Wednesday, December 19, 2012

The Twelve Days of Christmas - Social Work Edition

Like absolutely everyone else, those of us in social work often find the days leading up to Christmas to be particularly hectic.  It can be a hard time of year for many of our clients, so they may need additional support.  There are many charitable goings-on that we may be involved in, and most of us hope to get a couple days off with our own families.

Here's a little ditty to give you an idea of what the holiday rush looks like for us.  Feel free to sing along!  (I'm not typing out the verses over and over, you all know how it goes!)

Twelve grocery gift cards

Eleven overdue assessments  

Ten client Christmas parties  

Nine home visits 

Eight food hamper deliveries  

Seven flu shot clinics    

Six church hall turkey dinners  

Five volunteers!!!!!    (we love our volunteers)

Four donated toy drives     

Three office potlucks  

Two emergency room visits    

And one last minute crisis call!


Monday, December 17, 2012

Mental Illness and Violence

Do we need more funding for mental health services in this world?  YES.

Does access to early identification and early intervention programs need to be improved?  YES.

Does having a mental illness mean a person will become violent?  NO.

Does a violent act necessarily indicate that the perpetrator had a mental illness?  NO.  

Does speculating in the media about a person's mental health help anything?  NO.  

All it does is create fear and increase the stigma around people with mental health issues.  This is the opposite of what needs to happen to get people help and care, and does nothing to protect victims of potential future incidents.

In the aftermath of the Sandy Hook Elementary School shooting, it will be important to try to unlock the motives of the perpetrator, and discuss how this tragedy may have been prevented.  This will be an important part of the healing process for that community.  But since the gunman is gone, we will never really know the answers.  I hope that all this focus on the availability of mental health services might result in some positive actions.  But as with the lag in changes to gun control despite many mass killings in North America in the past few years, I have sincere doubts that this will happen.

What do you think about the assumptions and discussions about mental health in the news right now?

Wednesday, December 12, 2012

Hierarchy of Care

Yesterday I took a client to a doctors appointment.  We arrived about 5 minutes before the appointment time, but as with most doctors this one was running late.  No biggie.  After being there about 25 minutes, we and one other gentleman are the last in the waiting room.  The doc calls the other guy in and tells us "there will be no more waiting, I am missing my lunch hour".  I told him I couldn't continue to wait over his lunch time, so he let the other guy hanging out to dry and took us instead.

I told him I appreciated him seeing my client first, and he told me that next time we should not expect our appointment to be on time.  I told him I was okay with waiting 20 minutes or so and try to account for this in my scheduling, but I have other appointments to get to as well.  So he said that when I am bringing a client to see him I should not book any appointments for the rest of the day.  Because he might have to fit in patients who are suicidal, or in crisis.  WHAT DOES HE THINK I DO ALL DAY????!?!?!!?

I get that doctors are busy.  Their job is important, and I have certainly been appreciative when they will rearrange their schedule to see one of my clients who is in crisis or suicidal or whatever.  But why is his schedule so much more important than mine so that he can tell me how to arrange my day, and how to do my job?  I have other people to see too!  And don't expect me to feel sorry that your lunch will be delayed when I had to eat a sandwich in my car while making the 40 kilometer trip to pick up this woman whom he will now see for 5 minutes.   I may have been more sympathetic if he hadn't been so rude about it.  An over-inflated sense of entitlement won't get you far with me.

Tuesday, November 20, 2012

Academic Envy

A couple of my work colleagues are back at school this year, doing an upgrading program for working professionals.

Just overhearing them in the office have academic type conversations about white privilege, gender disparity, and social norms is making me itch to go back to school.  Or just butt into their conversation ;)

Monday, November 5, 2012

Everybody Wants Something

(Overheard at work)

"I want the Zit Remedy to reform and do a duet with Drake."

If you get it, you get it.  Made me laugh anyway.

Thursday, November 1, 2012

I did it!

Today is November 1.  And I got all my October contacts entered!*  On time!  Aaaaand---I made my numbers for the month!  The last time these two things BOTH happened?  I have no idea.  But I can tell you that it's been a while.  So Imma celebrate and high five myself.

*yeah, so the notes that belong to those contacts haven't all been written and entered yet, but I'm working on it.  At least they'll get counted.  This will not spoil my celebration!

Friday, October 26, 2012

What Makes Me Happy

This is about a client I had when I first started this job. I may have reflected on this story before in my blog, so bear with me if it sounds familiar.

He had been in the system for years, and had previously been supported by a coworker who left for another job.  He was a young man with schizophrenia and developmental delays.  He lived with his family (who wanted the best for him) including his grandmother who brushed his teeth for him even though he could do it himself.  It is fair to say there was a lot of learned helplessness going on.  

I was a little more eager and a lot less experienced then.  This man was more ill than anyone I had worked with previously.  My normal tactics did not work.  We were down to real basics - getting him to remember who I was, and remember his appointments.  Our appointments consisted of me trying desperately to make some kind of conversation while he was more interested in watching soccer or getting me to take him out for pizza.  All the while granny is knitting in the background and making me hyper aware of my youth and inexperience.  

