OK, folks, I've had it. I had an epiphany of sorts tonight and realized that my babblings, rantings, and ravings are not going to change anything.
A few years back I remember being embarrassed to have to tell people we no longer had outpatient counseling. Then the bed situation....how do you say to a parent, spouse, friend, that well....there are no beds, however we can have your loved one arrested for a somewhat-bogus minor charge and at least they'll be off the streets.
Now...well, this is almost too much. Yes, we can provide them a bed in a psychiatric hospital (maybe) but when they get out we aren't going to do anything. Nope....absolutely nothing; no case manager.....no psychiatrist, no medication....absolutely nothing.
I remember many posts ago writing about When is a hospital not a hospital...... well folks, that's where we are now. When is a CSB no longer a CSB. As far as Mid-Mountain is concerned, they have arrived. They are no longer a CSB. I'm sure that those of us who are left...all of us who are trying to provide services to the mentally ill, will do the best we can....but folks, there ain't much left and coworkers are leaving like rats abandoning a sinking ship. And, yes...our ship is about to go under.
If I were a mentally ill person in our city....I'd abandon ship also and move on to another town or city. It couldn't be any worse anywhere in the commonwealth. Hey, we've hit rock bottom and there seems to be no relief in sight.
Monday, April 21, 2008
This is a grim situation...something needs to be done....here are some ideas....
When situations and circumstances dictate, governments have a provision for declaring Martial Law. The Mid-Mountain CSB, needs to do something similar. The agency is going down the tubes: circling the drain; and the wheels have come off the wagon.
Surely, if there is a person at the helm…well, not sure what’s going on there.
Anyway. Where to start?
First off, we need a hierarchy of conscience (no, has nothing to do with Maslow), this is somewhat similar to women and children in the lifeboats first. Simply put, we need to decide what population most needs our help and is most deserving and direct our limited resources towards them. At present drug users are still, to the best of my knowledge, able to go through the intake process and receive services.
Soooo, may I pose the question. If a severely mentally ill person and a person (yes, I will try to use a little restraint here) who is using crack both show up at the same time and only one can be helped, who should we help, and why? OK. Good question.
I doubt we could find many severely mentally ill people who made themselves that way. I don't think the severely mentally ill get up one day and say, Hey, I want to be mentally ill. May we accept that the mentally ill person is innocent so to speak of creating his illness? Well, I will. Now the person using crack. Hmmm. OK, I know a lot of you have bought into the old, gosh, using crack is a disease.... and you're entitled to believe whatever you want and that's fine; however, you can't dispute that using crack is a criminal act that makes a person a criminal (please restrain yourselves, don't want to hear any, Yeah, buts...thank you). Soooo, assuming the SMI person isn't breaking the law....we have one coming to us who is a criminal and one who isn't. One who caused his circumstances and one who didn't. Should being a criminal in any way figure into who gets the services? Also, keep in mind few folks who use crack work....and just how and where are they getting their money to buy crack? Hmmm. Yes, I know you all are on the collective edges of your seats and are waiting for me to tell you how to turn this ship around....and I will. However, you're going to have to wait until the evening of April 21st. Will be back this evening to finish.
*****************************
As promised, I'm back.
OK. BTW, there's two aspects here. One, what to do now.... And two, what we must do in the future to get things back like they should be. OK. Here goes.
Without going into a whole lot of philosophical contortions, I'd say, that if two people are seeking treatment and there's only going to be one person served, except for some possibly unusual extenuating circumstances, most of us would go with the person who isn't a criminal. The person who had no control over their illness.
Sooooo, if that's the case, what do we do now? Yes, given the situation we're in. Using a war or soldier metaphor, when they're storming the ramparts, every one's a soldier. And, that's where we are folks.
Also, often when we're faced with a situation, a problem, we can look for a way to make something work or a way to make something not work. You guys had better be thinking about making something work.
The priority until things get a little more settled will be guaranteeing the folks in the project get the services they need....the follow-up with case managers and psychiatrists. That is the priority.
All of Them/They who aren't producing something...not working with our customers, are going to be told, ordered if you will, to man the ramparts. Yes, if they have the minimum qualifications, I believe it's a bachelor's degree, they can start carrying cases. Yes, they'll be training as case managers.
All case manager supervisors will immediately start carry cases.
Hmmmmm. I think I forgot to mention that all meetings will be cancelled and no more scheduled. It's obvious they aren't accomplishing anything as the ship is sinking and the water is just coming in more rapidly.....so, no meetings. If you have something to say that'll help us serve our customers and provide the services we're supposed to...hey, send out an email on one of your Blackberrys.
Effective immediately all substance abuse intakes will stop (don't whine, they'll start back when we're able). Whatever time the substance abuse folks have will be spent doing intakes for the mentally ill.
