Working for a System That Doesn’t Work
How stigma, media, and bureaucracy contribute to a broken mental health system.
In junior year of high school, I watched a lot of crime shows, and fell in love with Dr. Spencer Reid. I wanted to be like him, but after accepting the fact that I wouldn’t be able to handle crime scenes, I decided to study psychology. Seven years later, I’m currently working as a case manager at a mental health center.
Do you know how often people ask me if my job is dangerous? Or if I’m scared of being around these patients?
Like any job, mine has risks. But my best friend, who works at a vet’s office, will point to the puncture wound on her leg and tell you her that her job has risks. My boyfriend, who works long shifts as a paramedic, will laugh and recount stories of patients trying to fight him. I can even show you the burn scar across my knuckles from a heat lamp at the pizza restaurant I worked at in high school.
Most people would be quick to assume that the clients are the difficult part, right?
“The crazy people.”
Wrong.
The hard part is a lack of housing, funding, resources, support, and mostly, understanding.
It’s clear to see that there’s a negative stigma against mental health. Having these issues is seen as taboo, dismissed as “crazy”, or in the worst cases, used as a scapegoat when someone commits horrible acts of violence. The media perpetuates this disillusioned viewpoint. Sometimes in subtle forms, where the villains we see have some sort of affliction (looking at you, “Split”), but other times it’s more blatant, with the negative coverage and comments surrounding people suffering from depression, addiction, and other ailments.
When I began working in this field, I thought I’d be able to ease that stigma, or at least escape it. I thought I was among people like me, who were interested in how the mind worked and wanted to help those whose minds worked against them. I knew it wouldn’t be easy, but I never realized that it would be like this.
I see the way other healthcare professionals, like primary care doctors and dentists, treat my clients. The lack of patience with these patients. I have to explain to frustrated and concerned parents why their child still has hallucinations even on medication. I have to argue with caregivers at assisted living facilities who do anything but care.
But worst of all, I have to sit back with my hands tied while my clients face hardships that I don’t have the resources to help them with. I can’t always help them afford food or their bills, or help them find housing, or finally get them to a doctor for their never-ending ear infection because they don’t have insurance.
The American healthcare system is fucked up as it is, but the mental health care system is a whole other level. As both an employee and a patient (Lexapro Lexi, what’s up), I see first hand the way that the constant misunderstanding of mental health impacts the way it is handled in the public sector.
People don’t want to talk about it! People don’t want to address their own issues, and they definitely don’t want to address others’. There are some people that don’t even think mental health is real, or as severe and persistent as it is. Those that turn a blind eye to mental health are some of the same people voting for healthcare bills, or the ones writing the bills in the first place. Mental health is left out of the conversation until another public shooting happens and the media can blame the shooter’s mental state.
And then still, nothing gets done.
It’s not just the clients who are affected either. It’s the employees. I love my job, but I’m a mental health worker in need of a mental health day. Or week.
I thought that I was burnt out, until earlier today, my boyfriend showed me an article on what is referred to as “moral injury”. In an opinion piece for Stat News, Dr. Simon Talbot and Dr. Wendy Dean discuss the dilemma that healthcare workers face when they want to provide the best care they can, but are unable to. Most clinicians will tell you that their main goal is to ensure that patients receive the best treatment, but factors like business profits, insurance, and resources often jeopardize the quality of care. The article focuses on physicians, but can easily be applied to a lower pay grade: the case managers, the social workers, the therapists, etc.
When people aren’t asking if my clients are scary, they’re telling me how fulfilling my job must be.
Not. Really.
I cannot stress this enough that when it comes to mental health, the patients are not the issue, but the lack of help. Physicians, law enforcement, our neighbors and our government need a better understanding of mental health conditions and its patients. With an enlightened stance, the healthcare system can be adjusted to include provisions that make this field easier to work in, and therefore making treatment more effective and patients’ lives better.
Until then, I will go to bed tonight, get up tomorrow for a long day to start a long week, and argue and network my way through all of the red tape I need to in order to provide the best care for my clients.
Because if I’m not in their corner, who else is?
