Monday, June 28, 2010

Oh, you witty social workers

I’ll preface this by saying that I don’t usually wear shorts, but I did today.

Me, gabbing with my manager today: Wow, I never realized I had so many bruises all over my legs
Sarcastic supervisor: Nectarine, is this your way of telling me you have something you need to talk about?


Thursday, June 24, 2010


So, needless to say, even though I’ve been looking for a job closer to downtown for the past two years, I’m glad to be nowhere near the inner city this week.
I haven’t seen the fence, but I hear it’s big.

As I was discussing with some friends the other day, I don’t really know how to feel about the whole thing.

Back in 2002 when the G7 met in Kananaskis, Alberta, and 2001 when the Summit of the Americas was held in Quebec City, I was involved in a lot of activism and many people I knew attended protests at those events (or as near as the “designated protest zone” was allowed). We were anti-globalization and opposed fair-trade. The issues seemed clear, and we wanted specific alternatives to what the summit members were proposing.

Now, I don’t really know what summit leaders will be talking about. The more I read the news, the more confused I get. If, as Harper says “the discussion should be less about new agreements than accountability for existing ones” couldn’t this have been done on the phone?

Initially, I was frustrated that the news media seemed to be focusing on logistics and risk of violence when talking about protestors and seemingly not paying any attention to the reason the protestors are actually there. But I wonder now if it’s because there is no one good reason the protestors are there.

I’m sure many are well intentioned. I’m sure their issues are important. But when everyone is there yelling hundreds of different and unrelated slogans, I fear the message will get lost.

Am I disillusioned and out of touch? I do still think that public protest and peaceful civil disobedience has its place and can be an effective tool for change. I just don’t see it happening this time.

Given all this, there are only two things I am sure of: 1) $1.2 billion is waaaay too much and so not worth it and 2) this weekend, I will be anywhere but downtown.

Friday, June 18, 2010

Please, just go pt. 2

The housing transfer saga continues.
I met with the client. She had yet to make up her mind. She was highly anxious, and unfocussed and I could barely get a word in. I haven’t seen her like this in several months, although it used to be constant.

She wanted to know what I thought she should do. I wanted to tell her, but I didn’t. I reinforced that it was her decision, and tried to outline some pro’s and con’s.

Eventually, I ended the meeting since we were talking in circles. I suggested she call her worker at the housing agency and discuss it with her to figure out a final decision. We only have so much time.

Today, another message from her in the wee hours of the morning. She still hasn’t decided. I have a lot of thoughts and theories and hunches about this and about what I think she should do. But I’m getting too personally involved. This is counter-transference baby. I haven’t been able to connect with my supervisor for the past two days and I know I need to debrief with her, so I haven’t called the client back yet. I feel guilty about that.

This is rare for me. I’m usually pretty consistent about my boundaries, and I generally find it pretty easy to keep a healthy sense of detachment between me and my clients. But it’s bound to happen sometime, right?

Aarrgh! I really thought she was going to go for it.

Wednesday, June 16, 2010

Please, just go

I’m crossing all my fingers and toes today. A client of mine has been on a housing transfer list since 2006. She has been in supportive housing since 2004, when the housing agency made an “in situ” arrangement for a family member to rent to her, as he was going to let her live in the first and second floor of a semi-detached that he owns. This seemed ideal at the time (I’m told) because she has two children of disparate ages and three bedroom housing stock is low.

The situation has not worked out. He constantly asks her for money over and above the rent to pay for household bills, utilities, and improvements. She frequently gives in because, hey: she doesn’t want the lights to go out of the heat turned off. She has multiple complex health issues, and is on disability so she has funded this largely through a line of credit and credit cards. She is in DEEP debt. And majorly stressed. The effects on her mental health and family life have been devastating. I would go so far as to say there has been financial and emotional abuse happening.

About one year ago I started calling the housing agency to get an update on her transfer. Somewhat understandably, these things are not always a priority compared to new client’s who haven’t even been housed yet. The agency was able to show her one unit, but she didn’t take it. It was in a neighbourhood far removed from just about everything, and her daughter would not be able to get to her high school (she attends a special program). Understandable, but frustrating for all that it didn’t work out.

Fast forward one year. She’s been doing relatively well given the circumstances, and we’ve been working a lot on goal plans. We realized together that the housing issue is creating a huge obstacle to most of her other goals and aspirations. Since it’s been a year, I call the housing agency for updates, and to impress on them how urgent this situation has become. I do an email follow up and cc: the manager just to make sure we aren’t forgotten about.

Well that did the trick!

Two days later a unit has been found for her to view. We went to see it yesterday. It’s in a great neighbourhood, near the schools, nicely kept building and clean, good sized unit. She seemed to like it, but had one major concern which I’m really hoping will not sabotage the whole venture. If she says no to this one, she only gets one more chance.

Our work is supposed to be client driven, but I admit I was not unbiased with my client yesterday. I talked up what I thought were the good points, I printed out a map for her of the area, highlighting access to services, routes to school etc. I suggested ways that I thought we could work around her ONE concern.

She has to decide today. I hope she takes it.

Monday, June 14, 2010

Quote of the Day

"How can I be a mental health worker when I don't even know how to spell 'psychiatrist' or 'schizophrenia'?!?!