Effective immediately, any case managers who want to work overtime may. Nope, Them/They ain't gonna make a big deal out of it. No meetings. Nothing. Send all of the case managers an email.....and, yes they can set their own overtime hours. Folks, you gotta stop being morons. Step back, get out of the way, if you ain't working and producing...keep your mouths shut. If you are one of the Them/They, look where you've gotten us.
Once we get things sorted out here, we're going to try to find out how all of this happened. And, folks.....some of you Them/They may well be pulling the equivalent of mental health KP (for those of you who haven't been in the service....kitchen patrol) and may lose a stripe or two.
Now, a little good news.
Our Crisis Stabilization and Detox Unit that can’t detox. I’m assuming that there’s still a doctor over there and at least a few workers. Until we can get things going again, all project folks being discharged from hospitals, who don’t have an open case, will be sent there. Hey, there’s a doctor there and the other folks can act as case managers at least for the present time. It could be run somewhat like MSU…that is, supply meds and a doc.
OK folks, this is part one. Did I miss anything? We now have a way of serving the needs of the most needy and most worthy. Hey, that’s a step in the right direction.
Though this should have been discussed above…another aspect of possibly deciding who gets services in times like this, is the possible consequences of what happens when someone doesn't get services. Let’s see, the SMI person starts decompensating, having psychotic symptoms, and ends up in the hospital again. The crack user continues to use crack...which in all likelihood they're going to do no matter what.
I'm sure I've missed some things here and have some grammatical errors, but frankly, I'm whipped...just downright tired....and tired of metaphorically beating my head against the wall.
Till the next time......
Surely, if there is a person at the helm…well, not sure what’s going on there.
Anyway. Where to start?
First off, we need a hierarchy of conscience (no, has nothing to do with Maslow), this is somewhat similar to women and children in the lifeboats first. Simply put, we need to decide what population most needs our help and is most deserving and direct our limited resources towards them. At present drug users are still, to the best of my knowledge, able to go through the intake process and receive services.
Soooo, may I pose the question. If a severely mentally ill person and a person (yes, I will try to use a little restraint here) who is using crack both show up at the same time and only one can be helped, who should we help, and why? OK. Good question.
I doubt we could find many severely mentally ill people who made themselves that way. I don't think the severely mentally ill get up one day and say, Hey, I want to be mentally ill. May we accept that the mentally ill person is innocent so to speak of creating his illness? Well, I will. Now the person using crack. Hmmm. OK, I know a lot of you have bought into the old, gosh, using crack is a disease.... and you're entitled to believe whatever you want and that's fine; however, you can't dispute that using crack is a criminal act that makes a person a criminal (please restrain yourselves, don't want to hear any, Yeah, buts...thank you). Soooo, assuming the SMI person isn't breaking the law....we have one coming to us who is a criminal and one who isn't. One who caused his circumstances and one who didn't. Should being a criminal in any way figure into who gets the services? Also, keep in mind few folks who use crack work....and just how and where are they getting their money to buy crack? Hmmm. Yes, I know you all are on the collective edges of your seats and are waiting for me to tell you how to turn this ship around....and I will. However, you're going to have to wait until the evening of April 21st. Will be back this evening to finish.
*****************************
As promised, I'm back.
OK. BTW, there's two aspects here. One, what to do now.... And two, what we must do in the future to get things back like they should be. OK. Here goes.
Without going into a whole lot of philosophical contortions, I'd say, that if two people are seeking treatment and there's only going to be one person served, except for some possibly unusual extenuating circumstances, most of us would go with the person who isn't a criminal. The person who had no control over their illness.
Sooooo, if that's the case, what do we do now? Yes, given the situation we're in. Using a war or soldier metaphor, when they're storming the ramparts, every one's a soldier. And, that's where we are folks.
Also, often when we're faced with a situation, a problem, we can look for a way to make something work or a way to make something not work. You guys had better be thinking about making something work.
The priority until things get a little more settled will be guaranteeing the folks in the project get the services they need....the follow-up with case managers and psychiatrists. That is the priority.
All of Them/They who aren't producing something...not working with our customers, are going to be told, ordered if you will, to man the ramparts. Yes, if they have the minimum qualifications, I believe it's a bachelor's degree, they can start carrying cases. Yes, they'll be training as case managers.
All case manager supervisors will immediately start carry cases.
Hmmmmm. I think I forgot to mention that all meetings will be cancelled and no more scheduled. It's obvious they aren't accomplishing anything as the ship is sinking and the water is just coming in more rapidly.....so, no meetings. If you have something to say that'll help us serve our customers and provide the services we're supposed to...hey, send out an email on one of your Blackberrys.
Effective immediately all substance abuse intakes will stop (don't whine, they'll start back when we're able). Whatever time the substance abuse folks have will be spent doing intakes for the mentally ill.
