dreamer takes a sick day

If you've been following this blog for a while, you'll have noticed a trend, for a relatively healthy 22 year old, I'm really not all that healthy.  I'd given up posting about my sinuses, but in the past eight weeks, I've been to urgent care twice and my family doctor twice, taken three rounds of anti biotics, used nasal irigation, had decogestants react with my effexor, taken decogestants anyway and hoped for the best, and spent WAY too much time whining about my sinuses.  

My second urgent care visit was today.  It took six hours, but I think it was worth it.  I saw this awesome nurse practitioner student (I love nurse practitioners by the way).  He took the time to really figure out what was going on with me.  I got poked and proded, x-rayed and stuck for blood.  And this nurse practioner student figured out what the doctors didn't.  I don't have a bacterial infection.  That would be why the drugs didn't work!  Now I have some nasal steroids and the joyous diagnosis of "chronic sinusitis".  Colour me not impressed.  

Anyway, I think that's all I have to say about my sinuses, other then THEY HURT!  Last night I dreamed about having a whole drilled in my forehead to drain them.  I was sad when I woke up and it wasn't real.  

Housing Part Four: Barriers to Safe Housing

So now that I’ve written about kinds of housing, reason people need housing, and what safe housing looks like, it’s only fitting to consider some of the barriers to safe housing.  Why, in an industrialized nation such as Canada doesn’t everyone have safe housing?? 

Numbers

The fact is, where I live, there number of people in need of safe housing simply outweigh the number of units available.  I live in a city with an extremely low vacancy rate, and that rate is spread through all levels of housing.  If we were to measure the number of people living in substandard, crowded and unsafe housing and compare it to the current vacancy rate the difference would be staggering.  There just isn’t enough housing. 

Money

When you rent an apartment, there is more to think about then just the cost of rent.  There’s also the damage deposit, and this is a big one.  Almost always, no damage deposit means no rental, and in some cases you are expected to put down first and last month’s rent as well.  This can be simply unreachable for people living on fixed incomes, and since you don’t get your last damage deposit back till you move out… Oh, and did I mention that it is impossible to rent an apartment one what our social assistance system pays for a single persons rent, let alone a safe one? 

Poor Rental History/Bad References

Once you develop a spotty rental history, it’s really hard to get away from it.  I actually had a client turned down as soon as the caretaker saw his name, he’d heard rumors about him in the area and wasn’t willing to risk it.  For someone trying to turn their life around, it can be really frustrating to get shot down for this reason.  Of course, looking at the landlord’s perspective, why risk it! 

Disability

When you have a disability, including mental health concerns, finding housing becomes even harder.  How do you find a place, which meets your unique needs, often on a fixed income?  With such a low vacancy rate, even less are assessable, and even less of those are affordable. 

Literacy/Language

Another barrier to finding safe housing is literacy and language.  What if you can’t read or speak English.  How do you go through ads, answer and ask questions etc… if you can’t follow the language.  Immigrants often have a very difficult time finding housing and often have little money, which adds to the problem. 

Discrimination

I’d love to say that I live in a country where no one cares about the colour of a person’s skin, or the fact that two men are renting a one-bedroom apartment.  But I don’t.  And the truth is, there are some groups of people who are going to be able to find housing a lot more easily then others.  For example, it took me a total of two apartment visits to find one I wanted this time.  And I got it.  Actually, I got both; it’s just that I only needed one, so I chose the one that best suited my needs.  Of course, I’m a white professional, and that does matter, even though it shouldn’t. 

 

Housing Part Three: What is Safe Housing?

What is SAFE housing?

Now that we’ve looked at the types of housing and the reasons a person may need housing, I think it’s important to discuss what SAFE housing is.  I happen to believe that all of the options I went through two days ago have the potential to be “safe” housing, so what is it about a place that makes it safe as oppose to unsafe. 

