Imagine if...

I'm not on tumblr so couldn't reblog directly, but I found this via Geeky Therapist
From the original post:

This is the greatest thing I have ever seen. People do not understand that mental illnesses, such as depression, are actual chemical imbalances in your body. They are not brought on by choice. My dad was diagnosed with depression. He was so ashamed of it that he hid it from me and my brothers. A month later, he killed himself. The stigma that comes with mental illness made my Dad embarrassed to talk to his own kids about this problem because he felt like less of a man.

Erase the stigma. The more we talk about mental illness, the less likely it will end in suicide.

Pass it on.

Floating around on Facebook today...

Found at: Beatrice the Biologist

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?

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.

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!

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.

Mental Health Practitioner

A little funny for your Friday.


Mental Health Practitioner
by: tortuga713



*If you're having trouble viewing the video go here

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.

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.

GRRRRRR

*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.

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.

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)

Recovery 101 - Series Kick Off

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.



I’ve mentioned that when I started working in this field, I heard the word recovery tossed around a lot, but there didn’t seem to be any substance to it. I specifically remember being asked in my job interview about “recovery” – I think I said something about “believing that it is possible to get better” from a mental illness. The exchange was pretty vague on both sides.

I now think that part of the reason for this hazy understanding of recovery was precisely because it is so hard to pin down. Mental health recovery is different for each individual. But good community/social workers have always known that each patient/client/member has different needs and strengths, so there must be more to it than that.

From what I’ve learned so far:
-recovery is about living a full life (however you define it) not just getting by, coping, or managing
-it requires an individual to take responsibility for their own wellbeing
-a healthy, supportive, and empathetic environment makes so much difference
-it requires people to make choices for themselves. This may will include choices which lead to both successes and failures.
-the systems currently in place - hospitals, community mental health supports, families - although often well intentioned, may hinder as well as help
-recovery always involves HOPE.  This is probably the most key ingredient.

How do you define recovery?  What does it take?

What makes a Social Worker?

I have a confession to make: I am not a social worker.

That is, I don’t have a Bachelor of Social Work (BSW) or a Masters of Social Work (MSW). I’m not even a registered Social Service Worker, which is a two year diploma.

This does not stop my clients, or even friends and family from referring to me as a social worker.

I did go to school. One year of a Bachelor of Fine Arts (dropped out) and a diploma in Assaulted Women and Children’s Counselling and Advocacy (AWCCA). It’s an awkwardly titled and unique program, but I learned more there than in any other school I’ve attended my whole life. And it is in the Community Services department.

I believe in a recovery model of mental health work. Recovery is a word I’ve heard kicked around in mental health departments for a long time, but a lot of the time it seemed to be more of vague notion of an ideal rather than an actual working philosophy or model. It’s only been in the past year or so that I have really learned how the concept of recovery can be used to help clients and improve the work that I do.

I took to the recovery model very quickly, because it jives well with my feminist and anti-oppression perspective. These are things I learned in the good ol’ AWCCA, as well as my life experiences. 

Most of the time, I feel pretty well prepared to handle the work I do. I attribute this to my training, but also to my ‘lived experience’ - the things you don’t get out of a book. The recovery model values this highly. It emphasizes the importance of lived experience and in particular peer-support in doing mental health work.

Meanwhile, the social work sector seems to be headed for increased professionalization. I don’t really have numbers to back this up, but I have certainly noticed it from my constant perusing of job postings. More and more jobs are requiring BSW’s and even MSW’s for community work that has often been done by people like me. While I strongly believe that further education is a good thing, I do question whether this trend can be congruent with the recovery model.

I also would never want to disrespect or devalue the years of effort and hard work that others have put into their professional designations. Goodness knows I was proud when I graduated my program (with honours thankyouverymuch) but is completing a two or four or five year degree the only way to be a Social Worker?

More to come in a new blog series I am going to call Recovery 101.

Happy Hallowe'en!

As a mental health worker, I've gotta love a day that encourages EVERYONE to bring out their weird and different side!  Plus, I've always had a soft spot for anything dark and scary.  Stay safe everyone, and keep it spooky!

Who Are the People (with Mental Illness) In Your Neighbourhood?

Source: http://bit.ly/qASsuQ

There are a lot of stereotypes and assumptions out there about “who” mental illness sufferers are. No matter how many celebrities write books with “revelations” of suffering bipolar or PPD, or how many families contain at least one Crazy Aunt Mary many persist in believing that mental illness is the domain of the poor, stupid, homeless and criminal.

There is plenty of critical thinking and anti-oppression analysis we could do to figure out why people think this way (and why many with mental illness are vulnerable to becoming poor, homeless etc) but I haven’t the energy/time for that right now.

If any one needs proof that mental illness is something which affects people from all walks of life, they should spend just 5 minutes hanging around the local out-patient centre or treatment clinic.

I accompanied a client to his psychiatrist appointment today at Local Hospital out-patient clinic (I know! I said I’d never go there again, but reality bites). Someone who didn’t know him would see that he is a family man (his wife was with him) is middle aged, and might guess that he is an immigrant (English is his second language).

While we were there I spotted a familiar face that took me a second to place. A woman I recognized from my old neighbourhood - she spent a lot of time hanging around the back alley, lived (sometimes) in a nearby crack-house, and often stopped people to ask for change on the sidewalk. I used to try talking to her sometimes, but it was difficult because her tongue was always protruding (possibly a med side effect or a symptom) and she would usually walk away when I didn’t have any change to offer.

