Becoming Real about our Psychiatric Community
Being a real psych-nurse.... required BECOMING REAL about all the effects of mental illness
In November of 2017, I was working on Thanksgiving day in the ED at Unity Center in Portland, Oregon, talking with anguished parents about our seemingly futile efforts to help their loved one. At the time, I was deeply saddened with our inability to do more for their son and sympathetic with their frustrations. A frustration I have recently experienced first hand with our foster son.
Unity was a joint venture where Portland's four largest psychiatric hospitals closed and reopened as the consolidated, "Unity Center," with a special added emphasis on, "Emergency Stabilization," and community support.
At that time I had 22 years of floor and charge nurse experience and was excited to work in the new, "Psychiatric Emergency Room," where expectations for a quicker recovery and earlier discharge became a frequent, but often unrealistic hope.
In REAL psych-nursing the best we can usually provide are islands of relief in a troubled sea of changing symptoms. My task was to prepare them for success on this very difficult journey.
As a nurse, BEING REAL was about truly being there with them. Often in their pain and their loss, but also in helping them to recognize their victories.
The video clip below is this type of story.
The video clip below is this type of story.
https://www.youtube.com/watch?v=H4cC1SwFWxU
Titled: A Mother's Story...
This is the story of Kaye Warren's family as they share about the loss of one of their sons to mental illness.
In response, she and her husband Rick have committed themselves to making the problem of MENTAL ILLNESS REAL in the churches and communities across America....
So, why all this talk about being REAL?
In response, she and her husband Rick have committed themselves to making the problem of MENTAL ILLNESS REAL in the churches and communities across America....
So, why all this talk about being REAL?
It is important because it is the process that allows us to take the pain of others without damaging ourselves. It is simple enough for a child to understand, and as old as the hills. The conversation below is from a book that I read to my children on the topic when they were very young. It is titled, "The Velveteen Rabbit."
"Real isn't how you are made," said the Skin Horse.
"It's a thing that happens to you....
"Does it hurt?" asked the Velveteen Rabbit .....
"Sometimes," said the Skin Horse, for he was always truthful. "When you are Real you don't mind being hurt."
"It doesn't happen all at once," said the Skin Horse. "You become." It takes a long time. That's why it doesn't happen often to people who break easily, or have sharp edges, or who have to be carefully kept......"
Photo and quote source, Margery Williams' 1922 children's classic, The Velveteen Rabbit,
Today I am still hoping and praying that the Warrens will be successful in helping people to become REAL ENOUGH TO STAND WITH AND SUPPORT their neighbors, their peers and our families.
The video below is of a Sermon on the topic...
https://www.youtube.com/watch?v=W52-H5-6qW8
It is the only sermon I have ever given in front of a congregation. I gave it after I returned from the Conference on Mental Health hosted by the Warrens with approximately 10,000 healthcare and pastoral worker attendees. Speakers included Surgeon General Dr. Vivek Murphy and many, many others. They and their congregation organized and sponsored it at the Saddle-back Church campus in CA.
But all of this was from years ago... What about now?
Very recently KGW News broadcast a story about TODAY'S MENTAL HEALTH CRISIS and Portland's inability to keep mental health workers.
This broadcast discusses outpatient care at the community level. It presents some very good ideas that include, "peer support," and apprenticeship approaches and alludes to low starting salaries, (at around $40k) with the assumption that funding alone is the primary problem. But it did not mention how outpatient mental health worker pay scale and demand is influenced by hospital pay scales. With outpatient workers pay being lower.
It also does not mention the critical shortages of mental health workers in our local hospital. Shortages due to the significant pay cuts and the exodus of workers since the hospital consolidation into the Legacy controlled Unity Center.
Let me explain. With the consolidation of the city's four major Mental Health Hospitals into the Unity Center, overseen by the Legacy Hospital System, a vast number of Behavioral Health Therapists, (BHT) were demoted to the lower pay status of a Behavioral Health Associate (BHA).
This was not based on seniority or demonstrated ability, but solely on past educational achievement. In addition the employees of the more conservative Adventist's Medical Center and the more conservative workers from the other three hospitals were often criticized, or even ostracized for their conservative views or even lack of enthusiasm for advancing progressive social change. The failure of Unity to create respectful appreciation and compromise, created a culture shock for many on both sides.
Consider, the mission statement (at that time) from AMC.
"To demonstrate in human form the healing ministry of Jesus Christ."
It recently was changed to...
"Showing God's love through excellent service in patient care."
And Legacy's
"Our mission is good health for our people, our patients, our communities and our world. Above all, we will do the right thing."
It seemed that at Legacy, "doing the right thing," meant, If you are not excited about doing the "right, (progressive) thing." You should be pushed out.
Legacy's rejection and devaluation of the workers that held more conservative values resulted in many being fired, mostly by having their positions eliminated. Many quitting and many others retiring early like me. All making it easier to replace them with workers at beginner pay scale.
And so today we have a very significant shortage accompanied by low wages due to pay cuts as most BHTs were replaced with lower paid BHAs.
As for increasing mental health demand; the pernicious effects of substance abuse and addiction destroy mental health stability causing demand to explode!
With the recent decriminalization of possessing and selling small amounts of (formerly illegal) drugs, we have made well over 90% of the drug transactions that occur on our streets either legal, or only a misdemeanor. With our passively open border, (to Cartel activity), drug supply is more abundant than ever, and virtually legal.
Today, the incentives that made quitting use, like lack of supply, incarceration, negative social consequences, drug courts and even many recovery options have been removed. Theoretically voluntary counseling will solve this problem if we fund it sufficiently. But I find this very unlikely as I see no mechanism to create motivation for change. For many caught in addiction, even watching those around them die from overdosing has little to no deterrent effect. Since using is no longer interrupted by the negative circumstances we have eliminated, it is unlikely that it will be interrupted by anything but overdose and death. Sadly, in my opinion, the more likely outcome of throwing more money into counseling, will be very well paid, but very ineffective therapists.
I review the severity of these problems and homelessness in my post link at the bottom of this page.
Pondering Homelessness and Community
Where a permanent tiny house village is destroyed, and a public relations, Police Officer is interviewed and talks about the problems he sees with what I have described above.
Click the link below to see the blog.
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