Effective immediately, any case managers who want to work overtime may. Nope, Them/They ain't gonna make a big deal out of it. No meetings. Nothing. Send all of the case managers an email.....and, yes they can set their own overtime hours. Folks, you gotta stop being morons. Step back, get out of the way, if you ain't working and producing...keep your mouths shut. If you are one of the Them/They, look where you've gotten us.
Once we get things sorted out here, we're going to try to find out how all of this happened. And, folks.....some of you Them/They may well be pulling the equivalent of mental health KP (for those of you who haven't been in the service....kitchen patrol) and may lose a stripe or two.
Now, a little good news.
Our Crisis Stabilization and Detox Unit that can’t detox. I’m assuming that there’s still a doctor over there and at least a few workers. Until we can get things going again, all project folks being discharged from hospitals, who don’t have an open case, will be sent there. Hey, there’s a doctor there and the other folks can act as case managers at least for the present time. It could be run somewhat like MSU…that is, supply meds and a doc.
OK folks, this is part one. Did I miss anything? We now have a way of serving the needs of the most needy and most worthy. Hey, that’s a step in the right direction.
Though this should have been discussed above…another aspect of possibly deciding who gets services in times like this, is the possible consequences of what happens when someone doesn't get services. Let’s see, the SMI person starts decompensating, having psychotic symptoms, and ends up in the hospital again. The crack user continues to use crack...which in all likelihood they're going to do no matter what.
I'm sure I've missed some things here and have some grammatical errors, but frankly, I'm whipped...just downright tired....and tired of metaphorically beating my head against the wall.
Till the next time......
Saturday, April 19, 2008
Hey, how about a TOPLESS DAY!!!! Also Co-occurring and no wrong doors!!!!
Yes, from the agency that just keeps giving....good old Central Mountain CSB has done it again.
OK, I will admit that part of what I'm writing about is third-hand so to speak; however, several of my coworkers confirmed that they were sent a memo saying...OK folks, listen up....a memo that stated there will be no more intakes for case management when our clients are discharged from hospitals after being hospitalized using Project Funds. Those those of you who may not remember, one of our state's rocket scientists, several years ago, decided they were going to close the state mental hospitals and give the savings (from the closures) to the communities so that local bed space could be purchased (of course there were no local beds [this has already been covered]).
Anyway, (Hey, I've been working here twelve years and sometimes I get confused) where was I?
OK.
Let's say we happen across an actually mentally ill person who needs acute care....you know, inpatient treatment in a psychiatric hospital (as opposed to the crackheads and reprobates trolling for someone to take care of them). OK. Now up until a while back, here's how it worked.
A client couldn't see/have a psychiatrist unless they had a case manager. Also, couldn't have a case manager unless they'd been hospitalized twice. They/Them finally learned that the two times criteria was just too absurd.... Anyway, that all changed.
The client goes into the hospital. Discharge day they are sent to the CSB. They have an intake, are assigned a case manager and psychiatrist. Hey, that works well. They have ongoing care and don't run out of medicine.
Soooo, now I guess the folks go in the hospital. Discharged to the street. Finish off the few pills they were discharged with, decompensate, and yep.....go back in the hospital.
It's also my understanding that the crack house, my term of fondness and respect, for our drug treatment center is still taking intakes. Well, ain't that nice. Yes, bring in the ole criminals and give them treatment....but, let's spit on the mentally ill.
Just about enough to tick you off......
Where was I?
Oh, yes. It's going to get better.
This is Mental Health month. We had the old walk for the mentally Ill, wear ribbons for the mentally ill........... and now folks, yes, what we've all been waiting for,
Funny Hat Day......yes, folks, May 1st is Funny Hat Day (for the mentally ill). That's right. Wear your funny hat to work. And, we're going to have folks judge it and there'll be winners and losers and gosh it'll be so much fun and remember this will finish up or begin the month for mental illness awareness. Dang. Why didn't I think of that?
****** Here's the official announcement....honest.****************
OK, I will admit that part of what I'm writing about is third-hand so to speak; however, several of my coworkers confirmed that they were sent a memo saying...OK folks, listen up....a memo that stated there will be no more intakes for case management when our clients are discharged from hospitals after being hospitalized using Project Funds. Those those of you who may not remember, one of our state's rocket scientists, several years ago, decided they were going to close the state mental hospitals and give the savings (from the closures) to the communities so that local bed space could be purchased (of course there were no local beds [this has already been covered]).
Anyway, (Hey, I've been working here twelve years and sometimes I get confused) where was I?
OK.
Let's say we happen across an actually mentally ill person who needs acute care....you know, inpatient treatment in a psychiatric hospital (as opposed to the crackheads and reprobates trolling for someone to take care of them). OK. Now up until a while back, here's how it worked.
