Reality Check – What is CALM?

Serena: Welcome to the reality check psychosis is real. So is recovery podcast.

Ashley: I'm Dr. Ashley Weiss. I'm a child adolescent psychiatrist

Serena: and I'm Serena Chaudry. I'm a clinical social worker

Ashley: and we are the co founders of Epic NOLA, which is early psychosis intervention clinic in new Orleans and also the co founders of calm clear answers to Louisiana mental health.

Serena: On today's episode, we're going to tell you a little bit more about what Calm is and how it came about.

Ashley: Dr. Chaudry, tell me a little bit about your training and why you decided to work in this field. I mean, I know personally, but our listeners. Also deserved now.

I was not interested at all in doing clinical social work. I, while I was getting my M. S. A., W. I thought it would be interesting to also pursue my master's in public health to gain a different lens to use in working with communities. So I loved my training. I did that work for several years in New York City, working with survivors of torture and war trauma.

And while I found that work super rewarding, it was hard. to work at the community level and see changes happening so slowly. And while I was doing that work, I was able to also observe the impact that trauma had on some of the individuals in these communities. And that sparked my interest in the clinical work that I never had any desire to pursue.

Ashley: I'm from Alabama and coming to New Orleans for college was a, an exciting opportunity. Loved it here in the city. Decided to do my master's in public health, even though I know I wanted to be a physician, but I kind of wanted to explore what the bigger picture looked like before I went all in on medical school, because I knew once medical school started that I wouldn't be able to do anything else other than study medicine.

That's beyond just the ordinary, and, uh, so psychiatry was always pretty high up there in my interest. And then, I was in medical school in Florida, and Katrina happened. And, for some reason, I decided I needed to come to New Orleans post Katrina to do residency training. Which was It's wild and truly like in the trenches, so to speak.

And I got to be his therapist. I got to be his doctor. I got to be the person to support his family. To explain to his friends what was going on, to help him come up with solutions for working and how to take breaks when he needed to, and all these things, and I realized that this was something different that I was doing to kind of help this person in this first phase of illness, and I stumbled upon the first episode, Psychosis Literature, and Met a mentor, Dr.

Shirhari, who's at Yale, shout out to Vinod, finished fellowship and stayed on faculty and thought, wow, it would be really cool to only do this work and to have a clinic that's specialized in these individuals and somehow managed to have coffee with you. And so here we are.

about the fact that you had this idea, and then this idea, you had things in motion to start the clinic, and then we had coffee, and you shared that idea with me, and We joined forces and here we are.

Ashley: Yeah. I remember feeling like I'm going to be really manipulative right in this moment because I'm going to try to get a community mental health agency to bring me on as a child psychiatrist and also quid pro quo allow me to have a couple of hours to recruit first episode psychosis.

And part of the ask was to have you come on for a few hours. So it was, um, I think it was how it was meant to happen. But. Going from an idea to few hours a week, um, where you and Michael and I got to hang out and talk about patients to now doing what we do is a massive leap. Huge.

Serena: And I think the reason it's worked and the reason it continues to work, I believe in part is that we continue to think big and we continue to ask for things and try things that maybe don't seem to work.

Ashley: Yeah, so a little bit about our clinic and what is early psychosis intervention, I think that there's probably some room for explanation.

So we have a program, and it's really person focused and family focused, and I feel like that that was all. Those qualities were always just natural in the people that we, we work with now that they're very focused on the individuals and focused on families, which is great. But with that in mind, you know, we offer psychiatric services, which is usually medication management with some therapy.

Now they get to have a wellness coach and work out, um, in our gym. And so they kind of have a, I like to think of it as a early psychosis recovery home, instead of a medical home. more specific, but kind of their home base for when this first starts happening. We're a little bit unique because we don't discharge people.

I mean, people can leave if they want to. We're not going to make anybody stay, but they can stay in treatment for as long as they're getting benefit. from care.

And I think it's the Recovery home, so to speak for the patients and their families. And I think what's been really cool is to see also how we've been able to integrate families into different aspects of our care. If patients are wanting and willing to have them involved and thinking about our new family support group.

