Nathan Edmunds had just started ninth grade at Skyline High when he was overcome by a sadness so deep that he found it hard to get out of bed in the morning. He’d been a straight-A student with many friends, but both his grades and his relationships began to wobble as weeks went by and his sadness didn’t lift. Then, a couple of months after the onset of his depression, he began to hear voices.

“They were always saying negative things and putting me down,” remembers Edmunds two-and-a half years later. “They told me to hurt myself, so I did.” He began cutting himself across his arms with sharp objects. Afraid of the voices and of what was happening to him, he told no one.

The abusive voices stayed with him day and night. On the worst days, he could hardly hear what his teachers were saying over the din. His only relief came when he could finally sleep–and if he couldn’t sleep, he had to cut. “Cutting seemed like the only way to cope with the voices,” he says.

Edmunds says his mother could see he was troubled and asked him to get help, “but I thought I could do it on my own.” He wore long sleeves to hide the cuts. But one day his mother saw them and took him to a doctor.

“I thought of killing myself when I felt I would never find my way through. But I never acted on it,” Edmunds says. What were the voices like? “There were two main voices,” he explains. “One was male, really abusive and aggressive.” When asked if he ever figured out who or what the voice was, he replies steadily: “It was my father. He just passed.”

Edmunds describes the onset of his illness matter-of-factly, with the same articulateness and calm he maintains when speaking before audiences of dozens and sometimes hundreds of people. Now a seventeen-year-old junior at Skyline, he’s dressed in navy blue slacks and a button-down shirt, with his hair cut in a line across his forehead, like Paul McCartney. Confident and mature beyond his age, he schedules our appointment in between seeing his clients–the peers he counsels on a volunteer basis at Washtenaw County’s Community Support and Treatment Services (CSTS) offices on Ellsworth.

Edmunds is part of a vanguard of young people in the Ann Arbor area who are receiving support and training to learn how to manage their own illnesses–and also reach out to educate the community in an effort to dismantle a deadly stigma. They’re part of a four-year study called Michigan Prevents Prodromal Progression (MP3). It’s one of six studies around the country funded by the Robert Wood Johnson Foundation to test a revolutionary concept–that mental illness is preventable through early detection and treatment.

The goal of MP3 is to halt mental illness in the “prodromal” stage–before it results in the kind of psychosis Edmunds experienced. The challenge, says clinical director Elizabeth Spring, is that “we can’t use a scan or a blood draw” to detect developing mental illness–and many early symptoms, like mood changes and sleep disturbance, resemble “normal adolescent behavior.”

That’s why family members, teachers, and doctors all have roles to play in early detection. “If you think something is not right, get it checked out sooner rather than later,” Spring advises. “The most significant sign is a dramatic decline in functioning–a drop in grades and increasing social isolation.”

MP3 is now in its third year. So far, many of its sixty-nine young patients have achieved full recovery–including some who came to the program with early symptoms of psychosis, like hearing voices. “If the symptoms are impairing a youth in a way that they cannot function, then medications are explored for that person and that situation,” explains Spring. Otherwise, clients are treated through therapy, extensive education about their illness and self-care, family education and therapy, multifamily support groups, and intervention from MP3 staff in order to create supportive environments at school and work. Edmunds and other MP3 volunteers are trained to share their stories with their fellow students and work towards “mental health literacy.”

Hearing from a peer like Edmunds can inspire someone who’s suffering to seek help, according to Spring. “Just telling someone their problems are possibly an illness, and not a character flaw, increases the chances they will get help,” she explains.

Edmunds agrees that, if he had heard his own presentation when he was first getting sick, he would have gotten help sooner. “I just didn’t know what was happening to me then,” he says now.

Studies show 22 percent of adolescents have a severe mental health problem, but only about one-quarter are receiving any treatment. Fully half of the rest self- medicate with illegal drugs. And a frightening number find themselves in so much pain, and feel so alone, that they take their own lives. Suicide is the third leading cause of death for people aged fifteen to twenty-four, according to the Centers for Disease Control, trailing only accidents and homicide.

Even being in treatment is no guarantee of safety. MP3 lost an eighteen-year-old client to suicide within a year of its launch. “He was actively participating in the program and had just gotten an apartment, a job–there were no indicators” he might harm himself, Spring says. The death was a huge blow to staff and everyone in the program.