Thank you, unnamed co-worker, for making me laugh.

Why I Hate Being an Administrative Bearer of Bad News

Or “Being Part of the System”

Me: I should let you know that we have a six month waiting list.
New intake: Six months is no good, I won’t be here.
Me: Oh, where are you going?
New intake: I’ll be dead.


(I do however, love these new blogger template options)

Wednesday, June 9, 2010

The World Cares About Homelessness

As with most major events of its kind, when Canada hosted the Olympics in Vancouver a few months ago, there was much skepticism about the benefits of the event to the city. The population was divided between those excited to be on the world stage, and those who felt strongly that resources would be better put towards dealing with the highest HIV rate in North America, a growing homeless population, and other social issues in the city.

While I for one really do like to believe that these events can offer a chance for a positive legacy in a city, I was appalled but not totally shocked when I read this article about the “affordable housing units” that are now up for rent in Vancouver. They were constructed as part of the Olympic Village development plan, and were promised to be turned into badly needed “social housing” for the city.

Please tell me how teachers, paramedics, police, and public sector workers are being discriminated against by landlords, or facing chronic rates of homelessness? Why on earth would these professionals be the target population for any “social housing” project? And can even they afford the $1600 rent (for only 640 sq. ft.)!!!!!!!

Canada has been "working on" a national housing strategy to end homelessness for 17 years now. Is this as far as we've come?

In related news, street children in South Africa are being forcibly moved to remote areas prior to the World Cup tournament.

Tuesday, June 8, 2010

Bipolar Rhymes

Had a client rap to me about his hallucinations in an intake assessment yesterday. Twice! I stopped him before he could get up to show me his dance moves.

Monday, June 7, 2010

The Housing Worker’s Conundrum

Where I work, I am one of three designated “housing workers”. This means that my clients meet the basic criteria for our case management program* and were also at risk of homelessness (or actually homeless) thereby meeting the criteria for subsidized rent. Put it all together, and you’ve got Supportive Housing!

Supportive Housing can be really great for clients, because it is so much easier to recover in your mental health when you have a safe and comfortable roof over your head, and it’s easier to maintain your housing when you’ve got a dedicated worker (that’s me!) and program supports helping to keep you on track. I’ve seen it make all the difference for quite a few people.

The whole goal of Case Management is “recovery”. We are “recovery-focussed”. We promote “client recovery”. Although we provide long term services without a set discharge date, we expect and hope that we will support our clients to the point where they can do well with a decreased level of support i.e. we don’t want to be there FOREVER.

Eventually, this becomes at odds with the actual “housing” aspect of supportive housing. Just because a client can keep their own appointments, is actively volunteering in the community, has been connected with community supports and has learned how not to burn the house down does not mean that they can afford market rent. And if we remove their rental supports, this is most often going to cause some kind of mental health crisis.

Can you see where this is going?

A number of my clients fit in this category. They have toiled away with case management supports for years, and are doing very well thankyouverymuch. But there are no processes in place for me to withdraw from providing them with case management services, as it’s tied to their housing. In fact, their tenancy agreement states that I need to see them in their unit at least once a month. But they don’t want to let me in, because they don’t need me any more. Or they do want me to come, and I end up playing friendly visitor, or worse, having tedious appointments where I feel like some kind of safety inspector. It’s intrusive, and I always feel disrespectful of my client’s when I do this. Not to mention, it's a waste of everyone's time.

I get the sense that a good solution has not been reached because this is one of the remaining elements of fallout from deinstitutionalization. Supportive Housing my particular region has only been around about 15 years, so we're just starting to see clients as this point in their recovery. What I would love to see is a position created for a dedicated follow-up worker who could do occasional housing inspections with these kind of clients, and provide emergency support or referrals should they experience a relapse.

For now, I’m off to what I know will be another 10-15 minute appointment that will sound pretty much like this:
“Hi, how are you? Anything new? Mind if I look in your kitchen? Sorry, I’ll get out of your way now. See you in July.”

There must be other ideas or models out there. Any you know of?

*live in our catchment area, have symptoms of major mental illness, needs assistance in basic life skills/keeping safe in home or community/maintaining employment or vocation

Tuesday, June 1, 2010

Reading Material

I’ve never really done much reading about ‘mental health’. Truth be told, its not the field that I was trained in, and I find most publications by professionals to be boring, jargon-laced jibberish.

That said, I do find it insightful to check out books by consumers and survivors of the mental health system.

One of my favourites is local hero Pat Capponi, who wrote Upstairs in the Crazy House among others, and has also begun publishing a series of fictional detective mysteries set in a mental health group home.

I’ve just started reading a book called Voluntary Madness which a friend recommended to me.

So far it’s very engaging, and causing my mind to flip-flop between the consumer and service provider perspectives. My mind is running so quickly through the things I always question about the “mental health system”. Why do we continue to rely so heavily on medications? Are “diagnoses” really to be trusted? Has deinstitutionalization just dumped a bunch of people out on the street without sufficient supports and resources? What is “crazy” anyway, and who gets to decide?

Maybe I’ll attempt a bit of a book review when I’ve finished it.