On the Other Side of the Phone: Who You Reach When You Call STEP

“Hello, this is STEP. How can I help you?”

That is usually how the conversation begins.

Sometimes it is a clinician calling to coordinate care after a hospitalization. Often, it is a family member, usually a parent, who has reached a point where they do not know what else to do. Occasionally, it is the young person themselves, unsure how to explain what they are experiencing but knowing something is not right.

My role with the STEP Learning Collaborative is as an Early Detection and Assessment Coordinator. In practice, that means I am often the first voice people hear when they reach out about early psychosis. I am the one answering the phone when someone is trying to understand whether what they are seeing, changes in behavior, thinking, or functioning, might be something serious and what support might exist.

Over the years, I have answered thousands of calls. Many come from hospitals when a psychiatric crisis has already occurred and a young person is preparing for discharge. Others come much earlier, at the stage where families are scared, confused, and still hoping there is another explanation.

Nearly forty percent of these calls come from families.

They describe a son or daughter who stopped going to school or work. Someone who was once social and engaged and is now withdrawn, suspicious, and/or frightened. They may not have the right words, but they know something is wrong and needs attention.

Often, I am not the first call they have made. I am sometimes the first person who responds.

Not everyone who calls is ready for care, and not everyone who needs help is willing to accept it right away. Some young people agree to talk only remotely or only briefly. Others refuse outright. In those cases, the work becomes slower and quieter. Staying connected with families, offering guidance, and helping them think through safety and next steps while respecting autonomy.

Sometimes the opening comes gently.

On a Zoom call, a young adult is too frightened to speak openly, worried about being overheard. We shift to using a chat box. We talk less about symptoms and more about their life, their interests, and what matters to them. Trust builds. Eventually, they agree to come in, just to talk.

Other times, the opening comes through crisis.

A parent calls repeatedly for advice about an adult child who refuses treatment. They worry about safety but fear what could happen if they call for emergency help. When a crisis finally forces intervention, there is already a path to care. A place to land once things stabilize.

In those moments, my focus is simple. I help families communicate clearly to police and first responders that the situation is a mental health emergency, and I help responders understand what is really going on. The goal is safety and care, not escalation.

I have worked in mental health for decades, long enough to know that psychosis does not belong to other families.

Years ago, I sat in an elementary school auditorium watching a stage full of children singing, including my own son. A colleague leaned over and quietly noted that, statistically, some of those children would go on to experience psychosis in their lifetime.

At the time, it landed as an abstract fact. Later, it became painfully real.

Some of those boys, kids I helped shepherd through Cub Scouts, school trips, and community activities alongside my own child, did develop psychosis as young adults. I saw their suffering up close. I saw the fear and confusion their parents carried. And eventually, I saw what it meant when they were able to access specialized early psychosis care.

That experience never leaves you.

A big part of my job is talking about things that are uncomfortable. Fear, shame, and guilt can get in the way. I try to help lower those barriers so real conversations can happen.

I remind people that asking for help is not a failure and that needing support does not mean they have done something wrong.

Hope matters. And so does having someone answer the phone.

If you or a loved one are experiencing symptoms of psychosis, help is available.

Contact the STEP Learning Collaborative's Centralized Referral line at 203-200-0140 or fill out our online referral form, for a rapid screening and if eligible, referral to care.