Reference Tool — Not an Assessment

Psychosis, Emerging Psychosis & First-Episode Psychosis

Purpose: an educator reference guide covering classroom presentation, practical support, differentials, documentation and escalation for psychosis, emerging psychosis and first-episode psychosis. Australian context, 2026. It explains classroom-observable presentations and practical responses; it is not a diagnostic or screening instrument.

Immediate danger: command hallucinations to harm, severe confusion/agitation or inability to remain safe require urgent mental-health/emergency response. In Australia, call 000 for immediate danger.

The core idea: the educator question is not “Does this student have psychosis?” It is “What has changed, how is functioning affected, and who needs to know now?”

Start with a presentation

Click the one closest to what you're seeing. Each page covers what it is, what it can look like at school, and what helps.

Before a clear episode

Non-specific early signs and why school staff often notice first.

Other classroom-observable changes

Sleep, attendance, social withdrawal and academic patterns worth tracking.

Is it psychosis, or something else?

Differentials to rule in or out before jumping to a psychosis explanation.

Responding in the moment

How to talk with a student who is distressed, and what to avoid.

Classroom & academic support

Environmental supports, cognitive load and routine during acute symptoms.

Documentation & working with others

Objective records, confidentiality and one clear communication pathway.

Referral, risk & recovery

When to escalate, urgent indicators, and returning to school after an episode.

Evidence base

Sourced references from the original document.

Reference note: this guide is an educational synthesis, not a substitute for formal psychiatric assessment, diagnosis, safeguarding procedures, or individual clinical advice. Prepared 31 August 2026.

ES tools that may help

Safety first. Where psychosis or emerging psychosis is suspected, prioritise referral, safety and school processes. The systems below are secondary and do not replace clinical assessment or a safety response.

ES tools that may help with the classroom patterns you selected. These products do not assess or treat the condition above. They provide practical classroom systems that may help with some of the behaviours, demands, communication needs or regulation patterns you are seeing. Calm neutral adult response, reducing cognitive/task load, and objectively documenting change from baseline. Product suggestions are secondary to referral, safety and school processes.

Adult Response System

A$200

View system →

Instructional Demand System

A$200

View system →

Behaviour Mapping System

A$200

View system →

Hallucinations

Perceptions experienced without an external stimulus.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Hallucinations are perceptions experienced without an external stimulus and can involve hearing, seeing, feeling, smelling or tasting. They feel real to the person.

@What it can look like at school

Student may look toward an empty area, respond to unheard voices, appear distracted by internal stimuli or report seeing/hearing something others cannot.

✓What helps

Stay calm
Ask what the student is experiencing
Focus on distress and safety
Avoid ridicule or confrontation

!Keep in mind

Do not assume: talking to self, imaginative play, intrusive thoughts, trauma flashbacks and sensory misperceptions are not automatically hallucinations.

Delusions

Strongly held beliefs that are not consistent with reality.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Delusions are strongly held beliefs that are not consistent with reality and are not explained by the person's cultural/religious context. Direct argument usually increases defensiveness.

@What it can look like at school

Belief that classmates are sending coded messages, staff are monitoring them secretly, or ordinary events have special personal meaning.

✓What helps

Educator stance: Do not confirm the belief as fact; do not aggressively challenge it. Acknowledge the emotion and uncertainty.
Useful language: “That sounds frightening. I can see you're worried. Let's get somewhere quieter and work out who can help.”

Paranoia and suspiciousness

Ordinary classroom events can feel threatening or targeted.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Paranoid thinking may make ordinary classroom events feel threatening or targeted. The student may interpret neutral looks, laughter, corrections or technology as evidence of harm or monitoring.

@What staff see / what may be happening

What staff see: Arguments about hidden motives, refusal to use devices, fear of peers, accusations, hypervigilance, scanning rooms.
What may be happening: Threat interpretation is being generated from the student's current experience, not simple stubbornness.

!Avoid

Whispering about the student nearby, joking about surveillance, cornering them, or creating unnecessary crowds of adults.