Safe Housing Has

-          Proper fire safety equipment and meets fire codes

-          Clean hot and cold running water

-          Appropriate locks and security systems

-          Proper insulation and heating systems

-          Repairs are performed in a timely manner

-          Common areas are kept clean and quiet

-          Quiet times are respected and observed

-          Free from toxic mold and harmful pathogens

-          Bedbug free and when bed bugs are find adequate fumigation takes place

-          Enough space for each resident to have privacy when necessary

-          Rent and lease are clear and understandable

-          Some housing is assessable for persons with disabilities

Note: Safe housing does not mean that every person has the right to a mansion with an in-ground swimming pool!  While in an ideal world, every housing unit would be assessable for the majority of people with disabilities, considering the age of many buildings, this is unrealistic, there needs to be enough housing available, but it doesn’t need to be all housing.  Safe housing does not guarantee that the housing will be in what is considered a “safe” neighbourhood.  However, locks and security systems should be appropriate.  In more dangerous areas, this may mean extra precautions are necessary. 

 

Thoughts, ideas, comments?  What does safe housing look like for you or your clients? 

 

Housing Part Two: Who needs housing?

I’m assuming that the majority of people reading this blog have some form of safe housing.  This is simply based on what I know about the demographics of those who comment.  However, I’m also going to make the assumption that at some point in our lives, all of us have had to, or will have to, look for housing.  Because the answer to who finds themselves in need of housing, is everyone.  It just happens that for some of us, it’s easier to find housing then for others. And so we’ll begin here, with situations that create that need.  This of course doesn’t cover all of them, but gives an example.

Apartments being turned into Condominiums

I don’t know what things are like in your part of the world, but where I live, apartment building after apartment building after apartment building is being bought, upgraded, turned into condos and it’s residents asked to vacate the premises.  While there are laws around timing of this, it is still a daily reality. 

Aging out

Perhaps it’s your parents telling you it’s time to find your own place, aging out of the foster care system or adolescent mental health system, perhaps you’re aging out of something else.  The point is an inevitability of life such as aging can play a huge impact on a persons need for housing. 

Separation, Divorce, Death of Spouse

When a family splits up a need for housing is often created for at least one of its members.  For example, a client of mine wound up homeless after he and his wife split up.  His wife and children stayed in their residence and he bounced from family member to family member until there was nowhere left for him. 

Lose or Change of employment/income

A person generally lives in housing for which the rent is paid by their income.  A change in income therefore can lead to a necessary change in housing.  Job loss by one member of the family, a decision to go back to school, the loss of benefits or other income bonuses can have a huge impact on the level of housing a family is able to afford. Income can also be lost due to disability, mental health concerns, long-term illness, addiction etc…

When everything goes wrong all at once

Maybe it starts with the car breaking down, then a family member becomes ill, rent increases, and then you lose your job.  Another client describes the lead up to being homeless as starting with one little thing and snowballing from there. 

Above Market Rent Increases

Where I live there is legislation governing how much rent can go up in a given year.  However, landlords can apply to increase rent over this if they can prove why they need to.  This can lead a person to no longer be able to afford their suite for no reason other then this, and it can happen to anyone. 

Accessibility

As people age, they develop the need for more assessable buildings.  Perhaps a building with an elevator instead of stairs.  Or maybe it’s a child who needs the assess ability.  Lots of reasons that you may need to look for a place with better access. 

 

Housing Part One: Types of Housing

CB’s recent post about housing inspired me to do a short series of my own on housing, from a few different perspectives and looking at different types of housing as well as the different problems facing those who are looking for and attempting to maintain housing.  For today, we’ll start by looking at the different types of housing available where I live. 

Private Owned Property

This is very basic.  You buy a house or a condo and you live in it.  This is perhaps the “ideal” for housing, and what many people aim for.  Buying property enables you to gain equity, rather then simply having your rent sucked away. While housing can still be in a bad neighbourhood, you are free to make improvements as necessary. 

Private Rental Property

Again, basic housing, a house or apartment you rent.  These of course vary in their quality and location from the lowest of the low to first class furnished apartments.  In a rental suite, you pay rent to the landlord or rental company and in turn they are supposed to do necessary repairs, maintain the building and treat you fairly.  Obviously, this does not always happen.  For the most part, the more you pay, the more you get. 