A client couldn't see/have a psychiatrist unless they had a case manager. Also, couldn't have a case manager unless they'd been hospitalized twice. They/Them finally learned that the two times criteria was just too absurd.... Anyway, that all changed.
The client goes into the hospital. Discharge day they are sent to the CSB. They have an intake, are assigned a case manager and psychiatrist. Hey, that works well. They have ongoing care and don't run out of medicine.
Soooo, now I guess the folks go in the hospital. Discharged to the street. Finish off the few pills they were discharged with, decompensate, and yep.....go back in the hospital.
It's also my understanding that the crack house, my term of fondness and respect, for our drug treatment center is still taking intakes. Well, ain't that nice. Yes, bring in the ole criminals and give them treatment....but, let's spit on the mentally ill.
Just about enough to tick you off......
Where was I?
Oh, yes. It's going to get better.
This is Mental Health month. We had the old walk for the mentally Ill, wear ribbons for the mentally ill........... and now folks, yes, what we've all been waiting for,
Funny Hat Day......yes, folks, May 1st is Funny Hat Day (for the mentally ill). That's right. Wear your funny hat to work. And, we're going to have folks judge it and there'll be winners and losers and gosh it'll be so much fun and remember this will finish up or begin the month for mental illness awareness. Dang. Why didn't I think of that?
****** Here's the official announcement....honest.****************
As an activity for Mental Health Month, we will have a Funny Hat Day on May 1st. The sites participating are XXXX, VVVVV, NNNNN, & LLLLL. Judges will be at these sites to judge the hats. The staff with the funniest hat will win a prize.
***************************************************
OK. Where the hell did this come from? Did Them/They pull on the pipe too hard? Did They/Them forget to exhale? Something in the water down there?
Let's get serious, here. Who came up with this Funny Hat Day? And, how did they come up with it?
Hmmm. Did They/Them form committees? Have fifty meetings? Hmmm. Or, did they task (love that work) it to someone or some group. Or did one of They/Them just have a spontaneous creative moment? Oh, well.
Hey, if this indeed was tasked to some poor scmuck...well, my apologies (to the poor scmuck); however, it is providing a good laugh in a bizarre kind of way. You may notice that the goofy hat day is an activity for mental health month.
How in the heck can this be reconciled? We have no counseling services, we have no case management services (which means, I guess), we have no psychiatric services, and I would imagine we have no way of providing medications (Hey, doncha need one of them psychiatrist fellows to write one of them prescriptions?).....Ready for a horrible pun, It seems we're going to hang our hat on The Goofy Hat Day.
OK. It's May 1st. Yes, Goofy Hat Day. And, yes, I'm sure at least someone will show up with a goofy hat.
Now, we're parading around in our goofy hats and a mentally ill person comes to our office seeking help.
Gosh, sir or madam, nope ain't got no services for you, but, hey, you're welcome to hang around and see the goofy hats. You're suffering extreme mental distress? Hey, see that hat over there, that's a pretty funny one, ain't it.
You're having visual hallucinations. Hmmm. Sorry, maybe you better not come in.
Changing subjects. They/Them came out with this No Wrong Door Stuff! As I best remember it They/Them said that no matter what services a person sought at any of our sites, they would be welcomed with open arms and taken care of. Yes, if they were using crack (Hey, is that still against the law? No stupid, it's a disease.) we wouldn't send them to the old drug center, we would embrace them and provide whatever they needed (or demanded as the case may be). That's a pretty good one. It would seem that if a citizen is seeking mental health help today...hey, they ain't no doors and if they could find one it'd be bolted shut.
Well, I'm tired of writing and am going to quit for now. I'll tackle the co-occurring stuff later.
Now, what's this about topless? I almost forgot. Why not a topless day instead of a goofy hat day? Or, like a flash, how about a goofy hat and topless day. Hey, at least the mentally ill who might happen by seeking services might get a kick out of it. Yeah, topless with your goofiest hat and yes, there will be judges. I'll leave up to the judges as to well....hmmm... what they're going to be judging.
Till the next time.......
Wednesday, April 16, 2008
YOU DID WHAT!!!!!!!!!!!!
I was in an OK mood when I got to work...but, it sure didn't last long. One of my coworkers, who will not be mentioned by name (The second letter of her first name is E and the last letter of her last name...well, might be R.), authorized the citizens to piss away more money by authorizing CL #772345898 XCV5554443243 inpatient treatment. Before I waste too much more time on this....well, let me just say that in fifteen years he is right up there for all time sleazeball, criminal, malingering reprobate.
Oh, this is cute. The ER doc didn't feel comfortable putting his license on the line. Hey, that's his problem. Dang, what a.....(calm down) screwed up (wanted to use the F word) business.
Oh, this is cute. The ER doc didn't feel comfortable putting his license on the line. Hey, that's his problem. Dang, what a.....(calm down) screwed up (wanted to use the F word) business.
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