Disorganised thinking and speech

Speech may become hard to follow, tangential, fragmented or illogical.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Thinking can become difficult to organise. Speech may become hard to follow, unusually tangential, fragmented, illogical or disconnected from the original question.

@In class

Answers drift away from the topic, sentences become difficult to follow, writing loses coherence, conversation is hard to sustain.

✓Support

Use short concrete questions, allow processing time and avoid rapid-fire interrogation.

!Differentiate from

DLD, intellectual disability, autism, ADHD, anxiety, intoxication and ordinary slang/communication style.

Disorganised or markedly unusual behaviour

Behaviour that is difficult to organise around the situation.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Behaviour may become difficult to organise around the situation and can appear bizarre to others. This is different from ordinary rule-breaking.

@Examples

Wearing clearly inappropriate clothing for conditions, unusual repetitive actions, purposeless wandering, severe agitation or behaviour driven by unusual beliefs.

✓School response

Prioritise safety, lower stimulation and reduce demands while obtaining appropriate clinical support.

!Do not

Turn unusual behaviour into a disciplinary spectacle.

Negative symptoms

Reductions in ordinary functioning rather than obvious positive symptoms.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Psychosis-spectrum illness can involve reductions in ordinary functioning rather than obvious “positive” symptoms.

@May look like

Flat or reduced emotional expression, reduced speech, social withdrawal, low initiation, loss of interest, apparent apathy.

!Common misread / important

Common misread: Lazy, rude, disengaged, “doesn't care”, refusing to participate.
Important: Depression, medication effects, autism and severe fatigue can look similar.

Cognitive changes

Attention, memory, processing speed and organisation can deteriorate.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Attention, working memory, processing speed and organisation can deteriorate around psychosis. Academic performance may drop before staff understand why.

@What staff see

Forgetting instructions, losing track mid-task, difficulty following conversation, slowed work, poor planning.

✓Useful support

Reduce steps
Provide written/visual prompts
Repeat calmly
Allow more time and check comprehension

!Avoid

Assuming previous academic ability means current capacity is unchanged.

Emotion and affect changes

Blunted, irritable, fearful, distressed or incongruent emotional expression.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Young people may appear emotionally blunted, unusually irritable, fearful, distressed or incongruently emotional.

@Possible presentation

Laughing in situations others find serious, showing little visible emotion, sudden fear, agitation or tearfulness.

✓Support

Ask simple non-judgemental questions and respond to the emotion rather than debating the belief.

!Interpret cautiously

Expression does not always tell you what the student feels internally.

Psychosis: what it is and is not

Psychosis is a state in which a person has difficulty interpreting reality.

Reference tool — informs practice, does not diagnose or label.

iWhat it is / is not

May include: Hallucinations, delusions, disorganised thinking/speech, markedly unusual behaviour and changes in motivation or emotional expression.
Not automatically: Schizophrenia, dangerousness, low intelligence, deliberate attention-seeking or permanent disability.
Educator role: Notice change, support safety and functioning, document objectively and connect the student with appropriate mental-health care.

A student can experience psychotic symptoms and later receive a different diagnosis – or no enduring psychotic-disorder diagnosis.

Why school staff may notice first

School exposes changes that may not be obvious elsewhere.

Reference tool — informs practice, does not diagnose or label.

iWhy school staff may notice first

First episodes often emerge in adolescence or early adulthood. School exposes changes in concentration, attendance, social behaviour, communication and functioning that may not be obvious elsewhere.

Look for change: A clear shift from the student's previous baseline is usually more informative than a single odd behaviour.
Patterns matter: Falling grades + withdrawal + unusual beliefs + sleep disruption is more concerning than any one feature alone.
Do not diagnose: School observations should trigger support/referral, not a teacher-created psychiatric label.

Early changes before clear psychosis

Non-specific signs that can occur in several other conditions.

Reference tool — informs practice, does not diagnose or label.

iEarly changes before clear psychosis

Some young people show a period of declining function or subtle unusual experiences before a clear episode. These signs are non-specific and can occur in anxiety, depression, trauma, autism, substance use and sleep deprivation.

