Friday, March 07, 2008

“Care” in the Community

I’m aware that Mental Health workers sometimes read this blog, and some have previously commented that it helps them to see things from a different perspective. So this is a message to all those who provide “Care in the Community”.

Don’t get shirty when a “service user” who can’t even remember to change his underpants doesn’t return your calls. And if he has a spouse who usually takes care of these things for him, take a minute to think about why she might be letting those things slip at the moment.

Sometimes there are more important issues in life than your appointment schedule running at 100% efficiency.

Edit: After making such a fuss last week, she failed to turn up for a scheduled appointment with Mr Man today, and she didn't even call to cancel. Maybe life has taught her a lesson in "more important issues"?


Anonymous said...

Oh boy...can I relate. I missed an appointment with my therapist. Date and time went right out of my head...and I wouldnt have been able to attend anyhow. I was in the pits of despair, and felt frozen.

Bottom line...she sent me a nasty letter saying I obviously dont require her services.

It wouldnt upset me so much, except I cannot see the psych doc except via her. I dont know what to do.


Mr Mans Wife said...

Laurie that's terrible. There must be someone you can write to so that you can explain what happened and get yourself another therapist?

Mr Ian said...

As you indicated MMW - these issues are very often more symptoms than anything. Perhaps not of the 'illness' - but of the situation. I've had a very long discussion with a chap who can't get a good rapport going with a therapist - so they dismiss him from their care. The reason he can't get a rapport going is what he wants help with...

Too often therapists/health care staff get a little too precious about themselves and need to be brought back down to earth. I sometimes try to do that by asking my staff - "what did you do for ptX you were assigned today?"

Advice for 'service users' might be to politely call or write to the worker or their supervisor and highlight that there's an issue and clearly state the problem.
eg "When I missed my appointment I was sent a letter that I thought was strongly worded and it made me feel upset."
Include some positive things about the worker too if there are any
eg "Usually I have got on well with this therapist and have found them very helpful with x,y & z"
... and finish by stating simply what it is you'd like to be the outcome -= and what you're prepared to do to also:
eg "So there may be times where I am unable to make my appointment and my anxiety is too high to do anything about it. I could agree with the therapist to call each morning before my appointment to confirm I will be there. If I don't call in the morning then I may be having a bad day and perhaps would appreciate if s/he might call me to see how I am."

If however the worker just seems to be giving you their grief - whack a complaint in

It may not be easy to do for some people and I would suggest for those people to join an advocacy group who will support them to do these things.

Mr Mans Wife said...

Ooh, I'm curious to know what the chap wants help with now...

Anyway, thank you Mr Ian, for your wise advice as usual. I hope what you have suggested is helpful to Laurie, and others who may be having this problem.

I, on the other hand, am tired of writing letters. I wasn't there when she got shirty with Mr Man, so next time I see her I plan to gag her and then stick my fingers up her nose until I see air bubbles coming out of her eyes!

Catherine said...

Oh oh, she got shirty with Mr. Man?! I was thinking the situation was happening with him and she was snarky with you when you tried to remedy it. Not that it is acceptable in any case though.

True that about having more important things happening in your life.

Mr Mans Wife said...

Yes, it was with Mr Man. I still feel angry about it now. Does she think we have nothing better to do than to sit by the phone all day waiting for her to call?

I'm seriously considering unplugging the thing and throwing it out the window - what will she do then?

Anonymous said...

Mr. Ian.

What I wouldnt give to have someone of your ilk in charge of out mental health service here.

I actually did write to her...but alas, I have heard nothing in return. I dont know what to do now, as I fear contacting her supevisor would serve only to make things worse.

I was thinking of asking my GP to refer me to someone in the city, even though that city is a 9 hour trip each way.


Diane J Standiford said...

Your tagged by the way!

6 word memoir.
You know the one, where you
1) Write your own six word memoir
2) Post it on your blog and include a visual illustration if you want
3) Link to the person that tagged you in your post, and to the original post if possible so we can track it as it travels across the blogosphere
4) Tag at least five more blogs with links; and
5) Leave a comment on the tagged blogs with an invitation to play!

Mr Mans Wife said...

Eeek! Thanks Diane, I shall have to think about that one!

JafaBrit's Art said...

I have always felt that people dealing with mental health issues (physically ill people too) should have an advocate (not an overwhelmed spouse, child or relative) to help them navigate the system. How ill people (physically and mentally) are supposed to be able to keep on top of everything astounds me, let alone health care providers getting snippy.

anon, that is a horrible horrible letter, and as far as I am concerned totally uncalled for and unprofessional. I really like Mr. Ian's approach and hope it helps you anon.

Mr Mans Wife said...

Hi Jafabrit. Welcome to my blog!

There are advocacy services out there, but for some (not so) strange reason, people who work in mental health aren't always forthcoming about how to get in touch with them, and if you are new to mental health services you probably don't even know these advocates exist or how they can help.

We used an advocate when Mr Man was in hospital and the consultant was dragging his heels about arranging a second opinion. She must have scared the man half to death because he then arranged for the second opinion the same day!

I am now lucky enough to have a Carer Support Worker in our area, and if I need her to she will contact services for me and advocate for us.

I don't know why I didn't think of it before, but maybe that is what you need to do next Anonymous - contact an advocacy service. (I didn't reply to your previous comment because I felt it was adressed to Mr Ian)

Thank you for your comment Jafabrit.