Subsidized Rental Property

This is a system in which the government subsidizes some suites in a variety of buildings and areas through private companies.  Basically, you pay a certain percentage of your income; the government covers the rest (and property owners may give a discount) and get to stay in a nicer place then you could afford on your own.  I personally think this a great system, although many people have a huge issue with putting “poor” people in with “normal” people.  When they move to a building they don’t want there to be welfare recipients or low-income earners there. 

Public Housing

This is housing run by the government.  It operates on a percentage of income; you don’t have to be on social assistance to live there.  Often these buildings are grouped together, or a large amount of row housing is in a common area creating a little “town”.  These places are some of the most dangerous places in the city, and many have a police office in one of the row houses, or if nothing else, reserved parking for the police.  It’s just expected that they’ll be needed.  Many of the buildings are totally overrun by bedbugs and mice and are in awful states of disrepair.  I’m not sure I could actually spend the night in one.  BUT some people really like the sense of community they feel living in these areas.  Often family is living nearby and neighbours become friends. 

Rooming Houses

Just as it sounds, a rooming house is a house in which you rent a room.  While some are okay, most are the kind of places I won’t go visit clients alone.  Shared bathroom, shared kitchen, little enforcement of rules.  Dirt, bugs, filth, rodents, drugs, prostitution, exploitation etc…  At some the conditions are inhumane with little running water, poor insulation and other structural problems.  The fire risk is huge, and when there’s fire, people often die. 

Hotels

Then there’s the hotel system.  Many hotels in the core area offer rent by the month.  These are ancient hotels in bad repair.  A lot of them don’t have separate bathrooms, or any kitchen facilities.  The most popular establishment is the bar on the main floor.  I remember when doing practicum, one of my clients would meet me at the door and walk me back out because he didn’t feel that I was safe walking down the hallway alone. 

Room and Board

I don’t know how to even begin to describe these places.  Picture a large house, a cook, and a whole bunch of people many of whom are extremely mentally ill.  For a person entire rent and food budget from social assistance, they can stay there and get their meals there.  Often these places are two to a room, and you don’t get to choose your own roommate, and all meals have to be served within the cook’s eight-hour shift.  Rice and frozen vegetables are often served at all meals.  Dinner’s at 4, and then there are no meals till morning. 

Group Homes

Housing for the mentally ill or the psychically disabled.  From what I’ve seen, people with an intellectual or physical disability are treated much better then those with mental illness.  Many group homes are run for profit, so the owner tries to do as much as they can with the least amount of money.  If they can find a staff person to live there and cook there, well, they’ve covered the requirement for 24 hour staffing.  Clients often have roommates, and once again, they eat a lot of rice.  They are certainly not anything resembling therapeutic. 

The Shelter System

No reserved beds.  No privacy.  Everything shared.  BUT, it’s often better staffed, cleaner, safer, more friendly, more homey, and has better food then a lot of the other options out there. 

 

Negative Symptoms of Schizophrenia

I had one of those eye opening moments the other day.  We had a client present with all the negative symptoms of schizophrenia, and virtually no positive ones.  Actually, rather then realizing that she had gone off her meds, we assumed she was on too many meds.  I would totally have bet on her anti psychotics being too high.  

When she came for her intake, she seemed like your average young adult female.  By the time she started her first class session she was freakishly unmoving, unspeaking, and seemingly uninterested.  When I say unmoving, I mean it was as if she became a part of the chair.  Always sitting perfectly straight though, never slouching.  Her eyes would choose a point, be it the front, the back, or the desk, and they would never move.  Her "creepy" coloured contacts, gave her an even more frightening look.  Her answers were all in yes or no form, with the most common one being "no".  Being her counselor, it fell to me to confront her.  

The first time I tried, I got no where.  She gave me some "nos" and then walked out.  So then two of us sat her down a different day.  At this point, she informed us she had stopped taking her medications after having a "bad" time with them.  We let her go without pushing her too hard, as she was honestly scaring both of us.  Our supervisor met with her and her father today... we'll see what happens.  