I don't remember what the incident was, but somehow he ended up in hospital.  The family and I worked with the doctors to get a med review and he was started on Clozapine.  While he was still admitted I advocated to get him in with our ACTT program (Assertive  Community Treatment team - a more intensive level of support than what I provide) and he was accepted, so I never really saw him after his discharge from hospital.

Until one day I was in the waiting area of a psychiatrists office with another client.  I recognized this man's sister and then he came out from his appointment.  He looked me straight in the eye and said "Hi Nectarine" and then proceeded on his way.  

That was it.  But it was so much!  This person, who had met me at the door with a blank face week after week, giggled when he couldn't remember my name for months over a year prior at this time had said HI and addressed me by name!  He now attends one of our drop in programs and I see him over there from time to time.  Every time this same thing happens.  He says hello to me the same way, and then walks away.  It's all I'm likely to get, but it's so much.  It makes my day every time.  

Will this client continue to recover?  Probably.  Will he recover to a level that other people find "normal"?  Probably not, but to me, all the work he and his supports have done is so worth it to bring this human being out of the bubble his illness and medications had put him in.  I'm grateful to have been a small part of it.

Monday, October 15, 2012

Me Days

If you work in mental health services like me, or other health care settings, or hell - any job at all, does your employer offer mental health days?

Mine does.  They used to be classified as "mental health days" and now are part of our "personal days" which includes our sick days as well.

I've always thought this is a really great benefit, and makes sense since a mental health focused agency should understand that we all benefit from staff being in good mental shape.

Somehow I stopped to think about this today and realized that in my five years working here I have taken two - just 2! - mental health days.  Once was when we learned we were loosing our child care provider.  I was in a panic and needed time to focus on finding a new one.  The second was when my partner had been away for about a month on a job and had a really miserable time.  I wanted to be there for him when he got home.

So why?  Why if I value this benefit so much do I not take advantage of it?  There is guilt involved for sure.  And the dread of having more worked piled up when I return.  Plus the time consuming factor of having to rebook appointments.  Worry that I won't make my "numbers" that month if I miss a day.

I think I just like to know they are there.  That I have the option to take some me time without having to lie about being sick or something.  Maybe I'm just waiting for a really good reason to take a day.  What would that reason have to be?  I likely won't know until it hits me.

Friday, October 12, 2012

The Big Barn in the Sky

For some reason I remembered this story the other day and thought I should share.

This was a couple years ago when I was in an intake worker role.  A young woman had been referred to us who at the time was staying in temporary crisis housing for people with dual diagnosis (in Canada that refers to mental health and developmental disability).  Usually we would do intakes at our office but since she had no transportation, was not familiar with the area where she was housed and was in a pretty dire situation we agreed to meet her at the place she was staying.  Since this was an off-site visit with a client we'd never met before, and since we were curious about the program supporting her (hadn't dealt with them before) my intake partner and I decided we would both go to meet her.

This young woman had been through a lot.  Most notably, her mother had died recently and that among  other things ended her up in the crisis housing.  She had no other family, but did have close friends who were now her guardians and she would be moving in with them soon.  Despite everything she'd been through and her DD, she was engaging, optimistic and had a sense of humour throughout the interview.  We got all the information we needed, told her about our program and let her know we would be in touch.

Once outside, I commented to my partner that I was impressed  and pleasantly surprised at how together and well this young woman had seemed.  She looked at me with utter confusion and said "What?!  She was either psychotic or her cognition is lower than we thought.  All that talk about how her mother "bought the farm"?  I don't think she understands that her mother DIED, I'm really worried about her!  She thinks her mother is on a farm somewhere!"

At which point I burst out laughing and had to explain the euphemism.  It was a cute moment.

Tuesday, October 9, 2012

Unlikely Sources

I like to follow a lot of blogs.  Over the past couple years, this has become my favourite way to keep up with the world.  While some are fellow social work and mental health types, I also cover a lot of my other interests - feminism, crafts, food, stuff.

Lately I've noticed an interesting trend - proof that mental health affects us ALL.  A number of my favourite bloggers have been posting about anxiety, developmental disorders, depression and the like.  I love reading these posts and commend those who have decided to share their struggles with the blogosphere - it's a big world out there and breaking the culture of silence around mental illness can be scary.

Here are some examples:
Jen over at Epbot blogs about her experience with anxiety disorder
Gail VazOxlade, usually in the business of giving financial advice is sharing chapters of her book A Mind of My Own about raising her son who has autism
Alycia at the Curious Pug posts about using crochet to help keep depression at bay
Caitlin of Fit and Feminist discusses (in this post and others) her experiences with drug addiction, disordered eating, and being an abuse survivor.

Have you  found insightful or inspirational posts such as these in unexpected places?  Do share!

Tuesday, October 2, 2012

With Grateful Thanks

So.  I've been a little blase about posting lately.  I think this is because I've hit the doldrums again, struggling to feel motivated in my job and wishing I were (working) somewhere else.  The thing is, I'm here for now so I need to make the best of it.  With Canadian Thanksgiving coming up this weekend I've decided to think of all the things I am grateful for about my work.

