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Psychiatric Care

We believe mental health care works best when your provider already understands the context.

At Bywater Health, psychiatric care is rooted in a deep understanding of queer lives as they are actually lived. After more than 20 years providing medical care to LGBTQ+ patients, Chuck Williamson, MSN, FNP-C (he/they) completed post-graduate training as a Psychiatric Mental Health Nurse Practitioner at Johns Hopkins University to expand Bywater’s ability to offer truly comprehensive care—medical and psychiatric—within one affirming clinic.

This service exists because queer mental health doesn’t happen in a vacuum. Our patients are navigating relationships, sex, work, family, community, and identity in ways that are often misunderstood or outright pathologized in traditional psychiatric settings. At Bywater, care is informed by cultural fluency, clinical rigor, and long-standing trust within the queer community.

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Our Services

Our patients seek thoughtful, relationship-based support for depression, anxiety, ADHD, and mood-related concerns.

Our work is grounded in the understanding that queer people live across a wide spectrum of identities, bodies, relationships, and lifestyles. Mental health care must be flexible enough to meet that reality. Treatment plans are developed with full awareness of a patient’s physical health, sexual health, hormone use (when applicable), and lived experience.

Our model is intentionally different from many psychiatric practices. We do not rely on rigid visit schedules, punitive policies, or unnecessary check-ins to sustain care. Instead, we emphasize continuity, autonomy, and trust. That means adjusting follow-up and treatment over time based on what is clinically appropriate and genuinely supportive.

Note: We do not offer urgent evaluations, crisis intervention or accept patients with serious mental illnesses such as schizophrenia, schizoaffective disorder or Biploar I disorder with psychotic features. We recommend patients seeking this higher level of care call 911 for emergencies including active suicidality or go to Unity Behavioral Health Emergency Services located at 1225 NE 2nd Avenue in Portland.

Modalities we offer include:

Medication Management

Collaborative, evidence-based prescribing that accounts for the full clinical picture, including other medications, hormones, and long-term health goals.

Accelerated Resolution Therapy (ART)

A trauma-informed, evidence-based therapy that helps patients process distressing experiences without prolonged exposure or repeated retelling, often preferred by those who want meaningful relief without re-traumatization.

Spravato (Esketaine) for treatment resistant depression

We are a certified Spravato treatment site for those who have tried antidepressants and have not responded. Learn more about Spravato

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Request an Appointment

Care that respects your identity, your autonomy, and your reality.

If you’re looking for psychiatric care that understands queer life beyond surface-level affirmation, we invite you to get started.

Book an Appointment