Pause for Thought

Check this out --> Feminist Activists Find Peace in Thailand

I wanted to link to this article for a couple of reasons.  For one, feminism and VAW (violence against women) work are very important to me.  My training background is actually in assaulted women’s counselling, not mental health, although the two have obvious intersections.  I love learning about what feminist activism looks like around the world.

The other reason is that I found as I read this, I was contrasting the “retreat” experience they describe with the professional trainings and workshops I attend here in Canada.  The focus on “self-love and self-worth as an essential part of their work in the world” sounds really in line with my philosophy, but not my practice.  I certainly haven’t had many experiences in my professional life where there is such an emphasis on this sort of thing.  The perks offered to us at trainings usually max out at a free lunch, and possibly getting to go home a bit early. 

I don’t know much about Thai society or the culture of social service work there, so I can’t really comment on whether the needs of these workers would be different than where I am, and what they might make of their retreat experience.  But as the writer says, seeing “15 women grown napping together on the floor of a conference room after a lively plenary” would be “odd” to see in the U.S. (and I’m considering the U.S. and Canada to be more or less the same in this respect). 

It sounds nice.  But would it work?  Would anyone go for it?  I can imagine the mixed reactions of my co-workers – divided between feeling uncomfortable, and griping about how they could be making phone calls or getting assessments done instead.

Is this because we really don’t value self-care?  We talk a lot about avoiding compassion fatigue, but the general consensus seems to often be that we are responsible for this on our own time. 

On the other hand, is it because sleeping or meditating would be considered a private activity, and we would be asked to let our guard down to such a degree in a very public and shared space?  A lot of what they describe would be strikingly different from our typical professional activities and behaviours, and would (I think) demand a lot of openness to the experience.  Would this cross my boundaries?

I don’t know.  But I’m curious.

Has anyone experienced something like this?

Sibling Slip-up

When I meet clients for an intake assessment, I make notes on an unofficial “intake form.” It has prompting questions under headings like “medication” and “family history” with boxes giving me lots of space to write. I use it as a reference to complete the proper assessment on our electronic database later on. I often end up jotting things down in random boxes, as clients don’t always stick to the script.

So sometimes this happens:

Q: Are there any current family/marital issues?
A: brother, step-brother, step-sister.

My stomach in crisis

Emergency!

Where did all the office snacks go?!? They were here on Friday when I left, but now they seem to have disappeared…

I need something to get me though all these assessments.

I think there are some anxiety issues we should talk about...

No, just because you leave me SIX messages before the office is even open does not mean that I will meet with you four hours ahead of schedule.  You can pace around the waiting area all you like.

Couldn't resist another one...

“No ma’am, I don’t think they could fumigate the hospital and take your husbands clothes but leave him in the room.”

-co-worker on the phone with a woman whose husband apparently “took a bunch of pills” and somehow ended up in a psych hospital at the other end of the province. He called his wife complaining that “men in white coats”* removed all his belongings but left him in the room while they sprayed some sort of noxious gas, and she in turn was looking to us for help. She also wanted to know what “rights” she had if the doctor said he would call her with an update at 3:00 and it was 3:01.

Wish I could have heard the whole conversation!

*apparently not just a terrible stereotype anymore!

Thanks, Doc

Note in hospital records that my desk-mate was reading today:

“...this woman did not appear to be very bright”

...

Seriously? Is this considered a “professional” or “medical” opinion?

I’m going to start a training program entitled “Appropriate Note Writing for Dummies Psychiatrists.

P.S. thanks to a couple new "followers" for tagging along! Hi!

The Whole Story

Ontario is having municipal elections this year. I read this article this morning about one of the leading candidates in Toronto, Rob Ford. While I’m not sure who I’m going cast my vote for yet, I can’t say I’m a big fan of Ford. His general platform seems to be of the ‘cut taxes, cut services’ variety, and to be frank, he seems like a real blowhard. Not exactly my style.

I bring this up because I think the article does a good job highlighting some of the challenges that come up time and again when trying to fund social programs. We know (or most people in social services know anyway) that things like poverty, addiction and homelessness are difficult issues to address. Positive change will only come from systemic changes in supports, programs, and people’s attitudes.

It may be very easy for Ford to rail against thousands of dollars being spent on cigarettes and “to give free wine to homeless people” but it is short sighted, and it definitely doesn’t tell the whole story. He gives a line similar to what we hear from those who oppose things like harm reduction, safe injection sites and the special diet allowance (an issue which Ford has also had his say on, and really made a mess)

I’m reminded of many stories, but one in particular of a woman I helped support when I was working on a homeless outreach program. She had been chronically homeless, had schizophrenia, diabetes, and crack addiction. Naturally, she had a long back story that I won’t go into here. After she stabilized somewhat during a lengthy shelter stay, we were able to find her suitable housing. The trick was making sure she got her injection of medication every two weeks so she stayed well enough to maintain that housing. The only way our nurse could guarantee to see her every two weeks was to bring her a coffee and a pack of cigarettes. Now surely this was cheaper than paying for her to be in a shelter, hospital, or detox clinic all the time? Surely this helped her to live a better quality of life!

