Monday, April 14

Mental Health Patients

For my Community Experience, I interviewed a staff member that works with the girls' youth unit at a mental health facility. This was an enlightening conversation for me, because although I have a slight history of depression and anxiety in my family, I have never interacted with the mentally insane on a daily basis.  I also was able to relate topics from Multicultural Education class discussions such as privilege and social capital to what I learned about the young women.

There are twenty young women in this facility as patients for their mental illness.  Basic demographics about them are not encouraging.  Most of them come from abusive or neglected homes, with high poverty rates and a strong history of mental illness in their family.  Many have found better homes, through adoption and usually grandparents, but the scars from the abuse linger and have profound effects on their mental health.  These circumstances can almost be seen as a negative sort of privilege, where their social class and history of abuse make them more susceptible to a whole host of other stressors, including mental illness.

Sometimes, their parents and family life is a great support to their recovery. They receive frequent visits, every weekend, and their parents are actively involved with their treatment teams to understand the problems and solutions for their daughter.  How much improvement and how quickly patients recover is significantly impacted by the support the receive from their family.  However, some families do not have the means to visit, or the ability to focus on supporting their daughter's recovery because they have their own problems to deal with.  Some patients are even denied access to their families because they are a bad influence on them.  One girl is not allowed to see her mom during her recovery because her mom was her drug provider.

Many of the patients don't know how to act appropriately in social settings because of the households they were raised in as children. When they were younger, they learned that abuse and mental instability, acting out and other violent behaviors were the way to get attention and normal activities.  Even in the facility, it is important for the staff to set good examples of what "normal" and good social behaviors and interactions look like, because they have not had very many examples before. They also cannot mirror their peers, because in the facility they also have inappropriate social behaviors and are there to learn how to act in polite society.  These girls are lacking even the basic level of social capital, and are unable to relate in social settings.

Obviously, in addition to learning appropriate social behaviors, these patients need to overcome some serious mental issues.  The main illnesses that are encountered are depression and suicidal tendencies, self-harm and abuse issues, violent outbursts, and borderline personality disorders.  While their therapists and treatment teams work with them on these illnesses, the staff members are responsible for the follow-up and behavioral management enforcement.  Using the same system during free time, school hours and with more strict behavior plans, the staff are able to maintain reasonable enforcement and consistency with the girls. They use both positive and negative reinforcement, and let the residents know that most activities and "fun things" are privileges, not rights. The staff member I interviewed testified that the method and plan is effective and they definitely see an improvement in bad behavior.

School for many of these patients has been a bad experience up to this point.  They have been struggling with their mental illnesses and academics at the same time, and not succeeding in conquering either.  One patient, who had been abused, but also who has severe learning disabilities came to hate school and being the "stupid one" so much that she started to act out and become the bad one instead. This started her on the self-destructive path toward anti-social behavior that she is working on correcting in the facility now. In the facility, school is a more laid-back experience, with students setting reasonable goals, that they want to work towards while in the facility.  Examples of these goals are one patient trying to get her GED, and another trying to earn credit for the 9th grade year she is missing. There are two teachers in a room with 10 girls, which results in good personalized attention and behavior management support.  The educational goals are appropriate to the student's abilities, including their amount of participation and the pacing of the class and work deadlines.  Teachers take the attitude and position of "let me help you do this" and tries to bolster the student's confidence in their ability to succeed academically.

Most of the patients transition back to society through step-down programs, or to other facilities to help them with other issues, when this facility and staff in it have done all they can to help the patient.  Many patients transition back out of the facility within 6 months to a year, and almost all are ready for life again, with good social skills and behaviors.  And this is the most fulfilling part for many of the staff, getting to see the improvement in the patients and their lives from their entrance to their exit from the facility.

As a pre-service teacher, it is a scary thought to me to realize that I may have students that need more professional help than I can give them, and students that just received that help.  But just recognizing these issues exist, that there are ways of dealing with them appropriately, and help is available is a comfort to me. I have a responsibility to teach and learn from these students, just like all the others, and I hope to be a good adult example in their life, that supports them as they make right choices. I also want to prevent my students from getting to the point where they hate school so much, they would rather act out and be bad instead.  I want my students to feel and truly be capable of academic success. It will help with so many other problems that they may face in life if they can succeed, even in a small way in school.