TORONTO, January 25, 2017 - To destigmatize mental health challenges, let’s talk -- and let’s start by listening.
It’s an approach that Jeremiah Bach uses to support patients at CAMH’s Downtown West Clinic, which offers outpatient treatment and group programming to people dealing with schizophrenia and other serious mental health challenges.
As a Peer Support Worker (PSW), Jeremiah brings “lived experience” in the mental health system – he sought treatment years ago when bipolar depression disrupted his university education and his relationships. That experience blends with his expert knowledge of clinical care, CAMH programs, and the recovery movement, becoming a “foundation for practice,” he says.
Frankly, “I know what it’s like for someone to think you’re ‘crazy,’” he says. That perspective can make him more sensitive to the “sub-text” of conversations with patients, and help even out some of the power dynamics between caregivers and patients.
Jeremiah recently has been assisting a patient who came across on first impression as aggressive and intimidating.
Understanding emotions behind behaviours
“In working with this patient, I’m trying to listen to his emotions, to understand some of the feelings behind his behaviours,” Jeremiah says. “Some behaviors may be driven by symptoms such as ‘psychosis’, but there are underlying feelings there, like ‘I’m scared.’” I am encouraging the patient to talk about that. Here’s a person who has experienced trauma during childhood, who has had some bad experiences in the mental health system, and who is working hard to maintain his job in his chosen profession.”
Gaining a patient’s trust to get at underlying emotions involves a go-slow approach – “not forcing the issue,” and being non-judgmental, Jeremiah says.
Building trust – being clear about what is happening
Direct and clear language is critical. For example, when a Community Treatment Order is in place to maintain a patient securely in care, or when a medication dose is changes, “we can’t talk around those issues,” he says. “Even if the patient is uncomfortable with the message, the communication needs to be direct and accurate. They know you are being upfront with them about what is happening. That is also key to building trust.”
Clear language means using terms that are easily understood by the patient. In his Peer Support role, Jeremiah feels he can often bridge that gap between clinical concepts and clear language for a patient.
Getting a complete picture about the patient
The ability to listen includes knowing the patient’s history. In the case of the patient whose behavior could appear intimidating, Jeremiah notes that through CAMH’s clinical information system – I-CARE -- he was able to confirm that the patient did not have any history of aggression while at CAMH. “This also helps destigmatize this patient who may present as angry or agitated.”
And through a new application called Connecting GTA, Jeremiah got important context on the patient’s recent treatment outside CAMH, including visits to emergency rooms. “This really helps give us a complete picture so we can continue to help him,” he says.
A bridge to recovery
“Our role can be an important bridge between the consumer/survivor movements in mental health, and the clinical/medical model,” says Jeremiah. He’s one of 13 PSWs at CAMH, a role the organization has had in place for eight years.
Jeremiah has taken part in mental health consumer/survivor events such as Mad Pride. On the clinical side, he has completed Peer Support Training, WRAP (Wellness Recovery Action Plan) Training, PPAB (Partnering to Prevent Aggressive Behavior) and takes part in daily rounds discussing patients and treatment approaches. He also brings a broad scope of knowledge from his BA in Political Science from York University – the degree he finished after seeking help.
While a Peer Support Worker may have unique empathy for patient experience, they are a full member of an inter-professional team – which may include physicians, nurses, social workers, occupational therapists, educators and others. “I am clear with patients that I’m representing CAMH and am part of that CAMH team working for their care,” says Jeremiah.
PSWs are on the move, just like their patients. For example, Jeremiah will often assist patients in community, health and social service settings outside CAMH, assisting them with appointments, housing and many other issues.
Listening is critical to Jeremiah’s success as a Peer Support Worker. At the same time, he has grown to listen to, and celebrate, his own self and bring that understanding to his work with CAMH patients.
Today, he continues to connect lines of communication to battle stigma and help patients. “I understand that I am different, that I think and see the world differently.”
Meet another CAMH Peer Support Worker, Debora McDonagh, and learn how she worked with her colleagues to give CAMH patient Rodney a Reason to Hope.
Celebrating Peer Support Workers: Stay tuned for more information on Peer Supporters Day, an international movement that is gaining momentum to acknowledge the huge contributions of Peer Support Workers in the mental health field.