Possible changes: More isolation, reduced motivation, poorer self-care, concentration decline, odd or suspicious interpretations, disrupted sleep.
What matters: Persistence, increasing intensity, distress and functional decline.

!Avoid

Treating normal adolescent eccentricity or a single unusual comment as evidence of psychosis.

Functional decline

Education settings are well placed to observe recent functional decline.

Reference tool — informs practice, does not diagnose or label.

iFunctional decline

Current headspace early-psychosis referral guidance emphasises recent functional decline alongside positive/negative symptoms. Education settings are well placed to observe this.

School indicators: Attendance drops, work completion collapses, marked grade decline, reduced participation, abandoning previous interests.
Social indicators: Stops seeing usual friends, spends breaks alone, withdraws from trusted staff or group activities.
Daily functioning: Decline in organisation, hygiene, punctuality or ability to complete familiar routines.

Document what changed, when it changed, and how far it differs from the student's previous functioning.

Sleep and circadian disruption

Can worsen thinking, emotion and psychotic symptoms.

Reference tool — informs practice, does not diagnose or label.

iSleep and circadian disruption

Major sleep disruption can worsen thinking, emotion and psychotic symptoms. Severe sleep loss can also contribute to unusual perceptual experiences in people without a psychotic disorder.

School clues: Late arrival, sleeping in class, sudden reversal of sleep schedule, exhaustion, concentration collapse.
Ask / document: Changes in sleep pattern reported by student/family where appropriate; do not interrogate.
Escalate: Rapid deterioration plus almost no sleep, agitation or unusual beliefs needs prompt clinical attention.

Attendance and school engagement

Avoidance may reflect fear, overload, paranoia or exhaustion.

Reference tool — informs practice, does not diagnose or label.

iAttendance and school engagement

Avoidance may reflect fear, cognitive overload, depression, paranoia, exhaustion or the difficulty of managing symptoms publicly.

What staff see: School refusal, leaving class, hiding in toilets/library, repeated early departures.
Support: Flexible return, predictable contact person, reduced timetable if clinically/school supported, quiet spaces and gradual rebuilding.

!Avoid

Framing every absence as motivation or compliance.

Social withdrawal

Common but non-specific — most concerning as a new, substantial change.

Reference tool — informs practice, does not diagnose or label.

iSocial withdrawal

Withdrawal is common but non-specific. In emerging psychosis it is most concerning when it represents a new and substantial change.

Look for: Stops seeing usual friends, no longer joins activities, increasingly isolated, distrusts peers.
Could also be: Depression, anxiety, bullying, autism burnout, trauma, substance use or ordinary social change.
Action: Document change and combine it with other indicators rather than using withdrawal alone.

Academic deterioration

A previously capable student may suddenly fail familiar tasks.

Reference tool — informs practice, does not diagnose or label.

iAcademic deterioration

Psychosis can disrupt concentration, memory, organisation, motivation and confidence. A previously capable student may suddenly fail familiar tasks.

Pattern: Drop across multiple subjects, incomplete work, unusual errors, inability to explain what changed.
Support: Prioritise core learning, reduce volume, provide catch-up without punishment, coordinate adjustments.
Goal: Preserve connection with education while treatment addresses the illness.

Unusual beliefs vs culture, religion and normal adolescence

Eccentric ideas alone do not establish psychosis.

Reference tool — informs practice, does not diagnose or label.

iUnusual beliefs vs culture, religion and normal adolescence

Beliefs must be interpreted within cultural, spiritual, family and developmental context. Eccentric ideas alone do not establish psychosis.

Ask first: Is this belief shared or understandable within the student's cultural/religious context?
Consider development: Teenagers experiment with identity, spirituality, conspiracy ideas and unusual philosophies.
Concern increases: When beliefs become fixed, highly personalised, distressing, functionally impairing or disconnected from shared reality.

Psychotic-like experiences vs a psychotic disorder

Most psychotic experiences do not progress to a diagnosable illness.

Reference tool — informs practice, does not diagnose or label.

iPsychotic-like experiences vs a psychotic disorder

Unusual perceptual experiences can occur transiently in young people. headspace notes that most psychotic experiences do not progress to a diagnosable psychotic illness.

