Throughout this blog I seem to be going after specific worker areas in the mental health care system and I do this for a reason and that is I believe this is where the most changes can take place with the most ease. The much larger problem to the mental health system in this country, Canada, and other countries around the world is the infrastructure is controlled by people in the government who are barely qualified to be in office let alone making decisions that effect millions.
Budget cuts have put the mental health system in a noose and sooner or later something is going to happen that will knock the chair loose. When I was working I dealt with Children’s Aid Society(CAS) workers on a very regular basis as they basically controlled a lot of factors of the boys that I would work with. This system has been in place for a very long time but over the years the case load of each worker continues to grow year after year. At one point the workers had somewhere around thirty cases each to look after but now the number is fast approaching a hundred. So what happens is the children who deserve extra attention by their workers and should be making the next step whether into foster care or back home are being put on the back burner by other boys who spend way too much time in court and in trouble. This is not a conscious choice by the workers but when a good percentage of your time is spent in mandatory meetings, court hearings and the occasional treatment plan development it just does not leave you with the time to get to your entire caseload. Most of my boys relationship with their workers was done by fax machine which is wrong on all sorts of level but that is the way the budget cuts has led it too. Take a wild guess on how high the burnout rate is in this specific area. The CAS workers all started with the best intentions and that is to help children in trouble the problem is reality and budget cutbacks make their job extremely difficult and unfortunately too many young people go from John Doe to case number 9494, the caregiver part of a CAS worker has slowly been ripped away.
The first time I was in the hospital back in 05 I saw a therapist three times a week and she is a big reason why I decided to join my own fight again. This amazing lady set me up with a PTSD specialist in the community as she could only sees clients who are currently in the hospital. Anyway I lasted three meetings with the new therapist when I made the mistake of telling her I had a really bad night so I took it out on my body, according to her I was not stable enough to be in therapy. So when it was time to reenter the hospital I was sent to a local psych ward where I was a little bit shocked to find out that they did not have a on staff therapist as the budget would not allow it, yes thats right a psych ward that could not afford a therapist. What the hospital did was send a grief counselor down to see me I think three times during the month that I was there and this lady was good at what she did but just did not have the time to be effective. I saw my doctor every weekday for about five minutes at a time but his specialty is medication and diagnosing and not talk therapy which he has stated repeatedly over the years. The psych ward did have groups which are good for some people for small areas but nowhere near the impact of a one on one session brings. To me the system of emergency psychiatric care is designed to bring the person out of a crisis, medicate heavily then send back out the door and basically wait for the person to come back some time in the future. Medication enhances therapy and makes it possible for the person to really get at their problems but if there is no therapist around to help do the work the job is left to nurses whose technique comes from experience and not actual education. Someone told me that to work on the psych floor they need to take a two week course about dealing with mental health clients and I use to wonder why so many of my fellow patients would bring their issues to me. Maybe this is why I was always kept longer then the others as I was free help …. not likely.
I watched a documentary awhile ago about the new asylums in the states that appeared after a high number of state hospitals were closed due to budget cuts, mind you the new asylum is actually an older prison. I wonder where the politicians though that these people that populated the old state hospitals would go when trouble appeared or did they think the problems would just disappear but more then likely they did not care and just wanted to put through a sensible budget and the hell will the human consequences.
The only thing that will fix this area is money and lots of it but I am not going to hold my breath waiting for that to happen.
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Good post. I work with young people, many of whom are dealing with PTSD from childhood abuse. Some are on medication, some are not. But the whole issue of getting them the treatment they need comes up over and over. Money. Yes, it plays a huge part in it all, and it shouldn’t be that way.
Hoi! I was about to comment on your entry next to this but I noticed that this is a new one. And so I read.=)
I can understand your concerns. And for anyone or any body of organization and or research institution that will take real interest to make a worldwide feasibility study to find out factors why this happens, they must truly be sincere, uninfluenced by the government and well sponsored so they can bring HONEST RESULTS. Otherwise, the real reasons behind will be whitewashed. Budgeting is fashioned out of statistics dished out by paid ppl to the government. Perhaps , the government feels they cannot make MUCH money in the mental section. One issue to contend with is the influx of privatized half way houses and nursing homes. In the US, this could be the case. How about in Canada? They [state/government, the "mighty"] have to balloon it out somewhere where they can ‘moderate the greed’ subtly.:D I do not want to sound pessimistic as I am not. But corruption is everywhere. It is just so hediously obvious here in the Philippines, my country, that the term ‘moderate the greed’ [ a term used by a state witness- a Philippine govt official who stated boldly a co- govt official’s term during his investigation at a Senate hearing
Housing projects for the military and new public schools were put aside in favor of a sleazy deal for a national broadband project which is waaay too overprized!) I hope this isn’t the case happening in your country when it comes to budget allocation…?
It’s a sorry state to hear case loads exceeding per head and it was irritating to hear about a psych ward without a therapist…Here in the Philippines, that may happen with facilities in government mental instituions needing refurbishings and additional ones. Privatized halfway houses are better and private hospitals (at least here in Pinas in comparison with their government counterpart.) But even then, I can strictly observe that we lack mental instituitions here that are as organized as it should be the way hospitals treating physical ailments are. It is hoped that all over the world, measures will be done to better the patient’s well being holistically.
Cheers!
JazzyJean
I completely agree. I struggle with this dilemma every single day. It is extremely frustrating. I often take it personally when I’m confronted with remarks from my clients saying that I don’t care or whatever. It hurts because it is so so far from the truth.
I guess the problem when it comes to the mental health system crisis is the people in charge of the budgets really do not understand the impact of their decisions has on the day to day life of a lot of people. No idea how it can be fixed besides the obvious of a massive cash infusion. Too many mental health care workers are burning out as they are trying to handle the workload that two or three workers use to do.
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