On the way out of the office I recognized a woman I know from my family’s church. She’s a white, upper middle class professional who goes to bible study with my mom. I have actually run into her once before in a psychiatrists office when there with another client. We nodded to acknowledge one another and she seemed happy to leave it at that. We did this once again, adding a smile, when encountering each other at the hospital.

In the span of that five minutes I came across people from a wide cross-section of my own life, and who covered a good range of social locations.  And I know it’s not just me.

Helloooo Nurse (is there anybody in there???)

Me (on the intercom/phone thingy outside Local Hospital Mental Health Unit) : Hi, I'm Nectarine from Community Mental Health. I called earlier and one of my clients is here. Could you buzz me in so I can see her?


Nurse: Uh, I'm sorry ma'am, visiting hours begin at 4:30.

Me: I only work until 4:30. I'm not here to visit.

Nurse: I'm sorry, we don't allow visitors until 4:30.

Me: I understand that.

Nurse: I can't let you in here.

Me: Can I speak to my client?!?

Nurse: Who did you say you were again?

Me: I'm her case manager. From Community Mental Health.

Nurse: Well, I guess I can let you in.



*the magic door finally opens to admit Nectarine, and she approaches the fishbowl impenetrable force field nursing station and waits patiently outside the plexiglass for about an hour 4 minutes before Nurse emerges.*



Nurse: Uh, can I help you?

Me: Can you direct me to my client Janey Sad?

Nurse (looking me up and down): Where's your ID badge?

Me: We don't have ID badges, I can show you my business card. This is not my first time here.

Nurse scans my business card.

Me: So can you show me where to find my client?

Nurse: Don't you know? I thought you said you'd been here before?

Me: Uh, yeah, many times to see different people. My client just got here, I don't know which room she's in.

Nurse: I guuueeess I can show you.



*Nectarine follows Nurse down the hall where she opens the door to a patient room*



Nurse: Yeah, this lady is so confused. She's naked, you can come in.

Me: I think I should let her get dressed first...

Nurse (to patient): Helloooo! This worker is here to see you. THIS LADY IS HERE TO SEE YOU. (to me) Come on in...

Me: Uh, are you sure this is my client? That doesn't sound like her.

Nurse: Who?

Me: Ms. Janey Sad.

Nurse: Ohhh, this is Janey Nothere. She's sooo confused.



*another staff member kindly interrupts*



Staff: Did you say you were looking for Janey Sad? She's right here in the activity room, I'll get her for you.



*Nectarine meets with Janey (Sad) who is relieved to see her. Nectarine then waits twice as long outside the fishbowl nursing station, loudly but politely saying "Excuse me" before someone finally buzzes her out the door. She decides right then and there that she will personally drive all clients to Nearby Hospital in future as she is swears she is never coming back to Local again.*

System Shock

The thing that never happens HAPPENED. The system saved the day!

Allow me to explain.

My client is on long-term disability from his job due to his mental illness. His wife works full-time at a fast food restaurant. They have had subsidized daycare for their 6 year old daughter for the past two years.

They received notice recently that their subsidy would end as of September, as their daughter will begin attending full day school. They asked me to call Children’s Services to advocate keeping the subsidy, as they can’t afford the full rates. Children’s Services explained to me that once a child is past the preschool age, and in full day school it is presumed that they do not require the same level of care, and the parent should be able to manage this. Apparently, this is policy. She said she had never heard of any exceptions being made. I kinda see their point, but have these people never heard of P.D. days? Winter and spring break? Summer vacation???? There are many days when the little one will not be in school.

My client is doing well in his recovery, but is not yet able to take care of his daughter by himself for extended periods. He has appointments with various therapists, doctors, clinics pretty much daily, and has difficulty staying awake for long periods of time and handling stressful situations.

So today, 3 days before they are to be cut off the Children’s Services worker calls me back. Apparently the department has just finished approving a new policy which states that approved disability leaves will continue to qualify for supports beyond preschool age, and this already applies to this family.

Hallelujah! We must have saved up some good karma or something. I was all set to do battle with the higher-ups if need be, but they pre-empted me! Any of you readers who work in or receive social services will know just how rare an event this is indeed.

Not bad for a Monday morning.

Lost in Translation

I subscribe to an online discussion forum for housing workers in my area. I often skim the discussion notices I get in my in-box, however the following caught my attention:


User 1: Hello, we are searching for a Ga-speaking mental health outreach worker for one of our Ghanaian tenants who is struggling with schizophrenia. We've contacted a number of MH service agencies and settlement service agencies, but have had no luck. Any contacts would be much appreciated.
thanks

User 2: you can try Multilingual Community Interrupter Service who would be able to support you!!!

User 3: I believe the spelling is Interpreter. An interrupter service would be the polar opposite of that provided by MCIS.

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…

Happy Summer Solstice!

One of my favourite days of the year! We Canadians tend to get particularly excited about the arrival of summer.  I try to convince as many clients as possible to meet me outside and sell them on the fact that the light exposure is good for their mental health.  Not to mention we should soak up some vitamin D when we get the chance!

Admittedly, the nice weather around here has kept me away from the computer and my dear little blog of late, but I haven't forgotten completely.  New posts on the horizon...
Hope you all get out today and enjoy some sunshine!