Meaning: One report of hearing a voice does not equal schizophrenia.
Still take seriously: Distress, frequency, conviction, functional decline and safety determine urgency.
Educator response: Record what was said accurately and refer through appropriate wellbeing/health channels.

Clinical high risk / attenuated symptoms

Subthreshold psychotic experiences plus functional decline — specialist territory.

Reference tool — informs practice, does not diagnose or label.

iClinical high risk / attenuated symptoms

Some services use “at risk” or attenuated-symptom frameworks for young people with subthreshold psychotic experiences plus functional decline. This is specialist territory.

Educator role: Notice and document emerging changes; do not score or diagnose clinical-high-risk states unless using an authorised professional pathway.
Why it matters: Early intervention can reduce disruption and connect the student with treatment before functioning deteriorates further.

!Do not label

Avoid telling a student or family that the student is “pre-psychotic”.

First-episode psychosis

The first period requiring clinical assessment/treatment.

Reference tool — informs practice, does not diagnose or label.

iFirst-episode psychosis

A first episode is the first period in which clear psychotic symptoms reach a level requiring clinical assessment/treatment. Early specialist care improves recovery and education outcomes.

What school can do: Maintain connection, reduce shame, provide practical adjustments and communicate with the treating team with consent.
Expect variability: Symptoms and function can fluctuate over days/weeks.
Recovery: Many young people recover well, especially with early treatment and strong educational/vocational support.

Psychosis vs schizophrenia

Do not equate any hallucination or delusion with schizophrenia.

Reference tool — informs practice, does not diagnose or label.

iPsychosis vs schizophrenia

Why this matters: Do not equate any hallucination/delusion with schizophrenia. Schizophrenia is one possible psychotic disorder — psychosis can also occur in brief psychotic disorder, bipolar disorder, severe depression, substance-induced states and medical conditions.
School wording: Use “psychotic symptoms” or the student's confirmed diagnosis, not informal labels.
Diagnosis: A psychiatrist/mental-health team determines the diagnosis over time.

Mood disorders with psychotic features

Timing relative to mood episodes helps clinicians differentiate.

Reference tool — informs practice, does not diagnose or label.

iMood disorders with psychotic features

Bipolar disorder and severe depression can include psychotic symptoms. Timing relative to mood episodes helps clinicians differentiate them.

Possible clues: Marked mood elevation/depression, major sleep change, grandiosity, severe hopelessness plus hallucinations/delusions.
Educator action: Document mood, sleep, behaviour and functional changes; refer rather than deciding the diagnosis.
Urgency: Psychosis plus severe depression, suicidality or mania warrants prompt mental-health assessment.

Substance / medication-induced psychosis

Cannabis, stimulants and other substances can trigger or worsen symptoms.

Reference tool — informs practice, does not diagnose or label.

iSubstance / medication-induced psychosis

Cannabis, stimulants and other substances can trigger or worsen psychotic symptoms in vulnerable young people. Prescription/medical causes also exist.

School clues: Abrupt onset, intoxication signs, rapid change after weekends/absences, known substance use – but do not assume.
Do not confront publicly: Follow school health/safety procedures and involve appropriate professionals.
Important: Substance-related psychosis is still a medical/mental-health issue, not simply misconduct.

Trauma and dissociation vs psychosis

Can resemble hallucinations or paranoia — and can coexist.

Reference tool — informs practice, does not diagnose or label.

iTrauma and dissociation vs psychosis

Trauma intrusions, flashbacks, hypervigilance and dissociation can resemble hallucinations or paranoia. Both can also coexist.

Trauma pattern: Experiences may be linked to reminders, reliving, dissociative episodes or known trauma themes.
Psychosis pattern: May involve persistent unusual beliefs/perceptions not tied to trauma reminders.
School role: Describe the experience and context; leave diagnostic interpretation to clinicians.

Autism vs emerging psychosis

Autistic differences can be mistaken for psychosis — baseline matters.

