Sending out an SMS

I have been supporting a client for the past month and a half exclusively by text message.  Has anyone else done this sort of thing?  Usually we would discharge a client if we went more than 30 days or so without face to face contact, but in this case the client is at a high risk for suicide, so we wanted to try and stay connected any way we could.

And it seems to be paying off.  He finally consented yesterday to go to a hospital - not just any hospital mind you, but one hospital in particular, in the next city.  If we could send him in a taxi (not something we normally do) and if I could guarantee that they would admit him, and guarantee they would be "better" than the other hospitals in our area.  I told him no way I could do that, but I did get approval to send the taxi.

I'm glad I did.  The admitting psychiatrist actually called me this morning to get some history and let me know my client would be admitted.  This is unprecedented!  Last time I sent out the local Mobile Crisis team and they took him to our local hospital, they had discharged him before I even got back to work in the morning!  I know there are lots of reasons this may have happened, but it's still very frustrating and also compromised my therapeutic relationship with the client.  It's so rare that hospitals follow up with us in this way.  The psych even stated that he could see this client needs long term care more than a hospital stay, but was willing to admit him in hopes that we can facilitate that while he's in.

I love when things work out this way.  It remains to be seen of course what will come next with this client, but so far so good.  And after I worried that my texts were just floating in the abyss, probably not affecting him at all.  It's still not my favourite way to practice, but just goes to show any connection is better than no connection.

What a great start to my long weekend, happy summer everyone!

Top Fashion Prize

for the day goes to the client who came in wearing the bright yellow t-shirt that reads

I'M WELL ADJUSTED

x10 000 000 points!

Overheard clients in the hallway

I always go to my shrink, but I don't get any smaller!

I'm reading this now and realizing it's likely some lame old joke, but it's the first time I heard it, and it made me laugh.  Gotta love when people can laugh at themselves too.

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...

Mental Health *headdesk* Moments

How how HOW does a client who tried to kill himself TWICE this week and was brought in to hospital BY THE CRISIS TEAM, who found him intoxicated and holding a knife get discharged from emerg without ever getting admitted?!?!?

Five Minutes to Five

The time of day at which I put my phone to "Do Not Disturb".  Because no phone call at this time of day will last less than 5 minutes.  It's like, a law of nature or something.