The point is though, assumptions are bad.  We all assumed she was over medicated and totally missed the fact that she was in fact off her meds.  Even though I knew she had a diagnosis of schizophrenia, and I know about negative symptoms, it didn't occur to me till yesterday that what we were seeing were symptoms not med reactions.  

Schizophrenia isn't just voices! 

What I'm Reading this Week: Beyond the Razor's Edge

Redheffer, J. and Brecht, S. (2005).  Beyond the razor’s edge: Journey of healing and hope beyond self injury.  New York: iUniverse Inc.

I don’ t usually publish book review of books I don’t like, but this one, well, there was something about it that made me want write about it anyway.  Being a former self injurer (or whatever the popular slang for that is now a days), I’m often drawn to books about self injury, this one being no exception. 

The book is a collection of stories and poems written by the patients and staff of SAFE Alternatives treatment program.  SAFE stands for Self Abuse Finally Ends and is associated with a hospital in Chicago.  They are a one-month “cold turkey” program and provide after care for those living in the Chicago area. 

For those who’ve been through the program at SAFE and found healing through it, I imagine this book is a nice way of remembering those times.  I however found the book to be very narrow minded and very focused on how wonderful the program is.  It would be sort of like a book written by recovering alcoholics all of whom found sobriety in the exact same way.  In many ways SAFE resembles AA and the story repeated over and over again is “once I submitted to the process I began to heal”.  And maybe that’s true, but I’m a firm believer that there is more then one way of healing. 

I suppose I need to take the book for what it’s written for though.   The self-described goal of the book is, “to empower individuals to make healthier choices by sharing what has worked for others” (p.ix).  Well, they do share what has worked for others, but I really don’t think that the book is all that empowering.  If anything, I find that it could be frustrating in the way it promotes a very specific program, which is not all that accessible. 

Recommendations… well, I’d have to say don’t bother reading it.  Maybe if you want to go work for SAFE, or if your thinking of starting your own program and want to read about people’s successes in this one. 

The stories are good though.  It takes courage to share your story and each and every woman whose account is in this book had the courage to stand up and say, “this is me”. 

 

Staff Meetings...

We had a staff meeting yesterday.  All the staff in our organization.  I can't say I was impressed.  I am NOT good at sitting still for 2.5 hours listening to stuff that is mostly irelevant to me.  Then our executive director was all like "how come the employment people are so quiet".  And well, it's because we simply didn't have anything to say!  The meeting was almost entirely about our residential program which we have very limited contact with.  

On the other hand, the staff for my program has a staff meeting once a week.  It's quick, to the point, and relevant.  I also find them fun.  I look forward to them even.  I know that if I'm having problems or there's something going wrong, I can bring it up at the staff meeting.  We often have food or something.  For example, today there will be skittles.  

Then, every other week we have a client meeting at which we review the status and activities of each and every person in our program.  It is a seriously great way to collect help and suggestions and I great way to make sure that none of our clients are being forgotten about.  So really, it's just the all staff meeting's that I hate... but still, how I hate them.  

On another note, having a boyfriend is time consuming.  The intrepid one came over to watch the next disk of Friends last night.  It was awesome, but it took my whole evening... 

Poems on the Spot

He sits on the corner near my house. 

His sign says 

Poems on the spot

It's his way of panhandling

From his wheelchair

He's a strange man

I've tried for a long time

To break down those walls

Sitting with him

At the Salvation Army

His duct tape covered jacket

Has me asking the question 

Why?

It's cheaper, he says, with a frown. 

But I know where you can get new ones, free. 

Last week he told me, the poem business 

Isn't going all that well

Maybe he's losing his uniqueness

People are too blind to see

He's hurting deep inside

dreamer finds a boy (oh wait, I'm supposed to call him a "man")

You may have been wondering what happeneded to the dreamer over the past couple weeks.  Where have her deeply insightful and thought provoking posts gone?  Well, there is a simple answer, as happens to many of us, the dreamer has found herself a boyfriend who from now on will be referred to simply at "the intrepid one".  He got that name when we were 13 and it's stuck.  So yes, instead of lying on my couch blogging, I've actually been getting out of my house and seeing movies, and eating ice cream.  Although yesterday, we sat on the couch together and watched 8 or so episodes of Friends.  

