

Use of Assistive Technology – Access to text-to-speech software, audiobooks, or other tools to support learning.

Breaks During Tests – Scheduled breaks during tests to help manage stress or fatigue.

Modified Assignments – Adjustments to the length or complexity of assignments to better suit the student’s capabilities.

Note-Taking Assistance – Access to teacher’s notes or a peer’s notes to support understanding and retention.

Visual Aids – Use of charts, diagrams, and other visual tools to enhance comprehension.

Additional Support Services – Access to tutoring, mentoring, or counseling to support academic and emotional needs.

Permission to Keep Medication on Person – Authorization for students to carry needed medication with them during the school day.

Permission to Leave Classroom for Nurse Visits – Allowing students to visit the nurse’s office as needed to manage side effects or health concerns.

Snacks or Water – Permission to have snacks or water at their desk to help manage hunger or dehydration.

Access to a Recovery Space – Availability of a designated space (e.g., school social worker’s office or art room) for the student to use during intense symptoms.

Permission to Wear Headphones – Allowing students to use music or noise-canceling headphones to reduce distractions or manage sensory overload.

Access to Fidgets or Art Materials – Providing fidget tools or art supplies at the student’s desk to support focus and reduce stress.

College Classroom Accommodations

Accommodations for College Students

Below are a series of accommodations which may be appropriate for college students who experience psychosis. Some, all, or none of these may be appropriate for a given student—it is best to work with the student, their professors, their advisors, the school’s accessibility office, and other support staff as appropriate to find the best solutions for each individual.

Extended Time on Exams and Assignments – Additional time for exams and coursework to accommodate individual needs and reduce stress.

Notetaking Services – Access to professional note-takers or recording devices to assist with capturing lecture content.

Adaptive Technology – Use of advanced technology, such as screen readers, speech recognition software, or electronic organizers.

Alternative Exam Formats – Options for oral exams, take-home exams, or open-book tests to match the student’s strengths.

Flexible Attendance Policies – Allowances for occasional absences due to medical or personal reasons.

Priority Registration – Early course registration to secure classes at times compatible with the student’s treatment schedule or medication side effects.

Reduced Course Load – Option to enroll in fewer courses per semester to balance academic demands with personal needs.

Access to Academic Support Services – Availability of academic advisors, counseling services, and disability services for ongoing support and guidance.

Snacks or Water – Allowance for students to have snacks or water readily available at their desk to manage hunger and ensure hydration, supporting sustained concentration and overall well-being during class.

Ability to Have a Private/Single Person Room if Staying in the Residence Hall – Option to have a private room in campus housing to provide a quiet, personal space that helps manage symptoms, reduce stress, and support overall well-being.

Books for Youth and Emerging Adults

The Importance of Representation

For youth and emerging adults experiencing psychosis, seeing themselves positively represented in media is vital. Positive representation fosters understanding and reduces isolation, offering hope and resilience essential for recovery. Media that portrays psychosis with empathy and accuracy demonstrates that overcoming challenges is possible. Below is a curated list compiled by young adults with lived experiences of psychosis. Each entry includes a back-cover summary and purchase links, providing valuable perspectives and narratives that can inspire and support those on their journey.

Fiction

How it Feels to Float by Helena Fox

Purchase: Amazon | Barnes & Noble

Biz knows how to float. She has her people, her posse, her mom and the twins. She has Grace. And she has her dad, who tells her about the little kid she was, and who shouldn’t be here but is. So Biz doesn’t tell anyone anything. Not about her dark, runaway thoughts, not about kissing Grace or noticing Jasper, the new boy. And she doesn’t tell anyone about her dad. Because her dad died when she was seven. And Biz knows how to float, right there on the surface—normal okay regular fine. But after what happens on the beach—first in the ocean, and then in the sand—the tethers that hold Biz steady come undone. Dad disappears and, with him, all comfort. It might be easier, better, sweeter to float all the way away? Or maybe stay a little longer, find her father, bring him back to her. Or maybe—maybe maybe maybe—there’s a third way Biz just can’t see yet.

Made You Up by Francesca Zappia

Purchase: Amazon | Barnes & Noble
Alex fights a daily battle to figure out what is real and what is not. Armed with a take-no-prisoners attitude, her camera, a Magic 8 Ball, and her only ally (her little sister), Alex wages a war against her schizophrenia, determined to stay sane long enough to get into college. She’s pretty optimistic about her chances until she runs into Miles. Didn’t she imagine him? Before she knows it, Alex is making friends, going to parties, falling in love, and experiencing all the usual rites of passage for teenagers. But Alex is used to being crazy. She’s not prepared for normal. Can she trust herself? Can we trust her?

I Never Promised You a Rose Garden by Joanne Greenberg

Purchase: Amazon | Barnes & Noble
Enveloped in the dark inner kingdom of her schizophrenia, sixteen-year-old Deborah is haunted by private tormentors that isolate her from the outside world. With the reluctant and fearful consent of her parents, she enters a mental hospital where she will spend the next three years battling to regain her sanity with the help of a gifted psychiatrist. As Deborah struggles toward the possibility of the “normal” life she and her family hope for, the reader is inexorably drawn into her private suffering and deep determination to confront her demons. A modern classic, I Never Promised You a Rose Garden remains every bit as poignant, gripping, and relevant today as when it was first published.