Reference tool — informs practice, does not diagnose or label.

iAutism vs emerging psychosis

Autistic social/communication differences, unusual interests, literal thinking and sensory experiences can be mistaken for psychosis. New change from autistic baseline is crucial.

Look for change: New hallucinations, new fixed persecutory beliefs, major functional decline, new disorganisation.
Baseline matters: Longstanding unusual language/interests without deterioration are different.
Support: Share developmental baseline information with the treating team.

OCD intrusive thoughts vs psychosis

OCD thoughts are usually unwanted; psychotic beliefs are held as reality.

Reference tool — informs practice, does not diagnose or label.

iOCD intrusive thoughts vs psychosis

OCD example: “What if I hurt someone?” followed by checking/avoidance/reassurance.
Psychosis example: Fixed belief that external forces are commanding or controlling actions.
Important: Insight varies. Staff should not diagnose from one statement; assess risk and refer appropriately.

Neurodevelopmental differences vs disorganisation

These conditions can cause poor organisation and inconsistent performance.

Reference tool — informs practice, does not diagnose or label.

iNeurodevelopmental differences vs disorganisation

FASD, ID/BIF, ADHD and DLD can cause poor organisation, memory failure, unusual answers and inconsistent performance.

Differentiate by history: Neurodevelopmental problems are usually longstanding; psychosis often involves a notable new deterioration or new perceptual/belief changes.
School contribution: Provide records showing baseline functioning and recent change.

!Avoid

Calling longstanding learning differences “thought disorder”.

Medical and neurological causes

Should not be assumed to be purely psychiatric.

Reference tool — informs practice, does not diagnose or label.

iMedical and neurological causes

Psychosis-like symptoms can occur with epilepsy, brain injury, delirium, autoimmune/neurological conditions, medication effects and other medical problems.

Red flags: Sudden confusion, fever/illness, seizures, fluctuating consciousness, rapid neurological change.
Action: Urgent medical assessment may be needed; follow school emergency procedures.

!Rule

New psychotic symptoms should not be assumed to be purely psychiatric.

Responding when a student reports hallucinations

Understand distress, safety and immediate support needs.

Reference tool — informs practice, does not diagnose or label.

iResponding when a student reports hallucinations

Your job is not to determine whether the perception is “real”. Your job is to understand distress, safety and immediate support needs.

Try: “That sounds distracting/scary. Are you feeling safe right now?”
Ask carefully: Whether the voice/experience is telling them to do anything; escalate urgently if there are harmful commands or intent.
Then: Move to a calm setting, involve the designated wellbeing/clinical pathway and document exact words where possible.

!Do not

Do not make the student prove the hallucination, mock it, or join in as though the hallucination is objectively real.

Responding to delusions or paranoia

Direct confrontation rarely helps; agreeing can reinforce the belief.

Reference tool — informs practice, does not diagnose or label.

iResponding to delusions or paranoia

Direct confrontation rarely helps. Agreeing with the belief can also reinforce it.

Validate emotion: “I can see this feels very real and frightening.”
Stay neutral: “I haven't noticed that, but I believe you're experiencing it.”
Offer practical safety: Quiet space, trusted person, reduced crowding, contact with family/treating service according to plan.

What commonly makes things worse

Some ordinary responses can intensify fear, confusion or mistrust.

Reference tool — informs practice, does not diagnose or label.

iWhat commonly makes things worse

Some ordinary behaviour-management responses can intensify fear, confusion or mistrust during psychosis.

Avoid: Public confrontation, sarcasm, threats, multiple adults surrounding the student, debating delusions, forced disclosure.
Reduce: Noise, verbal load, unnecessary choices, sudden changes, long disciplinary lectures.
Maintain: Calm predictable communication and clear boundaries around immediate safety.

Classroom environmental supports

Small changes can preserve participation while symptoms are treated.

Reference tool — informs practice, does not diagnose or label.

iClassroom environmental supports

Small environmental changes can preserve participation while symptoms are being treated.

