Posted by: Kate | May 3, 2008

A Well-Oiled Snafu

It’s not a good sign, perhaps in any job at all but certainly in mine, when the client starts with a graphic description of precisely how he will kill his wife if you let him go home today.

A bad sign, but I couldn’t have predicted that it would lead to an eight-hour process, which might ordinarily have taken one, maybe two hours.  Nor could I have guessed that by the midpoint of the day I would field a request from my direct supervisor to speak to the head of the state hospital, the supervisor of the on-call psychiatrist whom my supervisor called a condescending asshole and then wanted me to intervene in some bizarre twist of political insanity.  I certainly could not have anticipated an evening that ended with me on the phone, giving official statements to police officers in two different states.

Days like this, I don’t enjoy my job.  I didn’t help someone; I got someone enmeshed into the system because I couldn’t find a better, safer alternative.  I got enmeshed, myself, but the difference is, I’m home and sleeping in my own bed tonight.  There’s a beauty in that, but it’s not as good as the days when putting my heart and soul into my work touches someone else’s heart and soul.  Those days are worth it.  This day was a paycheck.

Let’s face it, New Hampshire is not the place to be if you’ve got a severe mental illness, or even just playing it on TV.  There’s not enough money, not enough staff, not enough facilities to meet the basic needs of the chronically and acutely mentally ill, and so the attitude has shifted from a treatment modality to one of crisis containment.  We’re not actually trying to fix anyone here, and we’re not even trying to maintain a baseline; we’re just trying to keep the very worst situations from exploding.  It doesn’t always work.

I think it worked today.  That is, it did work for this specific calendar day, but I’ll be watching the news headlines closely in a little while, just in case this particular Band-Aid falls of the bullet hole too early.



  1. I think that is the whole country’s if not the whole world’s attitude towards mental illness. Unfortunately you have to do the best you can with what has been given to you . Sorry it wasn’t a worthwhile day but just a paycheck day.

  2. What happened to the guy? Arrested or committed?
    His wife probably has been having some great days, too, with or without a restraining order.
    You’ve helped them as much as you can Friday. More, since it sounds like you didn’t take no for an answer right away.

  3. Unfortunately, is there any state who is dealing with the mentally ill correctly? I know Oregon is not one of them either. (my husband’s nephew has schizophrenia and it’s been a battle to get him help)

  4. Sounds like an endemic problem in Western hospitals. Some years ago, all bu the most needed mental health units were closed down and patients with ‘minor’ mental disorders were housed independently with live in carers. It doesn’t work . . now we see suicidal teens in old people’s homes, lack of dimentia and Alzheimer’s facilities in aged care and all but the most manic are pretty much left to their own devices. You did what you could . . .

  5. It’s sad, but our hospitals don’t have room or resources for all the people who need help. Some get shoved off to prison, but even prisons have a shortage of room and resources. It’s so very, very sad. Thanks for trying to make a difference anyway. It’s so easy to say ‘can’t be done’ and look the other way.

  6. Gee, sounds like you saved a life or two today. You can only do what the parameters of the system allow you to do. Frustrating? Hell yes.

    I think you did good.


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