Schizo by Nic Sheff

Purchase: Amazon | Barnes & Noble
Miles is the ultimate unreliable narrator – a teen recovering from a schizophrenic breakdown who believes he is getting better – when in reality he is growing worse. Driven to the point of obsession to find his missing younger brother, Teddy, and wrapped up in a romance that may or may not be the real thing, Miles is forever chasing shadows. As Miles feels his world closing around him, he struggles to keep it open, but what you think you know about his world is actually a blur of gray, and the sharp focus of reality proves startling.

Nonfiction

Pardon My Psychosis by James Coast

Purchase: Amazon | Barnes & Noble

Pardon My Psychosis delivers a raw and humanizing perspective of the mental, physical, and spiritual toll a psychotic break takes on an individual and their family. Hallucinations and delusions of grandeur weave through James’s perception of reality, setting in motion the swift unraveling of time and space around him. Speaking with angels and defending his home against demons becomes an ordinary day. Until it’s not. When his mind shatters at work, the ER doctor suspects drugs, and his wife fears a tumor, but James wonders what all the fuss is about. His ability to see beyond the natural realm has burst into the open, and he is none the wiser. As the doors to the psych ward close, his wife disappears into the darkness, leaving him to fight the spiritual battles that ensue.

Pardon My Psychosis by James Coast

Purchase: Amazon

How can I cope with hearing voices and other mental health symptoms? Who should I tell about my experiences with psychosis? What steps should I take after a mental health crisis? Experiencing and recovering from psychosis can be isolating, especially if friends and peers can’t relate to what you are going through. With testimony from the author’s lived experience and using a range of practical therapeutic exercises that draw on ACT, DBT and Recovery-Oriented CBT, this workbook will support and inspire you throughout your recovery, and help you be the best possible advocate for yourself. With practical guidance on everything from coping with paranoia to dealing with stigma, as well as mindfulness strategies and advice on returning to work or school—this guide is with you every step of the way.

Warning Signs of Psychosis in Students

Students often spend more time at school than anywhere else, which means educators are often in a unique position to notice early warning signs of mental health issues, including psychosis. These signs can sometimes overlap with other conditions like depression or anxiety, so it’s crucial to offer support and encourage students to seek help.

It’s important to remember that many behaviors can be normal for students’ developmental stages. For example, changes in hygiene are not uncommon for middle schoolers undergoing puberty, suspicion or withdrawal may be caused by experiences of bullying in high school students, and difficulties with sleeping and eating often take place in college students living away from home for the first time. However, when these behaviors represent significant changes or lead to functional impairments—such as a once-social student withdrawing, or noticeable difficulty focusing or completing tasks—these may signal a deeper issue that requires attention. Recognizing and addressing these changes early can make a significant difference in the lives of students.

Changes in Thinking

Changes in Behavior

Changes in Feelings or Perceptions

Hallucinations and Delusions

Myths vs. Facts About Psychosis

Our culture perpetuates many myths surrounding psychosis and psychosis-related disorders. These myths stem from many places, including inaccurate media representations, similar but distinct language, or stigma around discussing lived experiences. Below is some information about the realities associated with psychosis.
Myth Fact
People who experience psychosis are psychopaths.
Psychosis and psychopathy are different conditions. Psychopathy is a psychological presentation characterized by a lack of empathy, emotional responses, and poor impulse control, frequently linked to antisocial personality disorder. In contrast, psychosis is a temporary state where a person loses touch with reality, affecting their daily functioning. Psychosis can be treated.
People who experience psychosis-related disorders are crazy.
People who experience psychosis-related disorders are not crazy. Crazy is a pejorative term and should not be used to describe individuals experiencing mental health problems.
People who experience psychosis have split personalities.
People who experience psychosis do not have split personalities. Because the name “schizophrenia” stems from the Greek words for “splitting” and “mind”, many mistakenly believe psychosis-related disorders cause split personalities, but this is not true. People who experience psychosis may experience hallucinations, delusions, disorganized thinking, apathy, and difficulties with cognitive tasks like concentration and memory. “Split personalities” are caused by a condition called dissociative identity disorder.
People who experience symptoms of psychosis are dangerous.
People who experience psychosis are unlikely to deliberately harm others. In fact, individuals who experience psychosis are more likely to be victims of violence than individuals without psychosis.
It can’t happen to me.
Psychosis can happen to anyone. One in six people report a psychosis-like experience at some point in their life. Psychosis can be caused by a mental health disorder, traumatic brain injury, neurological or neurodegenerative conditions like epilepsy and Alzheimer’s, and other medical conditions such as a brain tumor or stroke. Temporary psychosis can result from conditions such as sleep deprivation, use of hallucinogenic drugs, use of certain prescription medications, or periods of extreme stress or trauma. First episode psychosis affects three in one hundred people and is most likely to emerge between the ages of 15-35.
People who experience psychosis can’t lead normal lives.
Many people who experience psychosis lead productive lives. With the right treatment and support, individuals experiencing psychosis can manage their symptoms effectively and pursue fulfilling careers, education, and personal goals. It can be valuable to utilize available resources such as therapy, medication, and community support. It’s important to recognize and support the capabilities of individuals who experience psychosis, rather than focusing solely on the challenges they face.

