Defame the Mental Health System Not the Practitioner

» k1k1257 - Upholding Mental Health Standards - Professional Suicide

As a former CDMHP (County Designated Mental Health Practitioner), Minority Mental Health Specialist, and Mental Health Therapist, I would like it made clear that it is the Mental Health System that is creating it's own monster. In other words, when I hear about how they are so overburdened and overworked, my reflexive reaction is to use the "finger down the throat" gesture.

There are those of us who have evaluated hundreds of suicidal, homicidal, and gravely disabled persons in emergency rooms, performed on-site evaluations and have put our lives on the line only to have the Mental Health system fail us, too.

How many clients truly believe they are being cared for by agencies who provide not only medications, but therapy, as well? These are the disillusioned clients, "frequent flyers" who overburden hospital emergency rooms.

These unfortunate people are the ones who Mental Health agencies do NOT want to work with. They are too high maintenance. How many of us have heard the jokes about these clients? Who made them what they are in the first place?

Granted, Mental Health agencies need to be able to estimate projected budgets. But do they do it honestly? Are the levels of need really being considered, or are the levels of the client's ability to be "compliant" the determining factor as to whether that person will be entered into their system?

Those of you who have worked as CDMHP's have probably developed the same problems myself and many of my colleagues have. We have become physically and mentally taxed. We have acquired autoimmune diseases, PTSD, cancer, as well as many other stress related illnesses. Why, because we try to uphold the standards of the Mental Health laws but are constantly challenged.

It is my belief that no CDMHP should be affiliated with any mental health agency. Our decisions, right or wrong, should not be made at the risk of retribution from our agencies. We should not have to be "told" who to detain or not. We have enough grief trying to sleep after an evaluation "praying" that we made the right decision.

I have become sick to death about hearing the off-handed way "borderlines" are referred to. Like the verse which hangs in so many pediatricians' offices, "Children live what they learn," so did those clients about whom these unkind words develop.

Remember the "fee for services" era? Many case managers wooed their clients--having coffee with them, visiting them daily, attending to every little whim. Afterall, that's the way agencies got paid.

Then, after years of perpetuating co-dependency, all of a sudden, these people were dropped like hot potatoes. Suddenly their needs were "really not that urgent." Mind you, these people had already acquired whatever "in vogue" diagnosis needed to make them eligible for treatment at that particular time.

I had a client come in on her first visit with me, who introduced herself and proceeded to tell me that she was a schizophrenic and was able to tell me more about the diagnosis than I needed to know at the time.

This person had already been in the system for 10 years. Looking back in her chart, she had suffered post-partum depression, had her child abducted by her former boyfriend, and had to bear the grief of learning that her child had died while in the care of the child's father.

She was never treated for post-partum depression. Instead, she was given a diagnosis of schizophrenia, which is why her child's father took their child out of the state.

She was never treated for grief and loss. She was medicated according to the Psych Doc's diagnosis, who, made his determination by reading the chart notes of the case-manager, not a MHP.

How many of us have gone through audits for funding purposes? Quite a few, I'm sure. However, I found you make many enemies when you don't "doctor" your charts with paperwork that, quite frankly, didn't even exist when the client was first admitted as a client of the agency.

Making waves by citing RCW's and (in our case) WAC's regarding mental health care, refusing to accept orders to detain, informing clients of their rights to participate in developing their treatment plans, including requesting mental health therapy, or informing clients that they are being "case-managed" only leads to professional suicide. Try to get another job.

In my case, I tried. I have documentation, witnesses, etc. who can attest to the treatment I received because I did not "play by the agency's rules." Do I have legal recourse? No...none that I can afford, at least. Afterall, the burden of proof is on me. To make matters worse, I have been told that since I resigned due to Doctor's orders, I truly have no case.

Give me a break, the agency I worked with was afraid to "fire" me because of fear of being sued for discrimination. Case in point, an adult respite worker, who happened to be Black, released a client with all her medications, although it was charted that this client was known for many attempts via overdose. This was an example of one of many violations. The agency buzzed with talk of fear of being sued because the respite worker was Black. As a Pacific Islander and a Minority Mental Health Specialist, you can understand that, instead of firing me, they chose to make my life miserable, including documented attempts to try to "set me up."

