Where I work now, nobody talked about Virginia Tech this week. We were busy, I guess. In one meeting, I blurted out, "Who wants to talk about the Virginia Tech incident?"...nobody did. Later a member of the group said, "You know this place was really involved in Columbine...I think maybe everybody just doesn't want to deal with it again."
I know that the information about the shooter - that he'd been identified by his community as a 'disturbed' person - caused a kaleidoscope of images for me...all the disturbed people I've seen - the ones I'd 'evaluated' and deemed 'dangerous' or 'not dangerous' in the years I've been in public mental health, flashed before my eyes. How many times have I been wrong? What if I'd been the evaluator for this guy? What if I'd turned him loose after his hold expired. yikes.
I tried to inspire interest, at that meeting, by considering our response in a case I'd been involved in there. Recently we had a guy who'd traveled the road from aggravated robbery and drug possession to prison, to state mental hospital, to assisted living facility in the community. We "held the cert" on him - by which is meant that we had a piece of paper that stated he was ordered by the court to receive mental health treatment from us...which made us responsible in some sense for him. In about a week and a half he was staying out all night, taking drugs, and pounding on his mother's door in the middle of the night, demanding money.
I said, "We've got a cert! Put him back in the hospital." The agency said, "this behavior doesn't rise to the level of requiring hospitalization. The guy is making choices. Those choices will have consequences. You can't hospitalize someone for making choices. This is the Recovery Model!!"
The consequences were that within another week, he was evicted from his assisted living home. His social security benefit - which would have paid for the assisted living, was in that awkward moment betwixt in hospital and out, when payments haven't started yet. Our agency was the payee. So our guy had nowhere to live, no money, and a raging drug craving. I felt pretty confident in predicting that given how he'd spend his formative years, his choices would not be helpful ones.
So in the meeting I said, "Isn't this a discussion we need to have? Why do we make these decisions? How do we know we're right?" The evaluators in Virginia were "right" at the time - 2005 - he didn't kill anybody in 2005, after all. But if they'd "treated" him for a while...brought him in, got to know him ... had some human exchanges with him over a period of time ... might not that have changed 2007?
You ever watch "House" on TV? In House, there's 4 doctors who spend days thinking about, talking about, experimenting on, etc. a single patient. The patient's illness is the mystery, and the 4 (or more) doctors are the investigating team, who's sole mission in life is to figure out what's wrong and how to fix it.
If House had seen the shooter in 2005, he and his team would have devoted all their considerable talents to understanding his behavior. They would have dispatched someone to the family home, would have spent extended time with the parents and sister; would have examined the speech problem, diagnosed and treated it; would have CAT scanned his brain; would have observed and interacted with him with concentrated interest for as long as it took. Whatever happened next, the trajectory of the shooter's life would have been changed.
The idea of doing that with every guy that walks through the mental health door is ludicrous. Ha!
Doesn't happen.
Couldn't happen.
The Organization Stress paper describes in great detail why it couldn't happen...having just read it, the events at V Tech appeared to be the real life illustration ... a brutal movie about society's infrastructure failure, due to Organizational Stress.
Our regulations in this area, our evidence based studies, our Recovery Model...are wallpaper - hiding our lack of attention and resources to do work that doesn't result in profit.
So it goes.
Might not matter, if its true that cell phones are causing bee collapse...especially, if Einstein was right in saying that after the bees go, we've all got only 4 years left ourselves.
4 comments:
So the fort may not have lost $8 million dollars, but should anything be a surprize at our place, knowing that this kinda stuff is happening upstairs! Makes the false hopes and promises seem menial. Makes the lack of work, supervision, management, and ethics seem unimportant. Except for this is why $8 mil can disappear, and on a smaller scale, why patient care and employee satisfaction is so bad at the fort.
wait a gosh darn minute there Daisey. a year has gone by and folks are doin their refresher training with the compitency fair. 'has been cut down from 2 days of classes to one sit there and take it day. with the same dramatic impact. Its a group sffsrt too so's you don't have to be scheduled off the work site if ya were to mess up. The long bill has past and there touting 4+ % raises 5% + if you're a 2 or more. That's why the band on the Titanic kept playing. for the tips.
Maybe plugging that leak in the tax department was a good thing.
to the person complaining about the long term employees, complalining....you just spent all of your time doing what you accuse them of doing... not every long term employee sits around bitching all day. We are there because we care about what we do and want to make things better. I'm sorry you have such a dimm view of your co workers......
This was the best training I have ever had at the hospital. Our person did an outstanding job of keeping us focused, and it was fun also.......
Post a Comment