Purpose of Crisis Stabalization

After reading this weeks chapter on "The Audience" I struggled to come up with a topic regarding conflict.   I wanted to discuss something related to my new position and what I have been learning. I then remembered how I spent an afternoon at our crisis stabilization services unit, which is a 23 hour inpatient facility monitoring the clients safety.  I remembered a conversation I had with the nurse working at the Crisis stabilization unit and how she was explaining how she often had to make "judgement calls" on who to admit into the facility.  She asked me to look through the files of repeat clients to develop my own opinion of people who utilizes the unit.  She mentioned how most everyone needed to be cleared through the hospital with lab work.  She stated it is much easier to admit someone with clear undeniable mental health diagnosis than it is to admit and monitor a client coming down off meth or detoxing from alcohol.  She was doing a good job describing how there is a need for both and remaining politically correct with how we treat clients fairly in regards to needed services.

I looked through the files to discover the purpose of the crisis stabilization and how it is used in our community. I came to the conclusion that more people are utilizing the crisis unit with confirmed positive drug tests and other circumstances, such as being displaced.  The unit was created for clients with mental illness suffering a crisis and not for people coming down from drugs/alcohol or having housing issues.  What seems most complicated is people coming off drugs are experiencing a crisis just the same as someone suffering a crisis related to mental illness.  My question is do we utilize the same resources for both?  What happens if a bed is unavailable for a client with known mental illness? Can we explain to the patient after the crisis about their choices and consequences of using and possibly referring to a rehabilitation program tailored to their needs?  Overall, I am not sure what the right answer is but it is getting more complicated with dual diagnosis of mental illness and DOA dependency issues. I also think emergency rooms don't know what to do with them and it becomes an issue about money.   

Storytelling

I am scheduled for a training to discuss patients rights.  I meet with a woman who shares her background as a paralegal.  She provides resources in the community to help our clients with legal issues.  She explains her role and provides examples of why patients may call her. She explains most of her calls are from clients in locked facilities.  She explains she remains non-objective while listening to the grievance and then she begins her investigation.  She provides me with a book explaining rights and her goals of trying to work with both parties to reach a common goal. I think to myself about the difficulty working with the mentally ill population and having to decipher what is real and what may be delusional thinking.

As we continue the training we discuss laws relating to human rights, the discussion turns to my educational goals and how I wished we would have crossed paths sooner.  I shared with her information on a completed advocacy project in mental health and how she would have been a great resource.  Next, I share with her the focus of the distance learning program for Humboldt University and its concentration on the Native American culture.  She shares with me her Native American heritage and I share with her mine.  We both disclose how we are not federally recognized as being Indian.  We then take some time sharing and storytelling the journeys our families have experienced over the years.  As we come together we realize we can not share many of our thoughts and feelings about our culture with many people we work with.  She shares how she wanted to be an attorney to fight for her people and as the years went by she grew tired of fighting.  She has switched her focus to advocate for patients.  As I leave her office, I walk away with not only training on patient rights, but also some healing for each of us.  Through storytelling, I also grew more aware of the loss this Native American tribe suffers but more importantly how connected they are to their culture and people. I visited their website to learn more about the salmon coming home story. I f you have a moment please watch it is a great story between New Zealand and the Winnemem-Wintu.

http://vimeo.com/movingimage/dancing-salmon-home

 https://www.youtube.com/watch?feature=player_embedded&v=mpuqR1hwmgs

Thoughts on Personal Self and Worldview

 

In my opinion, the meaning of “personal self” is how our life experiences influence the way we function as a social worker.  The term “values” was used to describe personal self and our values contribute to how we learn empathy.  Personal values, ethics, and empathy were taught to me as a child.  For example, watching my father feed homeless people as he turns to me and says “don’t ever turn people away who are asking for food”.  My mother told me, “don’t laugh at people who are different because my aunt Barbara-May is retarded (that was the word they used back then).  In childhood it was learning, in adulthood, it was embracing these values instead of pretending they don’t exist.  I believe some people are not taught the value of human kindness and fail to develop empathy for others.  

In regards to personality, I believe I am the same person in public when running into my clients because my relationship with them is genuine.  In past experience, my clients with mental illness approached me in public places.  I would imagine my current clients who are higher functioning, would not want to explain how they know me due to stigma of seeing a counselor or social worker for help.  Due to confidentiality and HIPPA, I am unable to initiate any contact in public.  However, I inform them at intake about the law and invite them to approach me if they want.

At first, I was taught we should not share certain personal experiences because clients may use it against you.  I have found the helping relationship grows stronger with some discretion of self-disclosure and sharing.  I found sharing pieces helps them to understand we are people just like they are with real problems in past or present.  I am well aware of transference and how it may cause us discomfort but being able to recognize it and where you go with it is the important part.  Being open and looking for certain connections is important.  Some examples are relating to a client who has Hispanic roots or someone new to the community from the Mid-west or having someone close to you who abuses drugs or alcohol.  All these situations build rapport with client in identifying how you may have similar experiences.  

Worldviews are described as differences and how one idea does not fit all human races.  Understanding worldviews is meant teach us human kindness as a service and mindful awareness of who our audience is.  I find worldviews important to understand the diversity of cultures we are surrounded with and how every situation is different based on our culture and upbringing.   I reflect to my own place in this world of being different ethnicities and how we all experience life through different eyes.  We have to practice being aware of not bringing judgment or our belief system into the picture while working with clients. 

My favorite part of social work is witnessing the strength in the human spirit and all it endures in each person’s journey.  I have great respect for each story I hear and every culture I am exposed to.  I continue to learn from my clients and find myself thirsting for more in my journey.  I have once sat with a client who insisted I sit and eat a lunch of Puerto Rican food, she shared her recipes and they will always be a part of me.  Recently, working with a Native American client who shared her story of a not so great childhood and worse adulthood, thanked me at the end of the session for sharing a story about my family with her. This was symbolic for me because it made me appreciate her and what I learn from many great people.  I will always remember how a simple thank you from her made me feel competent and solidify my choice in the service field.