  • I have a job.  And compared to other social service sector agencies, mine pays decently well
  • lots of vacation time - I've been working here 5 years and now get 5 weeks vacation
  • Experience - I have the opportunity to work with a great diversity of clients
  • the environment here is by and large supportive and positive
  • I have the ability to set my own schedule much of the time (within bounds)
  • I have a lot of freedom to decide how to work with my clients
  • most of the buildings my client's live in have working elevators
  • I like my manager and supervisor
  • I'm provided with lots of opportunities for training
  • the agency has taken up a "recovery" based philosophy

What are you grateful for in your work?

Friday, September 28, 2012

But not much

Me: (asking about psychotic symptoms when filling out a client-directed assessment form)
Client: Sometimes I know things nobody else knows.  Just put down "a little bit psychic".  

Wednesday, August 22, 2012


What is a tactful way to record that a client repeatedly fell asleep during an appointment?  Poor person fell asleep while I had her at the psychiatrist, slept while I drove her home and fell asleep on her feet while I was speaking to her mother afterward!

Monday, July 30, 2012

Taking the Long View

I remember when I interviewed for my current job and was asked how I would handle transitioning to providing “long-term supports” - I was already working for this agency doing short term and crisis response work.  The director who was interviewing me stressed how challenging it can be for both worker and client to maintain hope, focus and direction over a long time.  I hadn’t really thought about it before, but must have come up with a reasonable answer, since here I am as a long term case manager.

I’ve now been in this role three, almost four years.  Some of my clients have been with me as long.  One of my very first clients has had problems with her housing situation since before I began working with her.  She also had mental health and physical health problems, family and financial issues amongst other challenges.  Basically, we both realized that until she had more suitable housing, it would be difficult to focus on her recovery, and I could basically only help her to “get by” in all the other areas mentioned.  Right from the get go I got heavily involved in working to address the housing problem.  There were family members, multiple agencies and her own issues to consider in this work.  What she needed was a first floor apartment (safety and accessibility issues) with three bedrooms (two kids of disparate ages and genders) in a particular area of town (so one child could attend a special needs school) with no carpet (severe allergy problems) and that would be eligible for the rent subsidy she receives (landlord would have to agree to work with that program, program would have to approve it and have the funds for it).  Like finding decent housing isn’t hard enough!
I won’t go into detail about all the ups and downs in this process over the past few years.  I will just say that a couple weeks ago, I got a call from a staff member at the housing agency.  I could hear excitement in her voice as she told me that she was looking at an apartment that she thought would fit all my client’s needs and criteria.  She could arrange a viewing in a couple days. 
The client came, kids in tow and looked around.  She couldn’t have been in the place more than 3 minutes.  It wasn’t going to work she said.  Why, I asked, as it had everything she wanted.  Did she want to take the kids to the park so we could sit and talk about it?  No, she wanted to catch the next bus, everyone was hot and she wanted to get home.

That was Friday, and on the Monday I met with her.  It went back and forth, she could see the advantage of the place, but there were certain problems…could she view it again?  I made the call and set this up.  My hopes were high, because I hadn’t even expected this much.  This time she came alone, left the kids at home.  Took a little more time looking around.  In my head I’m making plans about how to apply for grants to help cover the moving expenses, when I’m going to fit in an appointment to take her to get the key…the housing worker tells her she will need to know by the end of the day if she will take it.  I will call her in a couple hours to see what she has decided. 

When I do, she’s not ready.  Can I call later?  Of course I can.  This happens a couple times, until finally I tell her I can’t wait any longer and give her the housing worker’s number and tell her she will have to call directly.  I try to put it out of my mind as I go home that night.
Come the next morning, there are no messages for me.  It’s not until halfway through the day that the housing worker calls me to say that she will need a signed letter of refusal from the client, because she didn’t take the place.  The reason she ultimately gave was that the bedroom furniture wouldn’t fit.

I spent plenty of time that afternoon debriefing about this situation with my supervisor.  It’s times like these that it is difficult to remind myself of all those social work-y truisms – about client directed service, and individual right to determination and all that.  I will still be there to support this client either way, but I have to say I was mad.  As much as I can rationalize about her reasons, and empathize because of her history, I was mad.  Four years of work, for what?  I gave this woman my best and felt like it was totally disregarded that day. 

I know it’s not about me.  But this was one of those situations where BECAUSE I care, I couldn’t just forget about it.  It’s hard to think about possibly several more years of working with this client after this has happened.  This is where the long-term gets really tough.  This is where I start to feel tired and stuck.

The fact is, that what I need in order to keep going here are the same messages we use when talking about recovery.  Patience...hope...a willingness to fail in order to learn.  Finding the small successes that mark our progress.  Letting go of the things we cannot change.  Moving forward, because you can’t go back.  This is what will get me through the next four years of trying and trying again.  I can only hope that I will be able to inspire the same in my client.  After all, she is the one who must continue to live in her current situation.  And ultimately, she will be the one who determines when and how it changes.  Maybe I will even be there to cheer her on.

Friday, July 20, 2012

Newsflash: Stubborn Man Defies Death

What do you get when you forget your insulin daily, and subsist on a diet of cookies and Ensure?  A blood glucose level of 55!  Along with a panicked call from your doctor telling you to go to the hospital RIGHT. NOW.

But do you go to the hospital?  No, of course not.  Because nobody is going to tell YOU what to do.


Wednesday, July 11, 2012

Back to the Usual

So I'm back this week from some stay-at-home summer holiday.

