This is Emergency Services as its Defined on a Community Services Boards' Web Site

Emergency Services/Crisis Counseling is a State mandated program. This unit provides short-term crisis counseling and referrals to individuals on an emergency basis. Emergency and crisis response services include: telephone interventions; face-to-face assessments and evaluation (including pre-admission screening); psychiatric consultation and other clinical consultation about mental health, substance abuse, and special populations which include children, adolescents, geriatric, people with mental retardation, and individuals involved in the forensic system. Emergency Services/Crisis Counseling is staffed 24 hours a day, 7 days a week.

Everything on this website has been thoroughly examined, reviewed, evaluated, and ultimately approved by The Citizens’ Committee for the Advancement of Rational Thought and Actions in Virginia's Mental Health System….

Things Sure Aren't What They Used to be..Conditions Sure Have Changed

coming soon........

Monday, April 21, 2008

This is a grim situation...something needs to be 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, 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 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......