b.i.d.

Me: Do you have any medical or physical health problems?
Client: None
Me: Do you take any medications?
Client: Oh yeah, Metformin, Adalat for my blood pressure, Clonazepam, and one for my cholesterol...

A New Record!

Eight out of eight intakes showed up this week!  True, we had to cancel one due to an interpreter failing to show, but this is still a record for me.

Anyone in social services is bound to know that client's not showing for scheduled appointments is one of the most long-standing problems in our work.  If we don't make our numbers, programs may lose funding or we may not get paid.  It also means delays in clients getting the help they may need.

What a great way to go into the weekend!

Olfactory Advice

One of the best pieces of advice I ever received from a professor when I was in college was totally unexpected.  When we were first year and learning about doing intakes, she cautioned us to be prepared for meeting people who smelled bad.

In our line of work we are often meeting people who have poor hygiene (for various reasons) or who are living in spaces that are not clean, and therefore smelling a lot less than  fresh.

It was a quick off-handed comment for the professor to make, but something I totally had not considered up until then.  I think it prepared me to handle some stinky situations with more grace than I may have otherwise, and certainly reminded me not to pass judgement on someone for their olfactory state.

Eight years later, if I had a dollar for every time I've written "malodour" in a note...

The Problem With a Waitlist

Image found at http://oldgoldandblack.com/?p=27171

Is when you call a client who has been on it for months, possibly a year or more and they have NO idea who you are or why you are calling them.  We do check in calls with people while they are waiting, but there is still so much confusion.

Amongst other issues.

New Year, New Job

...except it's my old job.  Yep, I'm going back to intake!

I'm looking  forward to seeing new faces on a regular basis.  Also, my case load will be shifting to short term supports instead of long term, so I will be leaving all of my current clients.  I'm not looking forward to that part so much.  Telling client's you are leaving them is never easy, and some of these folks I have worked with for 4+ years.

Wish me luck.

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.

No Problem...

A client I recently started working with had been on our service wait-list for nine months. With such a long wait for support, it’s not uncommon that peoples illness or situation becomes worse between intake and initial service. That wait can be a very difficult time for many.

Before this person came in, I read the intake report. He seemed to have a lot of bad stuff going on, so when he came to meet me, I was surprised to see a very calm, well put together guy. Still, appearances can be deceiving, and I wouldn’t know more until I talked to him.

Through our initial conversation it came out that he is back living with his family (had previously been transient) is working a full time job that he enjoys, spends time with friends and has not had any psychotic symptoms in months. He also stopped taking all of his medications, and stopped seeing his psychiatrist.

After he left, the intake worker who had seen him last summer asked who he was, as she didn’t even recognize him. She asked me what had happened, and I told her what he had said to me:

“I stopped taking drugs. Even though I didn’t want to, I figured things would probably get better, and they did.”

Go figure.

If only it were always so simple…

The Wait

I’m still building up my caseload since I finished my Intake job. While doing intake, I supported nine people. Since February, I’ve had my numbers go as high as 16, but they now rest back at 14. It seems like every second person who get assigned to me has disappeared, or doesn’t want to engage in service beyond 1-2 visits. I guess it shouldn’t be surprising considering in most cases they’ve been sitting on a waitlist for over a year.

I really didn’t think it would take this long. I guess neither did they.

I wish

Me: The waitlist for case management is about 6 months to one year.  I'll call you by next week to let you know if you've been placed on the waitlist.

M. Eager: So I start next week?

Jaded

Is this a hospital?

No, we’re a community agency.

Are you a doctor?

No, I’m not a doctor.

Hm, maybe I won’t hate this place after all…

Okay then.

What is your marital status?
*blank stare*
Have you ever been married?
(long pause) Maybe…maybe not.

Let it...

Hmm, first major snowfall of the year.  I'm gonna go out on a limb here and bet that my new intake is going to be a no-show.

So much work to do...

"My husband when he was alive would get violent. It was abusive. But it's okay - it's normal."

Queue Jumping

(winding up a lengthy intake assessment) …our program has a twelve month waiting list right now. I’m going to take your information to our intake committee, and I should be able to call you within the next week to let you know if you’ve been accepted.
Mr. Konfused: so I start next week?

*headdesk*

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!

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)

Bipolar Breakthrough

A little more about this intake from yesterday.

Despite all the crying, the appointment went well. This woman has a lot going on, including being diagnosed with bipolar and PTSD. She seemed to have great insight when describing what she feels is problematic in her life, discussing symptoms, and acknowledging that she feels ready to get help.

Which is why I was surprised when an hour and a half in she says “it’s like I get these real highs, and then I just go so low. Does that have something to do with bipolar?”

Uh, yeah, I say. That pretty much sums it up. We discuss this a little bit more, and she says “you know, now I know what bipolar is. I was diagnosed over a year ago, and I didn’t know what it was. I will remember this as the day I learned what it was all about!” (cue crying episode #47)

WHAT? How is it you go a whole year with this diagnosis, and no one tells you what the bloody word even means? She received this diagnosis from her psychiatrist whom she’s been seeing for about 14 years!

Granted, her psych is a dinosaur who has announced his retirement about 3 times, but has yet to actually leave the building.

Here is a woman with a)great insight b)no cognitive issues c)lots of support d)a willingness to work with the mental health care system. It’s not as though she lacks the capacity to understand. Is this something that only happens to psych patients?

Now I’M feeling drained!

I think the intake I just had beat the record for “number of times bursting into tears”. I wish I’d kept track so I could be sure.

Prediction

My intake is not gonna show. I'm calling it now.
She's scheduled for 2:00. Current time: 1:54.


Update as of 2:23: called it!