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Faces of CMHA: Paul Bowser, Early Psychosis Intervention Clinician with the First Step team

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I could not ask for a better fit. To have the opportunity to work with young people and their families has been one of the greatest gifts. To meet people early on in their recovery, to be a part of helping them through one of the most difficult parts of their experience, and to see them transition from an acute episode to a period of stability and transitioning on to the rest of their lives has been wonderful. We see success everyday.

#1. What is involved in your role?

I am an Early Psychosis Intervention Clinician with the First Step team in Kitchener-Waterloo. In my role I am the primary front-line support person to individuals who are typically between 18-22 years old and experiencing the early signs of what appears to be a psychotic-spectrum disorder. Our team offers two services: assessment and treatment. When people come to us it is clear that something significant has happened, but there is no diagnosis and there may be a lot of reluctance to engage with mental health services. So part of what I do is offer an introduction to the program on that first encounter and help people feel comfortable with moving forward to figure out if they would benefit from our service. Over time my role can involve a lot of different things like psychoeducation, therapy, family counseling, case management, crisis intervention, assertive outreach.

#2. Why did you become involved in First Step?

I got very lucky. I was living in the Appalachian-region of North Carolina and my wife was accepted to a grad school program in this area. I sent a resume to the organization saying that if anything came up I would be interested in working for CMHA. I received a phone call from an HR person when I was still in North Carolina saying that there would be a new program starting, an Early Psychosis program. She said with my background it would be something I should take a look at and she encouraged me to apply. I did apply and actually had my interview the day after I crossed the border. I have been with the program ever since it started on August 14, 2006.

#3. Have you always worked in Mental Health?

I have spent much of the past 25 years working in mental health in some capacity, but it was a gradual transition. Before I went into this line of work, I was a US Army infantryman for a few years stationed overseas. Shortly after that I was reflecting on what I wanted to do professionally. I had been responsible for some peer counselling for members of my team in the army and I had enjoyed that. I then volunteered at a distress center and I liked the training and experience so I decided to take some psychology courses at a community college. Along the way I developed an interest in social work and applied to a BSW program. I had the benefit of three years of placements, and that is where I really developed a strong interest in mental health. Since 1993, I have been in a variety of front-line mental health positions but I have also worked with seniors, homeless youth, people with acquired brain injuries, people with addictions and done a lot of work with jails and police departments in both the US and Canada. During my MSW placement I also worked with CMHA Ontario Division on policy issues. Mental health has been a recurring theme in my career for the past 25 years though.

#4. What do you enjoy about working at CMHA?

I could not ask for a better fit. To have the opportunity to work with young people and their families has been one of the greatest gifts. To meet people early on in their recovery, to be a part of helping them through one of the most difficult parts of their experience, and to see them transition from an acute episode to a period of stability and transitioning on to the rest of their lives has been wonderful. We see success everyday.

#5. How do you support people in the First Step program?  

We have an interprofessional team approach that is very collaborative.  The team includes social work, psychiatry, nursing, occupational therapy, peer counseling, group programming, family education. The whole team is recovery focussed and we put a lot of emphasis on assertive outreach and responding quickly to people. We invite people to participate in a wide variety of therapeutic and recreational groups during their time with us. The family is well supported by our Family Educator and offered opportunities to learn from other families in the program too. Our nursing staff manages medication and monitors metabolic issues. As one of several primary clinicians, there are typically a few dozen people I am assigned to based on geography. I tend to meet people wherever they feel most comfortable, at home, work, school or the office. We start with an assessment to start to clarify the diagnosis for people and see if they need what may be up to three years of this particular service or something else all together. If we are the right fit, our team helps people through the early acute phase where the emphasis is on symptom reduction and learning how to reduce the risk of relapse. This may mean taking a good look at medication needs, their street drug use, the kind of stress they are under.   From there the focus tends to switch to figuring out how to work on some of the milestones young people usually work on like enrolling in school, getting a job, making social connections or living independently. Along the way we are also talking about what they might need in the long term after they graduate from this program. It is not unusual for people to go through a period of acute psychosis and have some ups and downs during their time with us but eventually feel like they and their family are on top of things enough to transition from us to their family doctor instead of another mental health service. Recovery from psychosis is expected and we see success everyday.

#6. What should people know about Psychosis?

Psychosis can happen to anyone. For 1 in 100 people it is an issue that requires professional treatment. Sometimes symptoms are the result of stress, street drugs, trauma. For some it is a medical condition that will require intensive support from a team like First Step. We are here to help sort that out and find the service that is right for them. First Step is part of a province-wide network of Early Psychosis Intervention programs. Every community in Ontario has an early intervention program like First Step. The Ministry of Health has expanded this type of treatment for psychosis over the years because it works. So instead of relying on the mixed messages people might find on the internet or get from tv and the movies, I would recommend talking to the early intervention program in their area if they are worried someone they know may be showing signs of psychosis. Click here to learn more about the First Step program.

#7. What are you particularly proud of during your time at CMHA?

There is quite a lot that I am proud of from my time at CMHA. I am proud of having played a part in developing the First Step program from the start. The first year I worked out of my car, we did not have an office in Waterloo Region. We have gone from a small team to a model program in the wider early intervention community and we have seen countless success. I am proud of the Peer Support group I started it in 2007 where every week people can drop in and speak to their peers. In 11 years we have never had a time where people have not shown up for the group. Many people have said that has been the most important part in their recovery, having somewhere they can speak to peers in a safe place. There are also the individual successes that I enjoy hearing about. After people who have gone through a very difficult time, it is a real pleasure to see them transition and hear that years later they are reaching milestones like getting married and having kids, becoming professionals and buying homes. More recently, I become a Clinical Lead for Mental Health and Addictions Recovery at CMHA WW, which I am excited about. I provide coaching to staff and represent our profession on agency committees and have the humbling opportunity to meet the many amazing and incredibly talented professionals from different teams within CMHA.

If you are in crisis or wish to discuss whether CMHA has the right service for you, call Here 24/7: 1-844-437-3247 (HERE 247).

Follow the ‘Faces of CMHA’ series for a glimpse into the lives of the people who spend each day at the Canadian Mental Health Association Waterloo Wellington working to inspire and support people to achieve the quality of life they desire. Join our team, click here to view current employment opportunities at CMHA WW.

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