At Risk Mental State (ARMS)

 
 

What is at risk mental state (ARMS)?

At Risk Mental State (ARMS) refers to a set of early warning signs that may indicate increased vulnerability to developing psychosis. ARMS is not a diagnosis—it’s a way of identifying people who could benefit from early, preventative support.

“I wasn’t unwell exactly—but things felt off. I didn’t feel like myself, and I was scared I might lose control.”

Different experiences of ARMS in adults

Adults with an At Risk Mental State may experience subtle changes in thinking, perception, and behaviour. These can include fleeting unusual beliefs, mild hallucinations, or feeling increasingly suspicious or disconnected. Some describe a growing sense that things don’t feel real or that their thoughts are somehow different. These experiences may come and go and often appear during times of stress, trauma, or sleep disruption.

ARMS does not mean someone will definitely develop psychosis—most people do not—but it signals a need for support. Without intervention, some individuals may progress to a first episode of psychosis. Identifying ARMS early offers an opportunity to reduce risk, treat co-occurring symptoms like anxiety or depression, and build psychological resilience.

“Working with ARMS is about early connection, not crisis. It’s one of the most hopeful areas of mental health care.”

Symptoms of At Risk Mental State (ARMS)

  • Unusual thoughts or mild delusional ideas
  • Hearing indistinct voices or noises
  • Feeling watched or suspicious without evidence
  • Loss of interest, motivation, or emotional range
  • Increased social withdrawal or academic/work decline
  • Trouble concentrating or following conversations
  • Feeling disconnected from reality or from oneself
  • Rapid changes in mood, sleep, or energy
  • Family history of psychosis or schizophrenia
  • High levels of anxiety, depression, or recent trauma
Our approach
 

Our approach to supporting ARMS

At Bloomfield Health, we offer early, structured assessment for individuals experiencing symptoms consistent with ARMS. We use validated screening tools, explore family history and recent stressors, and offer compassionate, non-stigmatising support. Our treatment focuses on psychological therapies—especially CBT for unusual experiences, anxiety, and trauma. Where needed, we involve family and provide education about early warning signs. Our aim is to reduce distress, support recovery, and prevent  progression to psychosis where possible.

 

Frequently asked questions

Not necessarily. Many people with ARMS never develop psychosis. Early support helps reduce the risk even further.

Stress, trauma, sleep disruption, substance misuse or sensitivity to life changes can all contribute. Some people have a family risk but never become unwell.

No. It’s a clinical state used to identify people who may be at higher risk—and who can benefit from early help.

Absolutely. Therapy is most effective early, when you still have insight and motivation to engage with it.

Medication isn’t usually recommended at the ARMS stage unless symptoms worsen. Psychological support is the main approach. Please speak to us about medication if you would like to know more about the options.

That’s understandable. We work without judgement and focus on helping you feel safe, seen, and supported. If it helps, you can involve your family or partner in any appointments.

Potentially, yes. Many people continue working or studying during support. We can help with stress management and adjustments.

Sometimes—but early support improves outcomes. Getting help early is not overreacting—it’s prevention.

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