Celebrating Twenty Years of First Step

Jun 23, 2026

In 2006, “James” was diagnosed with bipolar disorder. He experienced depressive symptoms, had trouble completing his homework, withdrew from friends and often thought about death and suicide. He then felt a sudden shift in his mood. He became very distracted and found it harder to fall asleep at night. When he eventually went into crisis, later determined to be a psychotic episode, and his parents brought him to hospital, he was referred to the First Step program. At that time, a friendly First Step staff supported James, meeting him regularly to help him understand his diagnosis and provided advice on coping with his symptoms. Three years later, after completing the program and graduating from his engineering program, “James” shared – “What I’ve learned is that even though it feels like there is no light at the end of the tunnel, there one hundred percent is, there is always hope and people around you to pull out of it… I would strongly encourage anyone that is dealing with psychosis to get involved with the First Step program.  I’m sure it will be as beneficial as it has been to me”.

What began as a small, five-person team of dedicated staff has, over two decades, grown into a vital program supporting hundreds of people like James each year. These are individuals not only navigating many “firsts” in adulthood – first jobs, first relationships, first time living away from home, but alongside their first experience with psychosis. Several of those early team members remain with CMHA WW today, including Paul Bowser, now clinician with DBT, Sherri Papadedes, nurse and risk lead, and Helen Fishburn, our CEO, who at the time was the program’s first manager.

Since its founding in 2006, the First Step program has supported thousands of individuals and families, providing not only mental health services, but stability, dignity, education, and safety to be vulnerable. Beyond the numbers are several stories just like James’ – people who have returned to school, repaired relationships, secured housing after years of instability, and developed healthier relationships with substance use.

This milestone is more than a marker of time. It reflects the evolution of both the program and the broader mental health system and offers a window into where we are headed.

The needs we respond to today are not the same as they were 20 years ago. Population growth and increasing cultural diversity, rising housing pressures, economic strain, and the impact of social media/AI and substance use, have reshaped the complexity of care.

In response, the First Step program has evolved. Eligibility criteria has expanded, partnerships have deepened across hospitals, community, and provincial networks, and models of care have shifted toward more comprehensive, intensive, team-based approaches. The team itself has grown to include critical roles in nursing, clinical care, peer support, occupational therapy, psychiatry, supportive education and employment, and family education and support coordination.

Encouragingly, early psychosis intervention is now a provincial priority. In the coming year, the First Step program will implement updated eligibility criteria and model enhancements, continuing to strengthen its impact as a leader in EPI care provincially.

While models of care, system pressures, and complexity have evolved, the essence of care provided by staff over the past 20 years has remained the same. Recent feedback from a family member echoes a lot of “James’” story from 20 years ago –

 “When my loved one was admitted, I was overwhelmed…The First Step Program led me on a journey from hopeless and helpless to helpful and hopeful that allowed me to learn about my loved one’s condition and contribute to their recovery. The First Step team provided expertise and diligence in their care and attention for my loved one…the family support group offered a community of shared personal experience and exploration that transformed trauma into tactics and best practices for moving forward. Our solitude was substituted with collaboratively shared goals cultivated through the guidance of professionals…they help to create an environment that increases the possibility of thriving — for both our loved ones and their families.

To all those who work, have worked, or have supported clients experiencing emerging psychosis, thank you. The difference created through environments of care like this is profound and lasting for transitional-aged youth and their families during one of the most difficult periods of their lives.