Helpful: Predictable seating, low-stimulation option, permission for brief exits, clear routine, one trusted contact.
Learning: Short tasks, reduced copying, written instructions, extra processing time.
Social: Avoid forcing group work when paranoia/withdrawal is acute; reintroduce gradually.

Reduce cognitive load

Concentration, processing speed and working memory can be temporarily reduced.

Reference tool — informs practice, does not diagnose or label.

iReduce cognitive load

Psychosis and treatment can temporarily reduce concentration, processing speed and working memory.

Do: One step at a time, clear written prompts, shorter chunks, frequent recap.
Assessment: Allow extra time, smaller task volume and flexible demonstration of learning where appropriate.

!Do not

Interpret slower work as deliberate non-compliance.

Maintain routine without forcing performance

Routine can anchor a student without inflexible demands.

Reference tool — informs practice, does not diagnose or label.

iMaintain routine without forcing performance

Routine can anchor a student, but inflexible demands can overwhelm them during acute symptoms.

Aim: Predictability + reduced load, not complete removal from normal life where safe.
Prioritise: Attendance connection, safe relationships, basic learning, sleep/routine support through family/clinical plan.
Coordinate: Adjustments should fit the treating team's recommendations and school obligations.

What educators should document

Objective school data can be extremely useful to clinicians and families.

Reference tool — informs practice, does not diagnose or label.

iWhat educators should document

Objective school data can be extremely useful to clinicians and families.

Record: Date/time, exact words/behaviour, duration, triggers/context, functional impact, safety concerns.
Compare: Previous baseline versus new changes in attendance, grades, social contact, self-care and communication.

!Avoid

Avoid writing “Psychotic”, “delusional”, “schizophrenic” unless this is a confirmed diagnosis or direct clinical terminology.

Confidentiality, dignity and stigma

Unnecessary staff discussion can permanently alter how a student is treated.

Reference tool — informs practice, does not diagnose or label.

iConfidentiality, dignity and stigma

Psychosis carries substantial stigma. Unnecessary staff discussion can permanently alter how a student is treated.

Share: Only with staff who genuinely need the information to support safety/learning.
Language: Person-first or student-preferred language; avoid jokes and labels.
Remember: Recovery is common. Do not treat a temporary episode as the student's permanent identity.

Working with family and treating teams

Education recovery is part of recovery.

Reference tool — informs practice, does not diagnose or label.

iWorking with family and treating teams

Education recovery is part of recovery. Orygen emphasises maintaining educational connection during first-episode psychosis.

Useful information: Attendance/function trends, successful adjustments, peer/social issues, cognitive load and observed relapse signs.
Ask: What should school do if symptoms increase? What signs require contact? What adjustments support return?
With consent: Create one clear communication pathway rather than multiple staff contacting the family separately.

When to seek prompt referral

Should be taken seriously and referred promptly.

Reference tool — informs practice, does not diagnose or label.

iWhen to seek prompt referral

New hallucinations, fixed unusual beliefs, disorganised speech/behaviour or substantial recent functional decline should be taken seriously.

Prompt referral: Contact school wellbeing/mental-health pathway, family and GP/headspace/local mental-health service as appropriate.
Earlier is better: Untreated psychosis can disrupt social and educational development.

!Do not wait

For the student to “prove” they are ill before seeking advice.

Urgent risk indicators

Some presentations require immediate emergency response.

Reference tool — informs practice, does not diagnose or label.

iUrgent risk indicators

Some presentations require immediate emergency response rather than ordinary school support.

Urgent: Commands to harm self/others, expressed intent/plan, severe agitation/aggression, rapidly worsening hallucinations, marked confusion, inability to care for self.
Australia: If there is immediate danger call 000 and follow local mental-health crisis procedures.
Staff safety: Do not manage a severe acute episode alone.

!Rule

Psychosis is a clinical issue. Behaviour management never replaces urgent mental-health or emergency care when safety is at risk.

Returning to school after an acute episode

Plan around current function rather than previous expectations.

Reference tool — informs practice, does not diagnose or label.

iReturning to school after an acute episode

Return works best when it is planned around current function rather than previous expectations.