Everything on Monday was running smoothly and over all it was a nice welcome back to work.  By the afternoon I was marveling at how calm I felt and I wondered how I'd ever let myself get so stressed about work!

So it's near the end of the day and I had pulled over on a quiet street in a shady spot to make a couple quick notes.  Just then, I hear a giant "THUD" and feel the car move like something heavy just got thrown at my passenger side window!  I turned my head quickly and saw a black blur near the bottom of the window before it disappeared.  Thoughts ran through my head - did some kid just whack into my car on their bike/skateboard/wheeled apparatus?  Was someone so upset about me parking in front of their property that they threw something at me?  Did a tree branch fall?

I stretched up and peered  over the (half opened) window to see the biggest, dirtiest black cat I have ever seen.  Scraggly would be an understatement, and you guys - he had a RED eye!  *shudder*

Needless to say it was the creepiest, meanest looking cat I've ever seen.

So, did he jump at me?  Fall out of the tree?  Was he TRYING TO GET IN THE CAR?  I closed the window slowly until he finally sauntered away.


Tuesday, June 26, 2012

That's what She said

Me: So how does your ex-wife feel about this change?

Client: Oh, she's okay.  She's come to terminologies with it.

Monday, June 25, 2012

Check it out

If you haven't seen it yet, go on over and read this post by SocialJerk about ethics and working in the social work field.  I couldn't have said it better myself.

Monday, June 11, 2012

You know it's bad when... are writing case notes and keep thinking you have put information from the wrong appointment because you're pretty sure this stuff just happened yesterday.  Which it did, because for once you are up to date on your notes.  And it feels so wrong!

Friday, June 8, 2012


Double whammy at the hospital today.  Two of my clients are there, and there is a case conference for one today, so I'm going to try to visit the other afterwards.

In one case, the client was doing so well and getting a lot of things going on in his life.  So many things in fact, that I believe he stressed himself out to the point of triggering a psychotic episode.

In the other case, the client has been unwell for a while, but this is the first hospitalization required in over 10 years.  Sigh...

At least both have been moved out of intensive and onto the general psych unit.

Monday, June 4, 2012

The Greatest Day

Client quote of the day for sure:

Client: It's the greatest day of my life!  I can't hear anything anymore!
Me: What? You can't hear?
Client: I can't hear the voices anymore, they're gone!

Friday, May 18, 2012

Review: Here At Home

I've recently been made aware of a really cool project by the National Film Board of Canada (NFB).  Filmmakers decided to follow the At Home project, a four year study funded by the Government of Canada to learn about the effectiveness of a "housing first" approach compared to traditional programs and supports in place to address homelessness.

I have written about some housing first strategies before.  It's a model that I strongly believe in.  The basic premise is that by providing people with an affordable place to live (by subsidizing the rent) and bringing supports to them, individuals are more likely to recover from mental illness and addiction, and be less of a drain on expensive services such as hospitals and homeless shelters.

The Here At Home film project starts as a website that shows you a map of the cities where the study is being conducted and provides stats about homelessness.  When you click on a city, there will be an associated video you can watch.   When one video finishes, it will direct you to the next one.  Videos chronicle  the stories of study participants including tenants, support workers, and people in the traditional stream of homeless services.

These people are extremely familiar to me, but may not be to most Canadians.  I work in a supportive housing program (not one involved in this study) and the stories in the videos show a good reflection of the people and issues I see every day.  The filmmakers have not glossed over anything, and I think they have done a good job of showing the successes and the service gaps, the happy stories and the sad.

The best part is that this project isn't over.  The study will be completed in March 2013.  More videos are being posted in real time as the study continues.  The website also features a blog about the project, a timeline of Housing First in Canada and information about the study.  The site is interactive and engaging.  If you have a chance, I strongly encourage everyone to check it out.  I will be following along for the next year or so, and eagerly await the report when the study is completed.

Canada is the only G8 nation without a National Housing Strategy.

Thursday, May 17, 2012

What it's worth, will it work?

Sometimes (often) we feel we just can't do as much as we'd like for clients.

One client of mine was facing particularly difficult financial straits this month for reasons outside of her control.  I offered to provide some grocery gift cards to help bridge the gap.  I was only able to get a $25 card, and felt a little sheepish giving it to her - I mean, you have a $0 bank account balance and need to eat for a whole month - how far is $25 bucks gonna go?  When we met again she told me she really appreciated my help and the card.  The day she went to the grocery store with it they had a "dollar sale".  How perfect!

Sometimes we worry that the situations our clients are facing are too difficult, and we worry about the barriers they face.

I helped this same client make a call for emergency rent bank help.  We were both surprised to find out how long it would take to complete the assessment and get help approved and processed.  She let them know the homeless deadline she was facing and they actually called her back really quickly.  She got in for an interview and to receive her money.  She called me several times that day distraught because it was a very dehumanizing experience for her.  But she got the money.  Got it to the landlord and secured new housing.

The next day the workers who called her back so quickly and processed her request went on strike.  If someone had not deigned to give her priority, what would have happened?  Sometimes when we think we face the impossible, the improbable happens.

When we work hard, sometimes it just might work out.