Things seem to be going well these days.  I have yet another set of antibiotics for the never ending sinus infectiong, but I'm trying to be really diligant about taking care of myself so that maybe this time it'll finally go away!  

Work is going well.  My case load still really isn't picking up that much, but it's summer, and apparently that's what happens.  I've been doing quite a few intake interviews though, which is nice, I LOVE learning people's stories.  

Church is good as well.  And I'm seeing my spiritual director again on Tuesday.  

Sophie Cat is doing well.  She really seems to like the intrepid one, which is good, because it's vital that the two of them get along.  Yesterday she kept a very close eye on him...it was kind of creepy actually.  I think she senses something is up because she doesn't stare at bestest buds boyfriend the same way.  Currently she's sticking her paw in her water dish and licking the water off her paw... she doesn't like to drink the normal way.  

So hopefully more social work posts shall follow soon.  I'm off to get my morning coffee before I go into major caffienne withdrawl.  

What I'm Reading this Week: Bad Therapy

Kottler, J.A. and Carlson, J. (2003). Bad therapy: Master therapists share their worst failures.  New York: Brunner – Routledge.

When I saw the title of this book staring out at me from the shelf I was immediately intrigued.  Bad Therapy?  Who writes about that?  I’ve read many books in which therapists share cases, both good and bad, many stories of those who survived bad therapy, and of course books that bash the entire idea of therapy at all.  Thinking it would be a collection of short stories, I stuck it in my bag for work the next day ready to jump in. 

While it many ways it was a collection of short stories, in other ways it wasn’t.  Kottler and Carlson put together a set of interview questions which they sent to participants ahead of time and conducted a study of sorts, so things didn’t flow quite as well as I’d hoped they would. 

The authors spoke to twenty-two different therapists, and while their biographies were impressive, I have to admit the only one I was familiar with was William Glasser the founder of Reality Therapy.  The therapists had a variety of backgrounds and worked with a variety of theories, which is something, I appreciated about the book.  Further, it was refreshing to hear therapists be honest about the mistakes they have made or were perceived to have made.  Although, I have to admit, most frontline workers I know are readily willing to admit they’re not perfect!

In terms of recommendations, it’s definitely worth checking out if you have any interest in therapy.  At only one hundred and ninety-nine pages it’s a short read, and due to the format, it’s good for reading when you only have a little bit of time.  It’s probably not a great read if you’re looking for something entertaining (which I usually am).  Finally, as I mentioned before it’s presented in interview format rather then as short stories and sometimes the flow seems just a little bit off, so if that’s important to you, probably not a book you’re going to want to open up. 

 

The Service Eater

Most social workers have dealt with these clients.  The clients who have been to every program under the sun and hope that yours will give them that something they need, that one extra push etc…  The question is, what do you do with them? 

Something I’ve noticed, is that many of these clients have a very negative mental filter.  Despite the positive things which may be going on in their lives, they focus exclusively on the negative and seem unable to take the positive into account.  They often seem very genuine and earnest, often citing the bad experiences they’ve had with other social workers/programs.  And yet for some reason, they keep trying again. 

While some of them have tried and quit every program, there are some that are still IN every program.  I recently had a client who was seeing something like six different counselors at once, and wanted to join our program on top of that.  Despite all the counseling, he was definitely not mentally stable and I recommended we put a hold on his admittance.  I don’t think adding a seventh (or however many) service is actually going to do the client any good. 

The thing is though, no one program is going to be right for everyone, and sometimes what people need isn’t so much a program but someone who will stick with them no matter how many times they quit.  For example, if a client has a counselor who is willing to take them back no matter how many times they storm out and find a new counselor, maybe that continuity will help them to make progress.  It’s hard to know though.  Sometimes the thirtieth program is the answer, it’s the one that clicks, the one that works.

Maybe this thought doesn’t have a point? 

What I'm reading this week: Cracked

Pinksy, D with Gold, T. (2003). Cracked: Putting broken lives together again, a doctor's story.  New York: Regan Books.