Um, we have a mom's group that we've had for many years now and we Been hosting fundraisers for the last couple of years in my mind is an awesome celebration of recovery from psychosis, and we've had family members, cousins, brothers, sisters, and patients sort of involved in those fundraising efforts, which has been really fun.

One of the reasons that that's important is that a lot of the people that come to our clinic aren't, they haven't been in help seeking mode. Uh, they're usually young, healthy, late adolescence, young adults that have kind of maybe drifted away from primary care, drifted away from going to see the doctor because they're generally well, and then, you know, start having psychosis symptoms.

And I think that's one of the things that you and I like really bonded on was being able to have this love of taking care of individuals, but also this need to send this message.

Serena: Absolutely. It's been fun. Sending the message has been fun. It's a hard message to send, but I think we found really creative ways to do it.

And I think some of those ways have been inspired by our patients and definitely inspired by our collaborators in this. And we're lucky to work with a social marketing. Group and film production company to help us with our messaging and with spreading the word and helping to young people to be reflective.

So shout out to Red Rock Marketing and to Fireside Productions for their help that we're doing with Calm.

Serena: I

Ashley: think one,

Serena: being able to work with people over time.

I found that to be so rewarding on a human level and clinically as well. I think it is rare in this day and age to be able to have a mental health provider that you work with over many years. And I think we've been fortunate enough to be able to work with patients. During their first episode of psychosis and throughout their recovery and to see how people recover and the meaning they make from their first episode of psychosis is super inspiring and, uh, Just getting to talk to those people on a regular basis as they grow up and move out into the world is one of my favorite aspects.

Ashley: I think that I really. Love getting to have the time to figure out, you know, a medication plan that really sits right and feels right with the individual.

And it's like this Parallel process of like seeing, you know, men, these medications take time. They take so much time, which is the most frustrating thing about being a psychiatrist is about their medications take a long time. It's so much different than like a 10 day course of antibiotics and your infections gone.

Like you have to wait months. And then like, usually around month four, this like thing happens where people start feeling more like themselves. And um, and then being able to kind of, you know, it's not all the medication, it's the medication combined with therapy, but seeing them like simultaneously truly like work together.

Like that's been really rewarding. And also makes them feel old. But, um,

Serena: But a good old. I think the other piece like in this growth over the past many years has been right, the growth of our clinic um, the space, so to speak. We grew out of our original space. We're located in a stand alone clinic in Mid City in New Orleans.

Ashley: I feel like we plotted that on a plane ride many years

Ashley: or

Serena: something.

Ashley: I was going through some of my old stuff, trying to clean up, um, and found some of these like old notes for people, um, that know Serena and I, they won't be, would not be surprised that there are a bunch of scrappy planned out projects we'll bring to everybody's attention.

Some moment in time, I'm hoping that people outside of New Orleans and more rural areas, uh, will have easier access over time. That's going to be fun.

Serena: I think this podcast was one of those scrappy ideas that It's now becoming a reality, which, you know, I'm really excited about sharing our passion and our team and our patients with the world.

By your reflection and help give people the courage to reach out to us or to someone in their area to get the help they need

I think that our decision to say psychosis and to talk about psychosis Explicitly with this word is, is important and has been very intentional to use this word in a way that is not troubling. It's just a, a word that describes certain constellation of experiences and it's often misused, but the only way that we can change misuse is to use them more accurately.

And the people that we were beginning to see were clearly saying psychosis. And it just felt really important to kind of make a stand about that. Kind of take it back, maybe. Sounds dramatic, but why is it a word that we're just going to continue to allow to be misused?

Serena: Yeah, I think there's been a really positive response from the community about this, too.

Ashley: I am too, and would love to like hear what people think, to see comments. I'd love to answer questions. Um, so please, please, please share this with someone that you might, where you think it might be useful. Ask us questions, send us comments. We are open to continuing the dialogue. Give us ideas for

Serena: guests to bring on, topics to talk about.

We're open until next time. Thanks for taking the time to get your reality check. And remember psychosis is real. So is recovery.

Ashley: If you have enjoyed this episode or found it useful, please subscribe wherever you get your podcasts from and check out the website, calm NOLA dot org.