Monday, April 23, 2012

Enjoy the Silence

Some clients will talk your ear off.  The moment you pick up the phone or step in the door you learn to expect an onslaught of questions, queries, observations, gossip, laments and explanations.  It can be hard to get a word in edgewise.  We learn a lot about these clients thanks to their willingness to share (or over-share as the case may be).  As workers, we work over time to develop this verbosity into opportunities for meaningful and constructive conversations.

With other clients the opposite is true.  Getting a full sentence out of them may be like pulling teeth.  I have two such clients right now, each with a very different basis for their (relative) silence. 

One is a relatively new client to me.  She has a long history of schizophrenia and “non-responsiveness to treatment”.  Part of the problem is that her mother speaks for her.  So we try to meet outside the house.  Our meeting tend to go along the same lines every time.  I greet her, ask some general questions (what have you been doing this week?  Anything good on tv?  How do you like the weather? etc) , try to bring up items from previous meetings, ask about plans.  Sometimes there is a head nod in reply.  Sometimes a quiet one or two word answer, which may or may not be related to the question.  Sometimes a moment of silence followed by “sorry, what did you say?” 
I can see that she’s struggling.  She talks to the voices a lot more than she does to me.  Under her breath, so I can’t quite hear.  She pushes on her eyes, opens and closes them repeatedly without looking at me.  She puts her head up and down off the table.  She has a lot going on, and I do get the impression that she’s trying to be present for our conversation while all these other things are going on for her. 
Slowly it’s getting better.  She is maybe getting used to me, will ask me questions sometimes, will give me a few words more of response each time.  I’ve referred her to a new psychiatrist who I think (hope) might progress where the last one stalled.  I’m working with her family on letting her speak for herself.  We’ll see how it goes.

The other is a long-time client.  We’ve worked together about 3 years.  I’ve seen him through several ups and downs.  But the silence is a new thing.  It’s not even silence per se, but quietness.  I ask a question and he says something in response but the volume knob must be turned to 1 because I can’t hear.  I ask him to repeat himself and he may or may not.  Several times I’ve resorted to being blunt “I’d really like to talk to you, but I’m finding it hard to hear what you say.  Can you speak up?”  This goes nowhere.  When I can hear him, I’m not sure I understand the content.  It’s tangential, it’s rambling, the associations are loose, as they say. 

It’s an important skill in the toolbox for every good counsellor – being comfortable with silence.  We are often invading people’s private spaces, their homes, the personal lives with our assessments and surveys and mandatory home visits.  We discuss difficult and painful subject matters.  We inquire about things some clients never may have spoken aloud to another person.  Sometimes the reasons are unclear.

So what can I do in these situations?  Show up.  Keep talking.  Give them space.  Catch myself when I’m becoming frustrated.  I’ve got the luxury (ha!) of working in a long-term program, so hopefully I can give them as much time, space and talk as they need before we have to say we’re not getting any work done so discharge becomes necessary.

Any other ways you can think of to support a client who is having trouble communicating?  

Wednesday, April 18, 2012

Role Reversal

Confession time.

The past couple months haven’t been my best.  In truth, the February/March time of year are usually when I struggle most with how I feel.  So this year has been no exception.

When I get depressed I have trouble focusing, lack motivation, become short-tempered with people.  I get chest pains and headache and I want to sleep all the time.  Pretty standard fare.  I usually cope with this by taking vitamin d, getting exercise, going to bed on time and generally making sure I practice self-care. 

As you might suspect (or know from your own experience) being a mental health worker does not make me immune to these things or perfect at coping with them.  It also doesn’t make me necessarily receptive to help.  Hey, I’m the one who is supposed to be doing the helping, right?

That particular kind of thinking is ironically what seems to have helped get back on the upswing recently.  So far this year I had been feeling particularly low.  It was starting to cause a lot of stress for me and my family.  My partner, who has had to deal with much harder issues than me basically sat me down and had an “understanding” talk with me.  At first I felt resentful, in all honesty because what he was saying is usually what I tell him to do.  Who is he to tell me how to feel better?  And then I had my “a-ha” moment!  I shouldn’t be resenting him for telling me what I already know – I should be using what I already know.  I had been totally lacking in self-perspective and had my defenses up so high I didn’t want to hear my own good advice. 

I’m not saying any of this to pat myself on the back.  It’s more to record and reaffirm what worked for me, because sometimes I have to work to remember.  There are challenges to being on both the giving and receiving sides of help, especially if you are more used to one than the other. 

Have you ever been a helper who needed to accept help?  Have you been able to use your experiences of being helped to pass along to others?  Leave a note in the comments.

Monday, April 16, 2012

Mini-rant of the day

Why why WHY doesn't ODSP cover more dental expenses?

My client has three teeth left.  THREE.  We found a clinic that will waive their fee for extraction, but dentures have to be made elsewhere and would cost him about $500 each (upper and lower).

I guess it's not "emergency dental care" but does this ensure an acceptable standard of living?  From what I understand some outside agency determines eligibility for dentures.  Crap, now I have to get on the phone and figure out if he can appeal or something.  I probably should have known this too, before I got his hopes up that he could get some teeth.