Don't get me wrong, this is not a poor pitiful me story. It is not about me. In fact, I am flaming mad that I am, because of disabilities resulting from the stresses of my job, that I can not continue to fight the system by being the best CDMHP I used to be. Even prior to my disability and eventual resignation, I could not get another job, because prospective employers were able to side-step positive recommendations.

The point of this discussion is multifold:
1) Do not blame the mental health system on MENTAL HEALTH PROFESSIONALS, trained MHP's. As long as they continue to let untrained workers diagnos client's we are in big trouble. Their are clients who have different diagnosis' or, the untrained, just copy the diagnosis made by the previous case manager.

2) Do not blame MHP's for administrative decisions made by personnel untrained in the Mental Health field. They are motivated by convincing clients that they are sick.

3) Do not blame MHP's for providing medication without therapy. The operative word in the system is "case-management." So, let's keep these people medicated so they can continue to co-exist in the community whether they need it or not.

4) Do not blame CDMHP's for not wanting to turn hospital emergency rooms and E & T's into turnstiles and raising the costs to hospitals and law enforcement agencies.

5) Do not blame MHP's for attaching mental diagnosis' to juveniles, which by the way, could affect the rest of the rest of their lives. Heaven help those who buy into what they have been told and out of feelings of helplessness, turn to self-harm or worse, completion.

6)Do not blame MHP's for providing fraudulent information on the behalves of their agencies.

7) Do not blame MHP's for the increasing numbers of clients entering the mental health system. I am proud to say that the clients who began with me, are productive members of society. They do need tune-ups once in a while, but then again, who doesn't?

8)Do not blame MHP's for the increasing numbers of "dual-diagnosed" clients. If you separated the clients out, you would find that prior to Social Security's ending financial aid to clients with drug and alcohol problems, you'll find there were a lot fewer clients with this diagnosis. MHP's are smart enough to know that until a client is clean and sober for at least 6 mos. a mental health diagnosis is hard to determine.

9) Do not blame MHP's for assigning mental health diagnosis to clients in crisis. Many of us prefer to defer our diagnosis until the crisis has passed because so many mimic each other and share the same symptoms. This is a system requirement.

10) Do not blame MHP's for taking "borderlines" seriously. They are a very high risk category because they tend to up the anty and many end up as accidental completions.

11) Do not blame MHP's for the adverse affects clients experience because they are being prescribed psychotropic meds by medical doctors who are besieged with samples from pharmaceutical companies. And, who require no follow up lab tests, but continue to supply refills.

12) Do not blame MHP's for holding nursing homes or adult care facilities accountable for caring for their patients not as "mental health" problems, but as people who were once vibrant and independent. When they get angry and throw things, or become incorrigible, they are not necessarily mentally ill. They have no other way to communicate especially if their previous attempts were ignored. They do not need to be "detained" because they are a nuisance. They are not necessarily a danger to themselves or others, or if they don't feel like eating breakfast, are not gravely disabled. Their behaviors are just magnified because they live in a smaller community.

The system needs to empower MHP's. We are trained professionals. Give us back the power to provide therapy. Give Emergency Services CDMHP's the ability to help people through difficult but temporary times. We all have them, but we're not all permanent clients in the mental health system.

Empower MHP's to help people become productive. Don't let the untrained convince clients they are worth no more than the paltry amount they receive from GAU and GAX.

Empower MHP's to sue for the right to do our jobs in order that we can help maintain the standards of the Mental Health Laws.

MHP's can be powerful advocates for the mentally ill. I invite anyone to assist me in finding an attorney who will not only help with filing lawsuits for unethical practices forced on MHP's by Mental Health agencies which has caused us to no longer be able to practice because of discrimination and retribution.

We have standards that we uphold because Mental Health work is not just a profession, but a passion. We earned the right to the wages we receive(d). We should not be replaced by unskilled, untrained employees who receive less pay. Who I might add hold degrees that are totally irrelevant to the profession.

I invite participation in beginning this process with a greater view in sight. If class action suits can be filed against those products people "choose" to purchase and become irrevocably physically or mentally impaired, then we should set the standard for standing up for our rights in order that we can simultaneously assist mental health clients who truly cannot fight for themselves, begin class action suits against the Mental Health agencies who are not providing them with the care they not only need, but deserve.

-- posted by k1k1257

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