Start with: Predictable staff contact, reduced workload, flexible attendance, quiet space and manageable goals.
Monitor: Fatigue, medication effects, concentration, social stress and symptom recurrence.
Build gradually: Increase academic and social demand as capacity stabilises.

Relapse warning signs and recovery

Schools can help notice signs without becoming surveillance systems.

Reference tool — informs practice, does not diagnose or label.

iRelapse warning signs and recovery

Students and treating teams may identify personalised early warning signs. Schools can help notice them without becoming surveillance systems.

Possible signs: Sleep disruption, withdrawal, suspiciousness, concentration decline, missed medication/appointments, substance use, deterioration in routine.
Plan: Know who to contact and what adjustments to reinstate.
Recovery focus: Keep expectations hopeful, practical and flexible; school connection can be protective.

Educator working summary

Change from baseline, function, distress and safety.

Reference tool — informs practice, does not diagnose or label.

iNotice, respond, act

Think in terms of change from baseline, function, distress and safety – not whether the behaviour looks “weird”.

Notice: New perceptual experiences, unusual fixed beliefs, thought/speech changes, withdrawal, cognitive decline and falling function.
Respond: Calmly, neutrally and respectfully. Validate emotion without arguing or confirming unusual beliefs.
Act: Document objectively, reduce load, preserve connection and refer early. Escalate urgently when safety is at risk.

The core idea: the educator question is not “Does this student have psychosis?” It is “What has changed, how is functioning affected, and who needs to know now?”

Evidence base & reference links

Sources

Reference tool — informs practice, does not diagnose or label.

iSelected Australian / clinical sources

headspace — Psychosis: causes, symptoms and support headspace.org.au — Psychosis: causes, symptoms and support
headspace — Early Psychosis referral checklist headspace.org.au — Early Psychosis referral checklist
Orygen — School's In: education during first episode psychosis orygen.org.au — School's In
Healthdirect — Psychosis healthdirect.gov.au — Psychosis
Healthdirect — Hallucinations healthdirect.gov.au — Hallucination
Healthdirect — Delusions healthdirect.gov.au — Delusions

Psychosis, Emerging Psychosis & First-Episode Psychosis

Hallucinations

Delusions

Paranoia & Suspiciousness

Disorganised Thinking & Speech

Disorganised or Unusual Behaviour

Negative Symptoms

Cognitive Changes

Emotion & Affect Changes

Adult Response System

Instructional Demand System

Behaviour Mapping System

Hallucinations

iWhat it is

@What it can look like at school

✓What helps

!Keep in mind

Delusions

iWhat it is

@What it can look like at school

✓What helps

Paranoia and suspiciousness

iWhat it is

@What staff see / what may be happening

!Avoid

Disorganised thinking and speech

iWhat it is

@In class

✓Support

!Differentiate from

Disorganised or markedly unusual behaviour

iWhat it is

@Examples

✓School response

!Do not

Negative symptoms

iWhat it is

@May look like

!Common misread / important

Cognitive changes

iWhat it is

@What staff see

✓Useful support

!Avoid

Emotion and affect changes

iWhat it is

@Possible presentation

✓Support

!Interpret cautiously

Psychosis: what it is and is not

iWhat it is / is not

Why school staff may notice first

iWhy school staff may notice first

Early changes before clear psychosis

iEarly changes before clear psychosis

!Avoid

Functional decline

iFunctional decline

Sleep and circadian disruption

iSleep and circadian disruption

Attendance and school engagement

iAttendance and school engagement

!Avoid

Social withdrawal

iSocial withdrawal

Academic deterioration

iAcademic deterioration

Unusual beliefs vs culture, religion and normal adolescence

iUnusual beliefs vs culture, religion and normal adolescence

Psychotic-like experiences vs a psychotic disorder

iPsychotic-like experiences vs a psychotic disorder

Clinical high risk / attenuated symptoms

iClinical high risk / attenuated symptoms

!Do not label

First-episode psychosis

iFirst-episode psychosis

Psychosis vs schizophrenia

iPsychosis vs schizophrenia

Mood disorders with psychotic features

iMood disorders with psychotic features