Whoa Mama

Thursday, April 07, 2011

Nothing cute about this

For two years I worked directly with people with serious mental illnesses. It was a meaningful, shaping, challenging and rewarding job. At the end of the day, it was a job. When I ultimately left to get my master degrees, I left believing that direct care work should be an experience everyone should have. I saw how people were stricken with mental illness and taken from happy, productive, loving lives, trapped in a cavern of paralyzing psychosis with voices or emotions driving your actions.

I once heard an accomplished professional with a PhD and schizophrenia talk about having to "go in for an oil change" every few years when her body chemistry or some less defined factor decreased the efficacy of her meds. That is to say, she started hearing voices again. She knew enough to self-monitor and typically was able to check herself into a psychiatric unit, most of which are locked by design for every one's safety. She recounted a story about how people's behavior changes by virtue of being locked up. She said she was waiting for an orderly to take her to an appointment on a different floor. She was waiting on a bench by herself when a wave of crisp lucidity came over her and she realized that she had her finger up her nose! "Now I know if you have to pick your nose, you do it in your car by yourself! Yet here I was seeped in the illness coupled with the anonymity of the hospital PICKING MY NOSE". Ultimately she again got herself balance and drove off to consulting jobs picking her nose in a better car than I've ever had.

She has stayed with me, her success with mental illness, the horrible challenges and injustice of life with mental illness. She is undoubtedly a success story. For every one like her, there are thousands whose illnesses are far to profound to ever hope to live with the freedom of driving a car and picking your nose. Yet you all know someone with a mental illness of some form. They probably mask it well and you likely don't know it. Sadly they may not know it either. Mental illness is far far far more prevalent than is commonly believed and it is NOT always violent. Some violent criminals may have mental illnesses, but a mental illness does not assign someone to a life of violence.

I don't intend to get too preachy about the system and treatment methodologies and politics and doctrine du jour. I want to say that I had the honor of working with some incredibly dedicated, inspirational, strong, creative, brilliant people in direct care. Truly amazing people devoted to helping this population thrive in whatever ways were possible within the parameters of their lives.

And in one year alone, I can think of three serious acts of violence in our population of 12 against our staff of 8. Mine was the least serious with a punch in the head by a woman who weighed about a 94 lbs soaking wet. Fueled by CRAY-ZAY voices in her head, over tired, undermedicated, over caffeinated and just generally pissed at me, she packed a whallop as I rounded the corner on a staircase. [Incidentally she was pissed at me because I was young, blond and drove a red car and she had just had a "break through" on her meds and was more lucid than she'd been in 15 years and realized that she wasn't young anymore, didn't have blond hair and would never drive a red car. All of which she documented in her journal.] Anyway, I was stunned and it showed. She wanted to hurt me and when I didn't react with hurt she wound up again. Trained in non-violent restraint and realizing it was coming this time, I took her down on the stairs and called for help. It was over. I was fine. That also stayed with me. When I got my mandatory counseling after it all, my manager said that anyone with violence in their past is prone to flashback and other effects of reliving their own trauma. That wasn't me, so what I ended up feeling was just sad for this woman. It was her last chance in a halfway house and she got sent back to the hell of which Ken Kesey only scratched the surface.

Today I listened to a piece on NPR about an incredible spike in violence in mental hospitals in California. I thought back to that night that the voices took Anita back to them. I thought about the fundamental issue of safety while providing even the most basic services for this extraordinarily risky and challenging and needy population. And I teared up in traffic when the audio played picketing workers chanting, "what do we want? safety!" I hope they get all get it because they sure as hell aren't getting paid well, surfing the web on their lunch, chatting whimsically with their coworkers, bringing sick kids to the office in a pinch, cutting out a few minutes early to make sure their elderly parent gets their meds or or or or


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