Saturday, November 10, 2007

Assaulting Nuts

Okay, so as some of you may know I work in mental health. I used to run a group home for "persons with severe & persistent mental illness who also had medical issues that made them difficult to place in traditional community care settings," i.e. schizophrenics with diabetes and that sort of thing. I found myself in that lofty position after years of working my way up through the ranks from the lowest of the low -- part time on-call direct care working night shifts and the like.

By the way, the pay is for shit, even at Administrator level, and the stress can be outrageous. Mental health funding waxes and wanes according to the political climate, so from year to year you're never sure what to expect. Hence nursing school. At least now I will make a living wage.

So anyway, I started at TinyLittleMentalHealthAgency in 1991. Other than taking a couple years off for the purposes of not losing my own mind, and then having a baby (thereby losing it anyway), I have been there ever since. However, TLMHA has ingested other mental health agencies in Metropolis, growing ever larger and more unwieldy. Think "Jabba the Hutt." Now it is BigBloatedCorporateMentalHealthAgency. But that is fodder for another post.

I've gone back to work weekends at one facility, just for some extra dough and something to do. And I work a bit of on-call, so I ended up at yet a different facility for Friday swing shifts in November. Last night I show up for my shift and find that one of the clients, who had been absent last week, is there. I have not seen her in about, oh, 8, 9 years. She used to live at the first facility I worked for, back in the day. She recognizes me and calls me by name.

So now I'm making dinner (Swedish meatballs, which evolved into Swedish meatloaf due to some logistical issues, and turned out damn fine if I do say so) and she keeps coming over and nudging my arm with her knuckle, saying, "Let me help. I'll make the dinner." I politely rebuff her offers. She does this a couple of times. I ask her not to touch me please. Then she asks me to help her. I am sympathetic and eventually suggest she might need a prn (as needed) medication if she is having a difficult time with her thoughts. She goes and gets one from the other staff.

Five minutes later, she is back in the kitchen and this time she nudges me as before, but pretty firmly. I spin around and ask her to stop touching me. She says nothing but drives her knuckles into my ribs and propels me across the kitchen. I holler for the other staff, who comes and asks the client to leave the kitchen. Perhaps the client should go lie down on her bed. The other staff accompanies her to her room upstairs, reminding her that she is safe here and that if she needs to go to the hospital, we can help with that.

Moments later the other staff comes down the stairs yelling for me to call 911. The client chases her down the stairs and out of the house. I call, the police are on their way, I step outside to find the client returning to the house. The other staff has gone in the back door. The client goes back into the house and locks me out. The other staff unlocks the door and goes back to the staff office with the phone in her hand. She calls the Mental Health Team that comes to assess and assist with escalating clients. I keep an eye out for the police, stepping in every few seconds to see what's going on with the client. Another client informs me that they are "struggling." The client is now at the office door, reaching over the half-door to unlock it, shoving the door inward as the staff tries to keep her out. I go to assist and the client moves away from the door. I tell the other staff to feel free to lock herself in the office if she needs to. She calls the Administrator while I go again to see if the police are coming. At last they arrive.

Pretty soon we have two officers, two Team workers, the Administrator and us two staff all milling around. The client is asked to sit in a chair which she does occasionally. She gets up and tries to head out of the room several times, very purposefully (perhaps to finish the ass-kicking), only to be gently restrained by the officers. Information is exchanged, the client is interviewed, we are interviewed. Finally they take her to the hospital.

Dinner is late, but the other clients are understanding and the meatloaf is complimented all around.

As assaults go, this was small potatoes. The other staff got the worst of it (the client scratched her arm and shoved her more forcefully than me, not to mention the chasing), and it was over with quickly. But having someone become so unpredictable is stressful, the adrenaline rush is quite interesting, and we both found ourselves crashing a bit later on. I yawned uncontrollably for the last hour and a half that I was there.

This was the first time I had ever had a client lay hands on me in anger (or delusion) in all those years of working in mental health.

Oh, and the thing that really sucks? If you are assaultive and must be taken away in a cop car, you must be handcuffed. Even if you are mentally ill and can't help it, and go willingly.


Elizabeth said...

Wow, you guys aren't paid nearly enough! Why do you think she got so aggitated? Was it seeing someone from her past, or has she been assultive to others lately? I hope your ribs are OK and you didn't get too bruised.

Impetua said...

I think she's just not stable, I don't believe it was personal or that I triggered it since I wasn't the only target. I didn't get hurt at all, just a bit shaken up from the weirdness of it all. This is a client who goes awol a lot and therefore does not receive her medication regularly.

And no, we're not paid nearly enough.