Say This, Not That Language Guide

Don’t Say This: Say This Instead:
You’re just imagining things. It’s all in your head.
I’m here to listen and support you through what you’re experiencing.
You’re overreacting. Just calm down.
It sounds like you’re having a really tough time. How can I help?
You’re crazy. You need to get your act together.
Psychosis can be a challenging experience, but there are ways to get help and manage it.
You don’t need therapy; you should just try to ignore it.
It’s important to talk to a mental health professional about what you’re going through.
It’s not a big deal. Others have it worse.
It’s not a big deal. Others have What you’re experiencing is valid, and seeking support is a positive step.
You should try to get over it without medication. It’s just a phase.
Medication and therapy can be really helpful for managing symptoms of psychosis.
You should just snap out of it. You’re holding yourself back.
It’s okay to take things one step at a time and focus on what you need to feel better.
You’re just seeking attention. It’s not really a problem.
Everyone experiences psychosis differently, and it’s important to respect each person’s journey.
You’re better off dealing with this on your own.
Finding a support group or talking to others who have similar experiences can be very helpful.
You’re being difficult. This will pass if you just try harder.
Your feelings and experiences matter. Let’s find the right resources for you.

Join our Youth Advisory Council!

We are looking for youth & young adults ages 15-35 with personal lived experience with psychosis. Influence change, empower others, and build connections!

The EPC YAC is working to reduce stigma about psychosis by sharing resources, raising awareness, and providing fact-based education in order to improve young people’s access to care.

Virtual meetings are held on the second Monday of every month from 6-7pm CST

Other Resources for Students and Families

Disability Benefits 101

A comprehensive resource for students and young people with disabilities. This tool provides calculators for school and work, helping you understand and manage your disability benefits. Even if your parents handle most of the paperwork, it’s crucial to understand how your benefits can support independent living and career goals. Learn how your benefits can assist in pursuing education, funding your studies, and understanding your rights as a student.

MPACT

A comprehensive resource for students and young people with disabilities. This tool provides calculators for school and work, helping you understand and manage your disability benefits. Even if your parents handle most of the paperwork, it’s crucial to understand how your benefits can support independent living and career goals. Learn how your benefits can assist in pursuing education, funding your studies, and understanding your rights as a student.

Pre-ETS

Pre-Employment Transition Services (Pre-ETS) is a collaborative program with vocational rehabilitation, designed to offer pre-employment services to high school students. This includes job exploration, workplace readiness, self advocacy, work-based learning, and post-secondary counseling. Specialists meet with students at their schools throughout the school year and work with school personnel to arrange meetings. Services are provided in individual, small group, or large group settings.

Early Psychosis Care Center

The Early Psychosis Care Center website contains a wealth of information and resources for individuals experiencing psychosis, as well as information and resources for caregivers and educators.

MOBHC Treatment Finder

The Missouri Behavioral Health Council (MOBHC) Treatment Finder is a statewide database designed to help you locate mental health providers based on your location and specific needs. With a user-friendly interface and integrated map, this tool simplifies the process of connecting with the right care.

Goblin Tools

Goblin Tools offers a suite of AI-based features to support your productivity and learning. It includes a to-do list manager that breaks tasks into manageable steps with time estimates, text editors that refine tone, a crash course generator for introductory summaries on various topics, and a recipe generator that suggests meals based on your available ingredients. These tools can make managing the side effects of mental illness easier.

OnTrack NY

OnTrack NY provides valuable resources and information for young adults and families dealing with psychosis. As a leader in the field, this platform offers comprehensive support and guidance to help individuals navigate their mental health journey effectively.

Orygen

Orygen is an Australia-based resource renowned for its cutting-edge research in youth mental health. It offers the latest insights and developments to support young people and their mental health needs.

NAMI Teen Resources

The National Alliance on Mental Illness (NAMI) Teen Resources page offers essential information for teens on various topics including finding help, communicating with friends and family, understanding the impact of social media on mental health, and managing mental health at school.

NAMI Young Adult Resources

nami.org
The National Alliance on Mental Illness (NAMI) Young Adult Resources page provides age-appropriate guidance for emerging adults on recognizing mental health conditions, disclosing them to others, seeking help, managing mental health in college, and understanding health insurance.

LifeLaunch

LifeLaunch is a Missouri-based resource dedicated to supporting young adults as they navigate the challenges of emerging adulthood. Embracing the unpredictability of this life stage, LifeLaunch offers a community of support, shared experiences, and practical advice, all infused with a sense of humor and resilience.

Accommodation Central

Accommodation central is a resource created by a regional educational services center in Texas with information about a variety of academic accommodation options. Suggestions are categorized by school subject and functional need, with examples and steps for implementation.

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