Schizophrenia is usually thought of as an illness that strikes early in life—often late adolescence or the twenties. But for a select few, symptoms arise much, much later. This is called late-onset schizophrenia (LOS) when it occurs after age 40, and very-late-onset schizophrenia-like psychosis (VLOSLP) when they develop after age 60. Although less frequent than early-onset schizophrenia, psychosis late in life is genuine, treatable, and diagnosable. Identification is important, as older adults have specific issues and require differentiated care that weighs safety, dignity, and autonomy.1
At A Mission For Michael (AMFM), we provide intensive care for schizophrenia—late-onset diagnosis included—at our California, Minnesota, Washington, and Virginia centers. Our combination of evidence-based therapy, medication management, family involvement, and life-skills training ensures every individual receives complete, integrated care. We know that experiencing psychosis in middle age is overwhelming, whether you are the one experiencing it or a loved one watching it occur. Our purpose is to make sure everyone does not need to walk that road alone.
Even though schizophrenia typically emerges between the ages of 16 and 30, about 20% of patients are diagnosed after age 40.2 Of those, women are more likely to experience LOS, and the symptoms may be quite different from those seen in earlier-onset illness. Very-late-onset psychosis (after age 60) also has its own presentation, at times with changes in sensory function, medical illness, or neurocognitive disorders.3
While rare, late-onset schizophrenia is not “senior confusion” or “just aging.” It does involve alterations in perception and thinking—hallucinations, delusions, and disorganized thinking—that interfere with daily living. They are not personality traits or normal forgetfulness. They are symptoms of a mental disorder that must be addressed in the same emergency setting as any other disease.
We accept most major insurance providers and can check your coverage levels for you.
If we are not an appropriate provider for care, we will assist in finding a care provider that can help.
Scientists don’t point to a single cause. Instead, late-onset schizophrenia likely stems from a combination of genetic, biological, and environmental factors:
Some theories suggest that estrogen’s protective influence can delay onset in women, which can explain why more women than men suffer from LOS. Others note that sensory decline can mask the distinction between hallucinations and misperceptions, complicating treatment.5
Late-onset schizophrenia appears differently from its earlier counterpart. Classic symptoms are:
Notice these warning signs. If a friend or family member suddenly begins reporting bizarre ideas, hearing voices, or acting paranoid without a reason, it’s not “old age.” They may be manifesting symptoms of a sudden mental health crisis that requires immediate evaluation.
Later diagnosis of schizophrenia is difficult. Physicians must eliminate other disorders like dementia, delirium, medication side effects, or major depression with psychotic features. Stringent diagnostic processes can include:
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Medication is only part of it. Therapy—specifically Cognitive Behavioral Therapy for Psychosis (CBTp)—helps people learn to reframe intrusive thoughts, reduce distress, and develop coping techniques. Group therapy, family education, and community support groups provide support and encouragement.
Our schizophrenia treatment programs at AMFM include:
At A Mission For Michael, we understand the emotional toll of late-onset schizophrenia. We’ve developed our programs to be empathetic, judgment-free, and extremely supportive. Our care entails:
We also provide free, confidential screenings to determine needs and refer you to the correct care plan. If AMFM is not the answer, we will refer you to trusted providers who can help.
Psychosis, especially when it is acute and frightening, can escalate suicide risk. Suicide is a common cause of death in the U.S., and older adults are especially vulnerable when faced with emotional pain and loss of control.9
If you or someone you care about is suicidal in crisis or having suicidal thoughts, the 988 Suicide & Crisis Lifeline is open 24/7. Call or text 988, or chat at 988lifeline.org, to be routed to a trained crisis counselor. The Lifeline provides confidential help, connects the caller to local resources, and can coordinate with crisis centers and law enforcement if safety is in immediate jeopardy.10
Funded by SAMHSA (the U.S. Mental Health Services Administration, an agency of the Department of Health & Human Services), the Lifeline represents one of the strongest federal commitments to national crisis services and advocacy.11
Delaying treatment doesn’t just enable symptoms to continue—it can allow them to take root. What may start as mild paranoia or a little confusing hallucinations can quickly escalate into a runaway mental health crisis that feels out of control to the individual and their family. Without intervention, individuals are at higher risk of hospitalization, self-harm, or heartbreaking family breakdown that leaves everyone feeling powerless. In contrast, early intervention often changes the trajectory significantly. Through intervention, many recover a sense of stability, reconnect with their communities, and are able to start building lives once again that feel meaningful. Early intervention gives space for healing prior to the case becoming stuck in longstanding pain, and study after study proves that when families and providers act rapidly, the outcomes are exponentially improved.
If you’ve noticed sudden changes in yourself or a loved one—like unusual fears, hearing voices, or pulling away from daily routines—it can be hard to know what to do next. The first step is often the hardest, but it’s also the most important. Here at AMFM, we understand that answering the phone is more than taking the first step in treatment; it’s about needing reassurance, guidance, and reassurance of support because you know that you’re not alone. We offer free, confidential consultations where you can share with us what’s happening in a safe, non-judgmental space. Our admissions team hears you out carefully, helping make sense of what’s happening and pointing you to care that is right for you. Even if you’re not sure whether it’s schizophrenia or something else, getting the process underway brings enormous relief.
If you’re ready to take that step, call (844) 714-4743 today to speak with an admissions counselor. Help is here, and hope is real—you don’t have to carry this weight by yourself.
National Institute of Mental Health. “Schizophrenia.” Accessed September 2, 2025. https://www.nimh.nih.gov/health/topics/schizophrenia.
Maglione, J.E., and D.V. Jeste. “Late-Onset Schizophrenia: Do Recent Studies Support Categorizing LOS as a Subtype of Schizophrenia?” Current Opinion in Psychiatry 27, no. 2 (2014): 110–115.
Tampi, R.R., et al. “Psychotic Disorders in Late Life: A Narrative Review.” Therapeutic Advances in Psychopharmacology 9, no. 3 (2019): 51–66.
U.S. Department of Health and Human Services. “Schizophrenia.” National Institute of Mental Health.
Howard, R., and D. Rabins. “Late-Onset Schizophrenia and Very-Late-Onset Schizophrenia-Like Psychosis: An International Consensus.” American Journal of Psychiatry 2013; 170(7): 727–734.
Healthline. “What Is the Age of Onset for Schizophrenia?” Last modified January 27, 2023. https://www.healthline.com/health/schizophrenia/schizophrenia-age-of-onset.
World Health Organization. “Schizophrenia Fact Sheet.” Accessed September 2, 2025. https://www.who.int/news-room/fact -sheets/detail/schizophrenia.
National Institute of Mental Health. “Mental Health Medications.” https://www.nimh.nih.gov/health/topics/mental-health-medications.
CDC. “Suicide Facts.” Centers for Disease Control and Prevention. Updated March 26, 2025.
SAMHSA. “988 Suicide & Crisis Lifeline.” Last modified April 2023. https://www.samhsa.gov/mental-health/988.
988 Suicide & Crisis Lifeline. “What to Expect.” Accessed September 2, 2025. https://988lifeline.org.