I really wish some people would take the time to look at the whole picture.

Family Dynamics

So last week I received a referral from one of the hospital social workers for a new client. I called the social worker, because sometimes the client is still in the hospital, and we can meet them there. It tends to really increase our chances of a successful follow up.

This client had already been discharged, but the social worker gave me some additional background and his impressions of the client (patient in his case, I guess). He tells me that this client was recently diagnosed with schizophrenia. He’s a truck driver, lives alone, his family is all in the US, but they are very supportive.
His father is a psychiatrist. His sister is a doctor. The other sister is a social worker. His brother is a development worker.

And I can’t help but wonder how the onset of a serious mental illness would play out in the family dynamics. Is it more frustrating than usual for the family to feel like they can’t help him? More importantly, how will this affect the client? Will he feel that understanding and support from his family, or perhaps like a failure and an outcast?

I know that it is not unusual for families to be challenged or seriously disrupted by something like schizophrenia. Feelings of failure and disappointment crop up on both sides of the equation.

I know that most of us have someone in our network of friends/family/acquaintances who has a mental illness. I have people close to me who live with/have survived eating disorders, alcoholism, SAD and more.

This case just struck me as particularly potent.

Clients without phones...

...make for a lot of work.

WHERE ARE YOU??!?!?

Dear Random Social Worker,

Thank you for referring your client to us. We would have called you back sooner, but we have only just received the referral form. We likely would have responded more quickly if you had faxed or emailed it as indicated on the top of the form. Instead, you left it sitting out on a desk in our rural office, you know, the one that is only staffed part time, and is shared with another community group? I’m sure your client’s information is safe though since you had the forethought to fold the paper in half. And I guess you couldn’t have known that our staff who works in that office was on vacation for two weeks, so again, our apologies.

Now, I realize that you must be a very busy woman (aren’t we all!) but if it’s not too much trouble, maybe you could take the extra couple of seconds to write in your complete phone number? A bit of information about the client would be helpful too – maybe more than “needs support – monthly visits”.

Oh, and by the way – Primary diagnosis: schizophrenia/bipolar. Well, which is it? I guess the client may have both (poor thing) but then I’m guessing one of those is the secondary diagnosis, and it’s just a little hard to tell which considering how you’ve squished it all into the one little box there.

Well, I hear from your outgoing message that you are out of the office for the next three days (how nice for you!) so I guess I’ll call you back next week.

Ta-ta for now!

Pills

I've just decided.

My main hope goal in life: to never have a med list as long as those of some of my clients.

Yikes.

Get that "deep cleaning tingle!"

This was something I had never seen before.

I showed up the other day to see a client for a home visit and to drop off his medications which I pick up for him once a month. He’s an older guy with schizophrenia, who is also extremely obese. For the past year we’ve been working a lot on housekeeping and personal hygiene, both of which he has trouble looking after and issues which could put his housing at risk (there have been complaints to the building manager several times because of severe malodour).

We’ve had some great success of late. He has budgeted and scheduled for a cleaner to come once every two weeks and clean his apartment. He also got some help to install an air conditioning unit, which has really improved a space that I once had to leave in order to not pass out from the heat and smells.

So, back to the original point of this story – I show up the other day and he’s got blood all over his legs, from the knees down. I asked him what happened, and he says casually that his legs were itchy.

What?!?

I needed some more explanation.

Apparently, he had soaked his feet for upwards of two hours in a chemical household cleaning solution in an effort to get them clean. He said that he stopped, and realized this was maybe not the best idea when his feet and legs started ITCHING and BURNING. “The cleaning lady wears gloves when she uses that stuff” he knowingly informed me.

O. M. G.

He seemed very non plussed by the whole thing, but then, that’s how he is with most every thing. I pleaded with him to wash his legs with some cool, clean water once I left, and asked him to please call his doctor or get some medical attention if the itching or burning came back.

Maybe I should have offered to get him a proper pedicure kit for next time. Although it might be a little sore to use a pumice stone for while yet...

Lazy, Hazy, Crazy Days of Summer

Okay, okay, so I know I’ve been a little neglectful of my little blog here lately (I can hear all 4 people who read it collectively nodding their heads) but I have good reason!

1) It’s summer, so I’m outside doing stuff
2) It’s summer, so it’s hot and I have less energy
3) And this is the real kicker – my home laptop crashed and has yet to be suitably replaced.