Bleg.  /endRant

Wednesday, April 11, 2012

Sweet, sweet fundraising

The agency I work for is a non-profit.  This means that we run off of government funding, grants, donations and the like.  This is generally okay with me.  Although I like getting paid, I don’t like making money off of people.  Way back when I was a student, I had a retail job.  I was generally an excellent employee (obviously), except my numbers sucked because I just wasn’t comfortable pushing people to spend money.  Anyway, this is getting off track.

The point is – DONATIONS.  They are great.  Altruism is a wonderful thing.  People give money so we can keep our doors open helping others.  In my personal life I donate to a number of worthy causes as much as I feel I can.

One thing that happens a lot where I work bugs me however.  Internal fundraising.  The United Way drive (since we have programs funded by them), the loose change collections to fund an upcoming special event, the membership drives for which you pay an annual fee, collecting contributions for the silent auction, the cookie dough sales, whatever.  More so than when I worked at other places, it seems almost every month there is a new way they are looking for money.  Isn’t it enough that I work for you people for a pittance?* 

I may have ranted about this to co-workers before.  I may have complained about it a bit at team meetings. 

But then.  This afternoon I am sitting at my desk trying not to let my mind wander as I catch up on notes, but it’s happening – that infamous 3:00 wall.  I’m so hungry I can’t even think.  What to do?  Search my lunch bag and eat the half a stale granola bar that is left in there for some reason.  Not cutting it.  Search my desk drawers, come up with an old pack of soup crackers.  Not cutting it.  Until like magic, she appears! 

“hey Nectarine!  Team SuperAmazing is having a bake sale for the upcoming (enter name of agency fund-raising event).  We have chocolate chip cookies, brownies, lemon…”

Stop.  You had me at chocolate chip!  And there was free lemonade to boot!  Internal fundraising, me and my tummy thank you.  I have never been so happy to contribute.

*it’s not actually a pittance, I am grateful for the income I have.  But it’s not exactly big bucks either

Tuesday, April 10, 2012

Mug Shot Memories

So we have to have ID badges for work now.  I had my picture taken a while ago, at a moment when I was rather unprepared.

The badge showed up today.  I look totally stoned* in the picture.

It's better than one I had for a job many years ago.  At  the time I had dyed my hair blonde and happened to be wearing a light coloured shirt.  This is where I should mention too that my skin tends to be paper-white.

The pic was taken in front of a white wall with a very flash-y camera.  I looked like a glowing yellow light instead of a person.  There was sort of a halo with eyes in the middle!

*I wasn't.

Friday, March 30, 2012

Fiscal, Financial, Federal...there's probably one more "F" word I could add here...

Any one else feeling the end-of-fiscal-year crunch right about now?  I haven't posted much of late as I've had some time spent in all day trainings at I'm also trying to get all my notes, stats, logs and whatnot done in time for the end of fiscal.

Money pressures are everywhere at the moment.  When our final numbers are tallied soon, we'll find out if we (my program at work) made quota in order to maintain our current funding.

My taxes are all prepared, but I have yet to take that depressing step of actually submitting them (we owe this year due to my partners self-employment income).

And the big one of course is that both the Ontario and Federal budgets came down this week.  Like a hammer, each one.  I'm hoping to get a better look at them in the days to come.

Once I've done all this, I'm also going to go roll all my pennies to deposit in the bank before stores won't take them any more.  My old peanut butter jar is going to seem so empty from now on...*

*for those of you out of the loop, one of the federal budget items everyone is talking about is that the Conservative government has announced the end of the 1 cent coin in Canada.  No more "take a penny, leave a penny" in the Great White North.

Friday, March 23, 2012

Things to Come

Meeting with a long time client yesterday, she asked me if I was leaving.  No, what gave you that idea?  She said that just before her last worker left (there was a transition in the agency) she had a dream predicting it.  Apparently she had a dream that I was now going somewhere else too.  Could this be a sign that my never-ending job search may soon produce an opportunity?  Hmm....

I'm also looking forward to seeing what the Mental Health Commision of Canada comes up with for it's mental health strategy.  The MHCC has a new chair whose vision for a Partners for Mental Health Coalition sounds interesting.  Currently, Canada is the only G-8 country without a national mental health strategy.

Tuesday, March 20, 2012

Number Crunch

I had 67 appointments scheduled with clients in the month of February.

48 of them actually took place.

2 sick days for me, several clients with cold or flu.  1 who cancelled for work.  1 who cancelled due to intoxication.  A few who just didn't show up for reasons unknown.

50 is our minimum target for face to face contacts each month.

Monday, March 12, 2012

Don't Tell

My 8 year old's understanding of confidentiality: "Clients are people who are secret"

Now why can't we just write that on the forms and get people to sign it?  Hmm???

Friday, March 2, 2012

The Mental Health Worker’s Reminders to Herself

1. When my supervisor assigns me a new client she is not trying to sabotage me. She is trying to get me to do my job.

2. When a client repeatedly cancels/misses appointments, there is likely something making it hard for them to come. It’s nothing against me.

3. When it is something against me, this is okay too. Not everybody has to like me. I will not be the best match for everyone. Learn from it.

4. Doctors are people too. They are likely rolling their eyes right back at me.

5. A client’s goals for themselves need to come before my goals for them.

6. When clients are skeptical because “you look too young to help me” remember – you’re a lot less young than when they were saying this to you 5 years ago!

