As a mental health practitioner, we are subjected to second hand trauma as our clients share their journeys filled with neglect, abuse, abandonment and internal struggles. Though I am continuously trained and educated on how to not only work with these clients but also take care of myself, it is no easy feat. It is my job and I treat it as such. Being in this field, however, does not pardon me from having my own life’s interruptions and tragedies. But tomorrow always comes.
In these traumatic events, mental health is always discussed. I admit that I subject myself to the media, reading the comments that people contribute from all over the country. I am in the field of studying people, and perhaps I just cannot help myself, it fascinates me. The polarizations of responses to national tragedies includes sarcastic political remarks, to religious prayers and concern for the most “sinful” attackers.
It is a consistent question about the mental health field, abilities and services being cut. And though most people who make these comments are only referencing what they see in political debates, they are not wrong. I have seen first-hand the power of thorough, life-changing mental health interventions, where teams of nurses, psychiatrists, psychologists and clinicians put their efforts together for families in need. It has driven me to continue my education in the field, and explore venues to not only help clients directly, but also to teach future therapists how to provide a level of treatment that is remarkable and impeccable. Our work needs to be 100 percent. It needs to be on point.
Unfortunately, I have also experienced high levels of care for clients who need the utmost intensive treatment be under the care of mental health workers who are burnt out and have run dry of patience, empathy and the ability to care at the level these clients need. The private practice outpatient level of care is booming right now with practitioners doing it on their own because working for a clinic does not pay enough for what we are providing. The constant battle with insurance companies drives the field and how workers can live a lifestyle that enables a balance between caring for others and ourselves.
The inpatient hospitals are not for the faint of heart. There are clients who have attempted or committed murder, who have tried to commit suicide in ways that take the lives of others, clients have removed their own eyes, hallucinate and respond to voices telling them what to do. It is an environment where staff need to be high in number, cautious, patient and safe. The clients can be unpredictable and impulsive, but they are also people. They are someone’s sister or brother, son or daughter, mother or father. And they are in a lot of pain. They deserve showers, meals, to be safe and above all, understood.
When people say the mental health field fails people, part of me agrees. With people who need such a high level of care, to prevent them from hurting themselves or others, we cannot fail them. We must pay attention to their actions and words. We must identify bizarre thought processes, heinous acts and disability before they act out even more. We must provide substance abuse treatment, not by therapists just out of college that had one class on the subject, but by providers who are deeply educated in the biological, psychological and environmental pieces. When people want to get better, we must understand that if it was easy enough for them to do on their own, they would. But it is not.
When I started working for the State of Connecticut, in the Department of Mental Health and Addiction Services, I was lucky enough to be provided a tour of Connecticut Valley Hospital in Middletown, Connecticut. This tour was provided by a former patient of the hospital, who is now an employee, who let me in to a world I certainly did not expect. The campus can be chilling, with abandoned buildings, separate from the world almost. The story of CVH is worth hearing and my explanation of it does not do justice to the in-depth description I was lucky enough to receive.
Connecticut Valley Hospital was developed from a place of love. People were sent to the asylum for things very different than today (i.e. “Anxiety of the mind”, “Menopausis”, “Nostalgia”, “Over work”, “Syphilis”, “Hysteria”). The culture at CVH was a community. Doctors and nurses often lived in quarters or houses on campus. Patients hand-built the still existing water sources, farms, to harvest for the campus kitchens. Patients manned equipment and were hands-on contributors in keeping the campus running. On my tour we explored the underground tunnels and were shown the remnants of the now gone over-ground tunnels that connected some of the buildings. This was helpful in moving food, supplies and staying out of New England’s cold, but these tunnels served more purpose. They protected patients physically and emotionally. See, the “normal” folk would often visit CVH, on Sundays perhaps, after church to drive through and “look at the crazies.” These tunnels minimized the ogling public looking for a circus act. It protected the patients. It came from a place of respect that the patients were thought of to deserve.
There are some floors of functioning buildings that have been abandoned. It was as if the hospital was running one day and just stopped. Old medical equipment is still set up: surgery tables, lamps, sterilization tools. You could feel the energy of bustling doctors and nurses, operating between cigarettes. What a world it must have been. And how different it is now.
The reality is that I tried working at a higher level of care. And my reason for leaving had little to do with the clients, co-workers or management. The political make-up that goes on behind the scenes, lack of discipline or acknowledgment of burn out and inability to care for these patients, influenced my decision to discontinue. I needed to take a different approach to my career, where I could make a difference. Perhaps starting there, I could build the reputation and power to make a difference on a higher level one day.
I joke that as I get older, I am getting softer. I owe this to being on clinical teams, however, that work relentlessly to make people better. I owe this to being a part of practices, clinics and a school that is dedicated to hope and doing the right thing; that don’t allow us to give up, that support a positive culture, that put the clients first, and that are careful. We intervene with families and hold high expectations of families and parents and offer support when it is needed. We do not give up.
The mental health field needs a reform in this country. It is not being run by those who can keep the balance of the finances and client care, but instead by insurance companies, taxes and liability, which I understand but, unfortunately, see the negative impact it has. Therapists are extremely valuable, and when well-trained they make a hell of a difference. If the country needs surgery, hire the surgeon. Surgeons are expensive, but if the job must be done right, then the person with the right tools needs to perform the procedure. I hope through these crises we are heard, because we are certainly here to help if offered the opportunity.