I'll be honest, I liked this book until I realized who wrote it.  Not being up on popular culture, I didn't realize that the author Drew Pinsky was the doctor on the shows Celebrity Rehab and Sober House.  I find those shows disgusting, as in they disgust me, not that they have gross content.  So pretend with me for a moment, that I don't strongly dislike the author's professional image and we'll talk about the book.

Pinksy writes about his time spent working as on a doctor on the chemical dependency unit of a hospital.  Unlike the model in my city, the unit seems to function as both detox and addictions treatment, with clients moving directly from hospital to sober living facilities.  The book takes us through average days in Pinksy's life following the lives of patients and their efforts to gain and maintain sobriety.

Dr. Pinksy addresses some of the common causes of addiction although he tends to take a somewhat narrow approach.  He is a doctor, so perhaps it makes sense that he pays a great deal of attention to the medical model and
the theory that addiction is a disease.  The book is clear that the way to maintain sobriety is to detox, start the twelve steps, find a sponsor, and stay in a sober living facility.  The author acknowledges no other paths and does not discuss other models of addiction.  He is clear that all addicts come from extremely dysfunctional families and were abused as children. While I don't have any studies contradicting this on hand, it "irks" me that there is nothing else presented.

Dr. Pinksy shows a great deal of self awareness in his writing, spending time discussing what many would term as "countertransferance" (although he does not use that word) and his reactions to patients.  I appreciated that fact that he acknowledged that he had these reactions and they played a part in treatment.  It takes confidence to talk about your awareness that a patient is trying to sexually seduce you and your reactions to this situation.

As for whether I would recommend this book, I'm not sure.  I might, especially if the person I was recommending it to likes Dr. Drew, but my dislike of his TV shows doesn't make me want to.  But, books are what they are.  If you're interested in a basic overview of one model of addictions and treatment it might be a good place to start.  The patients are interesting, and the story is well told.

Borderline Personality Disorder

You know, I’d never really understood the hype about Borderline Personality Disorder; I kind of thought of it as an over diagnosed phenomenon with a huge stigma attached to it. 

I’m starting to get it. 

I have a client with a diagnosis of BPD.  I have one more who meets at least as many criteria.  And they really are hard clients to deal with.  If it wasn’t for the fact that we have a good supervisor, I think this client could have caused a huge stir around here very quickly with a couple accusatory emails she fired off yesterday and today.  Thankfully our supervisor realizes that we actually are doing what we’re suppose to do and has not sided with the client.  Because the staff involved have a good working relationship she has not been able to turn us against each other.  It’s a good thing.

All that being said, I still think it’s an overdosed phenomenon with a huge stigma attached to it. 

Currently, our staff is doing all the right things, and I hope that the client, and us, will be able to learn something from it.  Because we work as a team, we’ve decided to be consistent in the way we approach her and deal with her.  This virtually eliminates her success in playing us against each other.  Further, we had a community meeting with all her service providers (and her mother), and came up with a plan.  We’re sticking with the plan and trying to reinforce it with her.  This means redirecting accusations of “you’re not doing anything for me” to “did you get on the list for this class”? 

It also means ignoring some of her more exasturbating emails and reminding her to come in for her appointments.  This reinforces our team’s boundaries, because from what I’ve read, and what I’m observing, boundaries are going to be everything.  Fighting with her, is obviously unprofessional, but more over, it’s not going to work.  Accusing her of things is not going to help her or us in any way, shape, or form. 

deinstitutionalization

Let me start by saying that I realize I'm touching on a controversial subject.  I'm going to talk about it anyway.  

A few nights ago I was at a meeting about disability rights legislation.  Yay advocacy and policy development!  Anyway, at the end, for the "check out" (gotta love meetings run by social workers...) we had to share a barrier we thought was faced by the disabled community or that we were currently facing.  I talked about lack of adequate access to mental health care, some people talked about attitudes, others about accessability and employment, all the normal things.  What surprised me, was the number of people who talked about institutionalization and how important it was that we continue with deinstitutionalization.  

