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UJust a few weeks ago, I was part of an emergency service that you probably do not know. I am a trained social worker as a Certified Mental Health Professional (MHP), qualified to perform badessments in 1983 under the Mental Health Act. Alongside two doctors, I badessed anyone considered to be at immediate risk to themselves or others because of their mental distress, and then developed an emergency plan to ensure their safety. If the treatment in the community was not enough, I would section someone in a psychiatric hospital. The law requires all local authorities to provide AMHP service 24 hours a day, 7 days a week, as mental health crises are not limited to weekdays.
I come back on some evaluations and I know I did the right thing. The middle-aged man who begged me not to stay near his window, convinced that his neighbors were looking for him and he would accidentally harm me, it was clearly impossible. Or I had time to stuff a woman's detention papers in her belt and chat with her while she was smoking before admission (where smoking would not be allowed), all the time in praying that she will not run.
I wish I had more memories like this one, detentions felt with compbadion and calm. Instead, I remember the teenage girl suffering from a psychotic episode that had been found barefoot on a highway. Local authorities have coldly informed me that there was no more room to place her because of her "unmanageable" behavior.
Then there was the woman who tried to pierce her father's eyes in the middle of an episode of schizophrenia; he told me that he had hidden the knives before my arrival. Her case had recently been closed to community mental health services because she had refused to dialogue with them. There are always abused and neglected people who cut, burn, starve and heal themselves in the hospital over and over, and who can not find any comfort.
The majority of detentions were preventable. I could usually identify a missed intervention, a lack of treatment, a rejection of community services that contributed to an individual's failure. I began to wonder how I could look at this job at the end of my life and feel proud when I felt so guilty doing it.
My guilt is due to having experienced a trauma myself. I noticed this when I spoke to patients with experiences similar to those of emotional, physical and badual abuse. I started seeing myself at many of the patients I detained, people whose vulnerabilities grew in their early years.
This "over-identification" is known to cause burnout among professionals and I was not in the shelter. I started having nightmares about my child molester, flashbacks that left me numb. I developed a weird phobia of illness and lost weight because I could barely eat. I kept going to work until I cried during my trip, sick to the idea of trying to be strong for my patients. I was fired and felt deeply ashamed. My family, friends and partner were incredibly kind while I cried and slept for several months.
Now, I am largely restored, exuberant to be able to eat and laugh and go out again. Sick leave has given me time to think about my vulnerabilities and to think about how I could continue to perform my duties without supervision because my local authority does not provide any. I realized that I could not continue without support and help.
In hindsight, it is clear that I used mental health services because of my own experience. I know what it is to walk on dark roads and the difference that simple kindness and the conviction of others can have. In talking to colleagues, I know that many have similar reasons for doing their job. My mistake was to believe that I could not be touched by the trauma of others because I was a professional.
My employer's mistake was that I did not have the means to recognize that it was a problem. By helping the AMHPs to not stay, by not recognizing that their staff needs time to think about the impact that detention might have on their detention, my employers perpetuate the myth that I believed: if you help you do not need help. yourself.
I am now working at the minimum wage so I can continue to be useful in my community. I am grateful because a few months ago I felt so broken and never thought of having another job. I would like my local authority to have the resources to help me before that happens, another professional abandoning the sinking utility ship.
• In the UK, Samaritans can be contacted at 116 123 or by email at [email protected]. In the United States, the national suicide prevention policy is 1-800-273-8255. In Australia, the crisis support service, Lifeline, is 13 11 14. You will find other international hotlines on suicide at www.befrienders. org.
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