7. Caring for myself will help me to care for others.

8. People will come and go, but paperwork is forever.

9. It’s okay to drown your sorrows with pizza and a half bottle of Shiraz on Friday night.

Tell me Going Mental readers - what reminders do you need to keep yourself going?

Thursday, February 23, 2012

Venting x2


Twice in the past few days I have called the hospital Mental Health Outpatient Clinic to get an update on my client's waitlist status. 

Twice I have been informed that the client is not even on the list!  They have no record of a referral. 

In one case this client's doctor told him he made the referral in October.  In the other, the client told me her doctor referred her last summer!  This client is brand new to me, so we're off to a busy start.

The outpatient clinic has a four month wait list.  They both should have been seen by now.  Now I am trying to help each sort out what happened.


*I do not endorse this method of stress relief.  If you are feeling upset, talk to your counsellor.  If you don't have a counsellor, call your local mental health services you might get one in a year or two.
In the meantime just try not to throw anything at anybody.

Wednesday, February 15, 2012

What Inspires Recovery?

This post is a part of the Recovery 101 blog series. The series will explore ideas, philosophies, language, tools and questions about mental health recovery. Submit any ideas for topics in the comments section of any tagged post.

Stories of success in mental health recovery often include a moment of inspiration.  An action by a friend or family member, a life event, a misfortune or a random bit of information learned may act as a catalyst to change in an individual's life.  The stories I have heard often describe a change in the individual's thinking which promotes a drive or motivation to recover.  They reframe their thinking.  They gain hope or a positive outlook.  They create a goal for themselves. 

As workers or support figures we are often searching to find this source of inspiration for our clients or friends.  Doubtless mental illness suffers are seeking it for themselves too.

Last week saw Bell Let's Talk day get lots of attention.  I decided not to write about it at the time due to it being a corporate sponsored event, and I don't have much to say about Bell.  The next day however one of my clients talked about watching a TV interview with Let's Talk spokesperson Clara Hughes along with other famous sports figures talking about their experiences with mental illness (depression and PTSD were covered as far as I remember) and how they recovered.  This client himself suffers with depression.  He told me that watching the show made him feel even worse.  He said they each talked about how their spouse or partner helped them get through - he does not have a spouse, and when he did she was more cause for pain than support.  He said they talked about how despite their various successes (Olympic medals, major trophies and awards) they still suffered.  His take?  If he didn't even have these type of awards, how much worse off does that make him?

Not the intended effect of the program I'm sure.  What was meant to inspire in this case, really didn't help. 

On the other hand I have taken clients to hear recovery stories shared by those in their community and they have reported feeling hopeful in their own lives as a result.  One woman I worked with who has bipolar disorder described watching coverage of Charlie Sheen go off the rails as inspiration for her to get better because she "didn't want to end up like that guy".  There are stories of people going to their doctor, support worker, family member and hearing the same message every day until finally "click!" something registered that was their moment of inspiration.

The moment of inspiration does not result in life getting fixed over night.  Things may not look any different for a while.  But down the road, further along the recovery journey it's the moment that someone looks back on and says "that's when everything changed for me.  That's when I knew I could get better." 

It's the moment that makes all the difference.  Because we can be surrounded by the most well-meaning people in the world, all the praise and validation one could ask for.  But if we are suffering inside, true change will not come until we are open to it.  And the key to open the door may come in all kinds of strange and unpredictable forms.

Wednesday, February 8, 2012

Fingers Crossed (Toes Too)

I applied for a job yesterday. 

Truthfully, I do this all the time, but this is one job I think I'd actually like to get.  It looks great on paper, and seems to fit most of my job search criteria.  So I tried to make myself look good on paper, and sent off the ol'resume.  Well, acutally a new resume.  I tend to nit pick and rewrite obsessively when applying for any new posting. 

So now fingers are crossed that I will get an interview.  And that it will go better than the last one!

In the meantime, I'm trying to follow-through with the goals I set for myself at work this year and remain positive.  One day at a time, right?

Monday, February 6, 2012

Wurkd fer mee

A co-worker exclaiming over some (presumably) outrageous spelling errors:
I'm not hooked on phonics people, but come on!

Friday, February 3, 2012

Bag Lady*

Yesterday I arrived to work carrying:

1. My work bag - contains my binder with forms, notebook, business cards and comes with me to all meetings and client appointments

2. My purse - contains personal, non work stuff like wallet, lip balm and ear plugs (they have come in handy, trust me)

3. My laptop bag - I don't usually bring this outside the office, but sometimes it's neccessity

4. A grocery bag - containing my contribution to the team pot luck (broccoli slaw - it was good)

5. My lunch bag - because despite the put luck luncheon, I was on my own for second breakfast, elevensies and afternoon tea

6. A gift bag - containing a very *lovely* purfume a client had gifted to me.  I told her I couldn't accept it but I had another client who would really appreciate it, and after it sitting in my car for a week, and me inhaling the fumes I really needed to give it to her.

7. My giant tea thermos.

Oh, and I had my crackberry in my pocket.

I think I need one of those personal organization assistant people** to help me.  Or I just need to listen to my 8 year old and use a backpack already.