JafaBrit's Art said...

I have had to navigate the mental health system in the Usa and I was a trained crisis counselor and didn't find it easy. some of the comments I faced as a mother (sometimes giving me a guilt trip because I questioned the need and cost of every bloody test under the sun they wanted to do) were shameful. One really has to be on their toes all the time and that in itself is tiring.

Mr Mans Wife said...

That is so true. It's shameful that patients and their carers should even need to have advocates - aren't mental health professionals supposed to be on our side? We don't need an advocate when we go to the local GP do we? And if you had problems navigating the system even as a crisis counsellor then what chance do the rest of us have?

Carol said...

Oh wow! I wish I would've written this!!! All of DH's providers are always calling HIM and making appointments with HIM and then, even though they know that he has problems with memory loss along with his mental illness, they are surprised and not very happy when he doesn't do what he said he'd do....l

Diane J Standiford said...

The medical community does same thing to me. I guess some people have to LIVE it to KNOW it.

Mr Mans Wife said...

Hi Carol. Yes, I know what you mean - I never understand why they seem so surprised! They must know what the symptoms are!

Dianne, I agree - as proved by Carol's comment, sometimes all the training in the world doesn't make a person understand.

Thank you both for your comments.

Mr Ian said...

The advocacy issue is very much the role of the health care professional. There is a dichotomy when you also work closely with the other professionals involved and I've had one or two serious advocacy issues take me close to losing my job.

I've always found Social Workers to be so much better placed and able to fill this role than nurses but they can also find themselves isolated out of the 'team' for doing so.

I am aware in plces like Canada they employed a system of 'service brokerage' which was essentially a more formalised advocacy model in which health care professionals (or others) could represent the needs of the 'consumer' and negotiate care delivery. It never really took off here when they tried it in aged care but I think it is a model well worth tweaking.

Mr Mans Wife said...

Yes, I suppose the problem is that each health care professional who is involved in the care of an individual has their own idea of what that person needs. We definitely had that problem when Mr Man was in hospital, and although there was one excellent nurse who was on our side, I can't cricise her for not wanting to lose her job over it. She was braver than most though, and wasn't afraid to stand up to the consultant.

Good for you though Mr Ian - you obviously care a great deal about the people you work with.

We only ever saw a social worker once, when Mr Man was being admitted under a section of the Mental Health Act!

Anonymous said...

I do laugh when they make a big deal about coming round for appointments but then dont turn up, its not right.

Hope everythings ok

Mr Mans Wife said...

Thank you Anonymous.

Tomorrow should be interesting as we have an appointment with her again. I wonder if she'll turn up this time?

Anonymous said...

Most of you know me as “Dreamwriter.” I recently
Launched a new blog called, “Bipolar Speaks.” One day something came over me as I was reading websites called “Post Secret” and also a blog who had a post where they had quotes from other Bloggers with mental illness about how they felt.

It occurred to me that WE need an escape to let out our feelings and frustrations. I know that a lot of bloggers say what they feel within their own blogs, but you are welcome to share your thoughts, opinions, and feelings.

You are welcome to help raise awareness and put a stop to the Stigma that lies within mental illness. We can change the world - one story at a time.

I thought it would be interesting
To design a “Safe Haven” for those who battle with a Mental Illness; and allow them to come and let out their most darkest, painful, and emotional feelings. This would be a great way to spread awareness by letting society know what is REAL about mental illness.

If you are interested, you can submit a story or short piece as an “Anonymous” contributor, or if you don‘t care about what others think, then feel free to reveal your blogger identity; its purely up to you.. I tried this several times and the “Anonymous” button works and ends up in my email as an “Anonymous” comment.

The rules and regulations are in the blog within a post. Take the time to read them thoroughly and I hope that you become a constant contributor.

Remember, we all have things on our chest to let out and we all truly don’t want others to know. But now is an opportunity for YOU to speak up, speak out, and be heard!

I know that I have a lot of feelings and issues that I don’t want my husband, friends, or family to know about…this is my chance to get it off my chest and I WILL be a constant contributor.

Depending on the issue, I might submit the story under both “anonymous” and my name.
Go to “Bipolar Speaks” and look around, don’t forget to display the Bipolar Speaks button on your blog and link it back to us.

By the way, I still have my other blog, so don’t forget about me over there, too. :)

Mr Mans Wife said...

Bipolar Speaks, thank you so much for stopping by to tell us about your wonderful new blog! I shall reproduce your comment in a blog post for all to see.

Abysmal Musings said...

Hello, I've been spending a sleepless night reading through your blog. What a brave pair of people you are. And great writing too.

Regarding "care in the community" - we soon learned that it was a rarity for my psychiatric nurse to turn up on the same day that he had arranged, let alone at the right time - we ticked him off a few times - no-one likes to hang around all day. As for the "crisis" team... ARRGH! They dutifully turned up each day to make sure I hadn't precipated a 'crisis' in the dead of night.

Thanks for your writing - it's very moving. I'm going to give my wife an extra big hug in the morning.

Mr Mans Wife said...

Thank you Abysmal Musings. And thanks for popping by and leaving a comment.

If the effect of my writing is that you want to give your wife an extra big hug, then I feel my efforts have been well worth while :)