I'm not sure why it surprised me.  It's not exactly an unfamiliar concept for me, and for that matter it is something our government is currently working on.  Our newest Assertive Community Treatment team was set up to take referrals only from the long term mental health care facility, at least in it's initial stages.  In otherwords, it was designed to be intensive support for deinsitutionalization.  

The thing is, in my experience, institutionalization, in some way, is necessary, until we come up with better options for psychiatric treatment.  I spent eight months doing practicum in Assertive Community Treatment, the most intensive form of community mental health care my province has to offer.  The clients have a team of professionals and twenty four hour on call support.  They have daily contact, sometimes twice daily, observed meds and assistance with just about anything you could need assistance with.  Unfortunately, even with this very intensive level of support it was necessary to make two referrals to the long term care facility during my eight months.  Of course during that time we had many success stories as well.  

See the thing is, despite everything the team was doing, these clients simply could not be maintained in the community.  One woman was living in a rodent infested house with rotting floors, sleeping in a urine soaked bed, the house was in and out with drug dealers and the dirt was incredible.  She absolutely refused to take meds or to move.  Eventually the police had to remove her from the home and the public trustee made the decision to stop paying her rent.  The last time I saw her, she was doing okay in hospital, but certainly not well enough to live out again.  Another was so mentally ill and so drug addicted she jumped off a bridge, thankfully not too high up.  The courts didn't know what to do with her many crimminal charges and once release from jail or hospital she'd disappear for days at a time without taking her meds.  Because of her spinal injuries, she was referred to long term for her own safety.  

And then there are the forensic patients.  We have a special locked ward for them.  And seriously, I've been on the "worst" ward in the long term care facility.  The patients there are very, very mentally ill.  They are affected in ways that I cannot even begin to imagine.  Maybe with time, and patience and new treatments something will change, but until then... where will they go if their insitution is shut down?  

Finally there are the geriatric patients.  I've got news for you, schizophrenia doesn't end with middle adult hood, brain injuries don't magically heal.  And while we do have specialized homecare services, some clients just need more then that.  

So, i do agree with deinsitutionalization.  I want to be very clear about that.  I also don't agree with the institutions of the past, however, I want to make it very clear that there is a time and place in which long term psychiatric care facilities are necessary, and I don't think closing them all, especially without replacing them, will do the community a whole lot of good. 

Spiritual Direction

So this evening, I went for my first session of spiritual direction.  Or maybe that's too clinical.  Perhaps I'll say, this evening I met with a spiritual director for the first time.  It's something a mentor of mine suggested to me when I was so depressed a couple months ago, and that I took some time to read about, think about, talk about, and pray about.  Eventually, I decided to go for it.  I really do want to feel connected with God and to nurture the spirtual side of myself.  

Basically, Spiritual Direction, or at least the kind I'm participating in, is a conversation between two people where the focus is God.  It's comparable to a counseling relationship, but it's far less clinical.  Further, counseling most often has specific goals and such.  Spiritual direction is all about the journey.  If the goal is to feel closer to God, you don't have to know what that will look like, or how you'll know when you're there.  Spiritual direction can go on for years and years.  The director listens, there is prayer, and perhaps you focus on a certain spiritual discipline together.  The two listen for the Holy Spirit and focus on what God is doing in the directee's life.  Often it invovles talking about daily life and recoginzing where God is, being more attunded to the working of the Holy in the ordinary.  

Tonight's meeting was a good experience for me.  I feel comfortable with the woman I found, and comfortable with her background.  She also felt comfortable working with me, and thinks that I'm in a very good place in my life for this journey together to begin.  

So we'll see where things go.  Generally you meet with a spiritual director about once a month or once every 6-8 weeks, however for the first couple months we'll be meeting every two weeks as we get to know each other and I get to be comfortable in her presence.  Spirituality has been a part of my life for a long time, but is something I often don't articulate very well.  Hopefully, I'll be able to articulate some of it here as well as other places. 

long time no post.

I'm still not posting much.  I was out a lot today, no time for writing.  Church, yoga, gelati, dinner, tossing around a frisbee with friends.  Much to do.  

BUT, for those of you who twitter... So does Sophie Cat!!!

Follow her on twitter :)  http://twitter.com/TheSophieCat   

that is all.