Psyched Out

Today is the last day of the month, which for yours truly means a frantic last ditch attempt to see our psychiatric patients who are missing in action. Either because they are very ill and have lost contact, very well and have blown us off, living in a different place now while not seeking treatment or simply uninterested. I try to see these people throughout the month, it's one of my main duties. So Last Day MIA's are the hardest to find, and I often spend the day in a very sad state of working hard while getting nothing accomplished. (MIA is NOT what we actually say, we have a convoluted and politically correct phrase in real life.) True, each try counts as an attempt to make contact and makes our Community Mental Health (CMH) happier if they read the records, but ideally I actually treat the people so we actually get paid. With CMH, these attempts are required weekly but not paid - only direct time is billable. One of my coworkers compared us to Dog the Bounty Hunter with substantial accuracy.

Naturally, I can't tell anyone (other than the patient) who answers the door where I'm from, since that would break confidentiality by revealing where the person was getting treatment from, or in this case not seeking treatment from. Now, these are poor people who usually live in neighborhoods where my white middle classness is out of place. People are suspicious of me, expecting that I am serving legal papers or selling something or asking for political contributions. So roommates and family members are not amused or willing to tell their mentally ill associate that I am there without a darn good reason which I cannot give. Even if I know the patient has signed releases to various people, I can't tell who they are when they answer the door unless they tell me their name, which virtually never happens. In any case, MIA patients tend not to have releases to anyone because of social isolation and/or an unwillingness to designate their roommate at the crack house as a participant in their treatment.

Worst of all are the people who you KNOW aren't there anymore, but you have to continue going to their (former) house weekly until CMH decides not to reauthorize them anymore, which can take up to a year. This is a total waste of time that we are not even paid for and which takes time away from people who are actually living where they say they do and needing treatment.

Bounty hunters don't have to do that. Maybe I should change careers. I bet bounty hunting pays more than social work, too!