I haven’t even had time to keep up with reading all the blogs I follow, which is saying a lot because it is usually a highlight of my day.

I promised some way back that I would follow up with a book review of Voluntary Madness, and I will get to it. I also want to get back to talking more about the work at hand, as I’ve been recently distracted by certain international photo-ops and spectacles – although I can’t promise it won’t happen again.

For now, I’m wimping out and posting this list that made the rounds of Facebook recently and was emailed to me by a co-worker. Even if you’ve read it before, it may be good for laugh, and isn’t laughter really the best medicine?

Onward! -->

You know you’re a social worker when…

1) You think $40,000 a year is “really making it”.

2) You don’t really know what it’s like to work with men.

3) You know all the latest lingo for drugs, where to get them, and how much they cost.

4) You’ve started a sentence with “So what I hear you saying is…”

5) You’ve had two or more jobs at one time just to pay the bills.

6) You tell people what you do and they say “that’s so noble”.

7) You have had to explain to people that not all social workers take away kids.

8) You use the words ‘validate’, ‘appropriate’ and ‘intervention’ daily.

9) You spend more than half your day documenting and doing paperwork.

10) You think nothing of discussing child abuse over dinner.

11) People have said to you “I don’t know how you do what you do”.

12) You’ve never been on a business trip or had an expense account.

13) You know a lot of other social workers who have left the profession for another.

14) You’re very familiar with the concept of entitlement.

15) Staying at a job for two years is ‘a long time’.

16) Your phone number is unlisted for good reason.

17) Your professional newsletters always have articles about raising salaries…but you still haven’t seen it.

18) You’re very familiar with the term ‘budget cut’.

19) You can’t imagine working at a bank or crunching numbers all day.

20) You’ve had client who liked you just a little too much.

21) Having lunch is a luxury some days.

22) You’ve been cursed at or threatened…and it doesn’t bother you.

23) Your job orientation has included self defense.

24) You have the best stories at any cocktail party.

25) Your parents don’t know half of the stuff that you’ve dealt with at your job.

26) You know all the excuses client use for a failed drug test by heart.

27) People think it’s a compliment if they mistake you for a psychologist.

28) It’s a common occurrence to walk through metal detectors.

29) You’re thankful that you have a license without having to go to school for umpteen years like a psychologist*

30) You work odd hours and wonder why others can’t also be as flexible, or why we have to be the only ones who work strange hours.

31) Despite the poor reputation of a social worker you job has you interacting with those in higher authority positions (lawyers, doctors, judges, government representatives, superintendants, directors, etc)…and they come looking for you in a panic when they need you…

32) You can make just about anything a client does into a ‘strength’.

33) You laugh at things “normal” people would be shocked by.

34) You constantly struggle with the work/life balance.

35) You find it hard to get babysitters as you don’t trust anyone with your children.

36) You’re exhausted but you keep smiling!!

37) Hearing the worst news stories does not shock you in the least bit.

38) You think nothing of saying the words vagina, penis, or anus in a daily conversation.

39) You assess your date (in your head) while out on a date just to see if they meet criteria for any DSM IV diagnosis.

40) Your mother tells people you’re a psychiatrist or a psychologist. For the umpteenth time, I’m a social worker.

41) Your significant other has learned that when someone greets you in public not to ask “who was that?”

42) You know the suicide crisis phone number, the food shelf and the community shelter phone numbers off the top of your head.

43) Your family/friends/acquaintances/co-workers will approach you with a “hypothetical problem” to help them with and you can’t charge them for your advice.

44) When people ask for your help, they expect you to have all the answers and solution to problems that do not even exist, immediately. We’re social workers, not magicians.

45) You know where to find ‘free’ anything (clothes, food, equipment, transportation) but you are not eligible for any of them yourself.

46) You are considered an “expert” in financial assistance for your low-income clients but you can’t keep your own cheque book balanced.

47) You have a file or a list posted in your office on “Stress Reducing Techniques.”

48) After a long week of solving other people’s problems, you recognize that you haven’t dealt with your own at home.

49) You don’t know what “sick days” are and you call your vacation times “long mental health breaks” or “burnout prevention days”.

50) The clinical staff find the patient/family situation appalling and in urgent need of intervention and in your “social work” opinion, you don’t really think it’s all that bad. You’re pretty sure you’ve seen worse.

51) You love/loathe the idea of role-plays and know that they are not necessarily something kinky.

52) You’ve found yourself in a group situation with other social workers discussing a super deep topic, and someone says that they’re happy they were able to have the conversation with other people who “get it” and everyone immediately agrees.

53) You really do have the best gossip around, but have to make sure to remove any possibly identifying information first.

54) You really know how to enjoy a good bottle of wine!

*I'm assuming this was originated in the USA, as social workers are not 'licenced' where I live.