*this term always gets this song stuck in my head

**this is a thing, right? These people really exist???

Wednesday, January 25, 2012

Recovery Defined?

This post is a part of the Recovery 101 blog series. The series will explore ideas, philosophies, language, tools and questions about mental health recovery. Submit any ideas for topics in the comments section of any tagged post.

Somebody recently send me this link to an LA Times article from last month about a new definition for recovery. While not introducing any new concepts, it is newly agreed upon by the Substance Abuse and Mental Health Services Administration in the U.S. The definition is thus:

“A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”

I have to say I kind of like it. It’s open-ended as it doesn’t specify those who suffer from some particular ailment or circumstance, and it’s free of loaded language like “meaningful activity”. It refers to people, not clients/patients.

Here are some other definitions of recovery:

The ability to live well in the presence or absence of mental illness - or whatever the person chooses to term their experience (Mental Health Commission, NZ)

Recovery is the personal process that people with mental illness go through in gaining control, meaning and purpose in their lives... (CMHA Ontario)

The goal of recovery is to become the unique, awesome, never to be repeated human being that we are called to be (Pat Deegan)

Tuesday, January 17, 2012

First Contact

Meeting a new client for the first time can present many challenges.  Not least of these is figuring out WHO you are meeting.  I mean this literally - as I rarely see clients in the office, and won't go into their home until I know them a bit (and barring extenuating circumstances) I generally make these appointments in some kind of neutral, casual public place ie. coffee shop.  Such places generally have all kinds of people strolling in and out, so without any face recognition, it can be tricky to identify your client. 

I try to ask them for a bit of a physical description when we arrange the meeting.  I have learned that most people are not very good at giving this type of information.  Unless there is a really obvious feature like they use a wheelchair, or have 3-foot long dreads, most people describe themselves in pretty basic terms - I'm kinda short, I have dark hair...useful stuff.  I don't know if this is lack of self-awareness, or self-conciousness that prevents people from being more specific.

So I try to describe myself in order that they can find me.  I try to go with some specifics that won't easily confuse me with others - I have a nose ring, I carry a large purple bag, I wear a red scarf.  But many clients are nervous about a first meeting, and may not approach me.  To be sure some are the complete opposite, but I've had at least one woman sit in her car staring at me through the Tim Horton's window for almost half an hour before she could psych herself up to approach me (I'm really not that intimidating!). 

Then there's always the tried and true but slightly embarrasing method of "asking around"  - is your name Bob?  No?  Sorry to bother you.

I can't help but feel this gives people the impression that I'm there for some really lame mid-afternoon scuzzy-coffee shop blind date or something.

Some clients have cell phones and sometimes they even give me the number, so then I can try to call them.  Hopefully, their phone is turned on.  And hopefully it has minutes.  And hopefully they're not screening calls thus ignoring my "restricted number". 

Usually, we track each other down eventually.  Sometimes we don't.  When this happens it may mean days or weeks of trying to rebook and not miss each other again.  In my experience, when a client and I miss each other the first time, it's not been a good sign for things to come.  These have often turned out to be the clients who don't want to engage, or that I will end up chasing down just to get a few measly face-to-face contacts before they disappear completely. 

I have two new clients to meet this week.  Look for me, I'll be the anxious, jilted looking lady with purple bags under my eyes.

Friday, January 13, 2012

Friday the 13th resolutions*

So I realize I'm a little late to the game, but I've decided it's time to make some resolutions for 2012.  Not for my personal life which is practically perfect in every way (or not, whatever) but for my professional life. 

It actually makes more sense to do this now that on January 1st. 

On January 1st I was in full-blown vacation mode.  Driving along country roads gazing at the snow dusted fields, fresh from enjoying a cozy night with some friends in an old farm house.  Pleased with myself for downing enough water and eating half a loaf of olive bread to soak up the booze so I didn't feel too hung over.  Spending the rest of the day snuggling on the couch....ahem, what was I talking about again?  Oh yeah, resolutions. 

So anyway, things were rosy at New Years giving me no impetus to change.  By now I've been back to work for a week, and admittedly it's made me a bit of a grumpy bear (that's what AM would call me in his most mock-caring voice).  This attitude sucks.  For me, and everyone around me.  I'm sure this doesn't exlude my clients.  I care about them, I really do, and I don't like to feel that this doesn't come through in my work.

So I'm working on resolving this (ha, see what I did there?) or perhaps to put it in some more social-worky terms I'm trying to develop some strengths-based goals for myself.    In some cases I'm just renewing old goals.  Here's what I've got so far:

1. Practice positive thinking, not just for clients but for myself
2. Better self-care: always
3. Learn to say NO to things that will only drag me down (I really suck at this currently)
4. Keep up the job search, the right one WILL come along
5. Find creative ways to get involved at this job that will promote a better experience
6. Be thankful for what I have - be happy

They're not exactly SMART goals yet (10 points if you know what that is) but like I said, I'm working on it.

So what about you, any professional or personal resolutions this year?  

*I know there is some kind of joke about bad luck in here, it's just not coming to me.  TGIF

Tuesday, January 10, 2012

From a client assessment by one of my co-workers:

Roger is responsible for paying his phone bill independently.  He does this through online baking.

*yes, small things like typos amuse me.*