Even for those who survive, mental illness can be utterly devastating, infusing and undermining every area of their lives–academic, social, emotional, familial. “It’s robbing them of their youth,” says Spring.

Early results indicate that MP3’s model holds promise for minimizing and even neutralizing the catastrophic impact that mental illness can have on a teen’s life. But it can work only if teens are willing to seek help in the first place. Like Edmunds initially, many are so frightened, ashamed, and confused that they hide their condition for months or even years. And that gives the voices way too much time to win. “The longer the brain goes untreated,” Spring explains, “the harder it is to fight back.”

I first met Edmunds in May 2010, when he and a group of half a dozen students gave a presentation for every Skyline student and staff member–a total of roughly 1,500 people–about the symptoms and prevention of mental illness. As Edmunds used PowerPoint slides and described symptoms, statistics, and the relationship between mental illness and substance abuse–all too often taboo subjects–the audience was riveted.

When I approached him afterward to ask for an interview, he smiled and said: “Sure.”

“And you can be thinking about whether or not you’ll let me use your name,” I offered.

“Oh, sure,” Edmunds. “You can use my name. No problem.”

“You don’t understand,” I explained. “If this article is accepted by my editor, it will also be published on the Internet, and it could be out there for years and years.”

“I don’t have a problem with you using my name,” Edmunds said as he calmly continued to pack up.

He has not always felt so comfortable about his illness. In an interview later, he tells of getting released from the hospital for the second time in December 2009 and going back to school “too soon.”

How soon?

“The next day,” he says, smiling ironically at the memory. “I spent the whole day in the counselor’s office, crying.”

He had asked his teacher to let his fellow students know that he was in the hospital, and his friends had sent encouraging Facebook messages. His family also was a huge support, he says. “My mom was always right there next to me, telling me everything would be OK,” Edmunds says. “Mom’s my hero.” Edmunds says his eight siblings also have been supportive (he is in the middle in age).

Family support is one of the touchstones of the MP3 program, and MP3 counselors also help their clients make the transition from hospitalization to home, school, and/or work. Edmunds believes his second hospitalization might have been prevented if he had the support of MP3 after his first hospitalization. Originally diagnosed with “major depressive disorder with psychotic features,” Edmunds was given one set of medications during his first hospitalization. He was out for only about a week before he had to go back in again. This time he was diagnosed with schizoaffective disorder and given a new medication regime. After his second release, he was one of the first teens recruited for the MP3 program.

Spring says it’s “not unusual” for people to be hospitalized more than once. But one of the most significant early signs that MP3 works, she says, is that “almost everyone” who came to MP3 after a hospitalization and stayed for at least ninety days has not needed to be rehospitalized.

Despite the MP3 program’s success, its funding will end next year. When the grant runs out, Spring says, Washtenaw County Community Mental Health will continue to provide services for those teens who are displaying the early symptoms of mental illness and who qualify for Medicaid. Others will be referred to other program providers, though right now there is no centralized system for doing that. While the county can’t accept private insurance, Spring says she knows of psychologists and psychiatrists in town who have expertise in early detection and treatment, and she also recommends support groups at the U-M Depression Center. Public education will continue to be a priority.

“There needs to be awareness about what mental illness is and the role of stress,” she says. “Mental illness affects people at all socioeconomic levels. If you have a brain, you can have a mental illness.”

Counting all six studies nationwide, Spring says, 338 teens have received treatment. Of those, about 90 percent returned to full functioning. There’s not really a number to compare that to, she says, because clients came into the program with varying symptoms and illnesses. Researchers who are collaborating on the project at the Depression Center will be able to better evaluate the program’s effectiveness in the next couple of years.

Nathan Edmunds is sold. After full-blown psychosis and two hospitalizations, he is hopeful that the nightmare is over. He says he hasn’t heard voices or cut himself in eight months, and he knows enough now about himself and his illness that he’ll be able to keep it from progressing if he starts to get sick again. He also has accepted that he will probably have to take medication for the rest of his life.

He’s now in the process of “graduating” from MP3, but he plans to continue to provide peer-to-peer counseling during his senior year at Skyline. Asked why he’s willing to go public with a disease that’s surrounded by stigma and to devote so much of his free time to educating people about mental illness, he says simply, “Because I was so freaked out about it that I don’t want anybody to have to go through what I went through.”