Sept 15 - AT THIS centre, shocking purple and brilliant green greet you. The garish colours are not most people's idea of a mental facility. But then, Orygen Youth Health in Melbourne, Australia, is not your typical mental health facility.
It is one of the most effective schizophrenia clinics in the world.
The man behind it, Professor Patrick McGorry of Melbourne University, is a passionate believer that early treatment of schizophrenia gives people a chance of a normal life.
He has thought so for 20 years, back when it wasn't a commonly held belief. He managed to convince government and private sector corporations to finance his experimental centre.
Orygen - named for Generation Y - began in 1991 as an early psychosis service, a small outfit with just a handful of doctors.
Today, Orygen is viewed as a cutting-edge mental health centre. Britain and Singapore both adopt its model of early intervention.
It helps 800 new patients a year. Half have what is called a 'social recovery', meaning they can hold down a job or attend school, and have friends, even if some have to remain on medication.
The rest also do better than those treated elsewhere. The key to its success: early identification and aggressive treatment of youth at risk of schizophrenia.
In 1994, Orygen started a mental health clinic specially targeted at young people. Most schizophrenics start showing symptoms in their late teens or early 20s.
To draw in young people, the clinic was set up first at a shopping centre, to 'de-stigmatise' mental illness, said Dr Alison Yung, the psychiatrist in charge of the place.
Today, the clinic has moved to the main Orygen centre which is near both Melbourne and Monash universities. The brightly painted centre caters to all mental health problems among youth such as personality disorders, not just schizophrenia.
'I don't think people feel ashamed of coming here. They talk to their friends about this service.
'It's different from 15 years ago when we had a hospital like Singapore's Woodbridge,' said Prof McGorry, who is one of the external consultants at Singapore's Institute of Mental Health, and who finds Singapore's institutional approach 'bizarre'.
Institutions for mental illness tend to cater to adults and are 'focused on control', Prof McGorry explained. 'It is not geared for teens and young adults in a salvageable situation.'
Staff at the clinic identify youth at high risk of getting schizophrenia - in what doctors call the prodromal phase - and are proactive in trying to prevent the disease from erupting.
Dr Yung has come up with a list of symptoms to look out for. This is derived from extensive interviews with schizophrenia patients on their own early signs and symptoms.
These include: feeling suspicious that other people were out to get them; feeling very self conscious, thinking people are looking at them because they are doing something wrong or look different, and hearing whispers (rather than voices).
Thanks to its proactive approach, Orygen's patients get treated just two months after the first symptoms appear - much lower than the international average of one year.
On average, Orygen patients spent 13 days a year in hospital, against 46 days by non-Orygen patients.
Orygen also boasts a strong applied research unit that has resulted in better outcomes for patients.
It has a research budget of A$8 million (S$10 million) to A$9 million a year and 120 full-time researchers looking into ways to help patients. It also has an annual clinical budget of A$14 million from the state government, and a staff of 140.
Orygen researchers have found that patients will benefit from less medication, since anti-psychotic medicine has side effects.
Long-term use of the older generation of medicines can cause patients to end up with blank-looking faces. Some make involuntary movements like flicking their tongue in and out of their mouth (a symptom referred to as the 'fly-catcher') or repetitively jerking their arms or moving their feet while seated.
Another recent finding that has Prof McGorry excited is the effect fish oil has on preventing psychosis.
A small study in Austria among youth at high risk of getting schizophrenia showed significant protection with fish oil. Eight out of 38 in the control group developed schizophrenia within a year, compared to just one out of 38 in the group taking fish oil.
Prof McGorry will be leading a nine-centre study to verify if the initial findings can stand up to scientific scrutiny. He would love to include Singapore in the study, except doctors here are not yet at the stage where they are picking up prodromal patients, or patients who are at high risk of schizophrenia.
He said: 'If we can show that it's useful, even if it works for only 10 to 20 per cent of patients, we can use it for the whole population as it is such a safe treatment.'
