Hawaii’s first specialty clinic for young people with early psychosis is expanding with a bigger, more visible office in Ala Moana.

Founded in 2015, OnTrack Hawaii treats teens and young adults within two years of their first episode of psychosis, a severe mental disorder characterized by a break with reality.

Each year about 100,000 young Americans experience psychosis, which usually develops in the late teen years or early adulthood. Symptoms include hallucinations, social withdrawal, delusional thinking, changes in emotion, disorganized speech and generally bizarre behavior. These symptoms are also being diagnosed at younger ages.

Until this week, OnTrack operated exclusively out of a one-room clinic on the University of Hawaii Manoa campus. The new clinic on the 15th floor of the Ala Moana Building offers a sleek new option that is many times larger, with easy access to free parking and public bus routes.

OnTrack Hawaii Clinic Director David Cicero celebrates opening day of the program’s new clinic in Ala Moana. OnTrack is Hawaii’s first coordinated specialty care clinic for youth experiencing their first episode of psychosis.

Brittany Lyte/Civil Beat

OnTrack offers its clients collaborative treatment plans that are tailored to fit each participant. The goal is to get young people experiencing psychosis back “on track” at work, school and within their relationships with friends and family.

The program is free. It is funded through the state Department of Health by a block grant from the federal Substance Abuse and Mental Health Services Administration.

About 30 young people have participated in OnTrack since it launched almost four years ago. There are currently a dozen active clients, but the program has the capacity to serve more.

David Cicero, OnTrack’s clinical director, said he hopes the new Ala Moana clinic will help boost OnTrack’s visibility and draw in new clients.

“I think some people are really scared hearing that they have psychosis, and because of that they sort of avoid treatment,” Cicero said. “We work with families a lot and people are understandably upset to hear this about their kid.”

“And the kids and young adults are upset themselves. But research has found pretty conclusively that the longer people go without treatment, the worse people tend to do later on. So the idea is to catch people early and then they have less time without treatment and they tend to have a better prognosis.”

Cicero said all but two of OnTrack’s former clients have returned to work or school. This is the main metric by which the program measures its success.

OnTrack Hawaii’s new Ala Moana clinic is much larger and more conveniently located for many of the program’s patients than the original clinic at UH Manoa.

Brittany Lyte

About 35 percent of the program’s participants were referred from The Queen’s Medical Center. A quarter came from the state Department of Health’s Family Guidance Centers. Clients also find the program through referrals from Tripler Army Medical Center and private practice psychiatrists on Oahu and the neighbor islands.

Most clients stay in the program for about two years, taking advantage of services including cognitive behavioral therapy, medication management, case management, family psycho-education and support. The goal is not to eradicate symptoms of psychosis, so much as make them manageable so that the person can enjoy a better quality of life.

In the future, Cicero said OnTrack plans to make its services more accessible to neighbor island residents, who typically have fewer psychiatric treatment options on their home island.

OnTrack’s clients are generally between the ages of 15 to 24, which mirrors the average age of onset for psychosis.

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