Nothing to report save some totally insane clients.
Would love to disclose some details re. 2 particularly insane clients, but I'd be breaking confidentiality laws, not to mention fill up several pages with completely psychotic material. Just a tid bit:
Case #1. Our system has completely failed this "consumer", to use the present most politically correct term. Over a span of 6 weeks, he's managed to get hospitalized 8 times. For several completely idiotic reasons, our system continues to believe he is able to fend for himself in a skid row shelter. I and several other strong advocates in the community have followed this situation and pleaded our case in the most professional way. I've decided to change tactics and challenge our hospital's clinical determinations.
What it comes down to is that our system sees him as Axis II, a personality disordered individual who malingers in an effort to find and gain housing. They see his psychosis as factitious and instead see his bizarre behaviors as affected. Hmm, lets look at his behaviors, shall we?:
1. Found on the street corner by police swallowing rat poison and eating his own vomit. "Wow, he's faking it I guess."
2. Found naked in a supermarket aisle eating the white part of wonder-bread because "It's never been touched by human hands...therefore it's clean". Sounds like fun!
3. Taken into custody for assaulting a hospital orderly. "People sometimes get angry, don't they?"
4. Cut his arms and wrists and painted his eyes, cheeks, and nails with his own blood. "But isn't that what all the kids are doing now-a-days?"
5. Assaulted and mugged three times by skid row drug dealers over a 2 week period, the last assault requiring a 1 week hospitalization stay. Now suffering from trauma status post his assaults and coupled with his pre-morbid psychosis begins to scream the "N" word repeatedly every time an African-American looks at him. "My goodness, what a racist!"
6. After each of his 6 most recent hospitalizations, he is deemed to be appropriate for discharge into a shelter...but walks out each time within the hour he arrives only to disappear into the community for days without bathing or eating. Each time he emerges at the hospital, he is filthy, with signs of exposure, and is losing and average of 8 pounds a week for a total 55 pound weight loss over a 6 week stretch. "No No No, he's on a diet."
7. He refuses medications, refuses to wear clothing, masturbates ceaselessly, is frightened when approached, completely delusional, totally tangential, NO money, NO resources, NO family, NO friends, NO home, with the slimmest grasp of reality. In his most lucid moments, he knows to go to the hospital for help...that's about the extent of his grasp on reality. "Did I mentions he's racist?"
NO YOU FRICKEN MORONS!! This poor soul is GRAVELY DISABLED! One could imagine that our system would NEVER allow a sight and hearing impaired man in a wheelchair with an IV stuck in his arm to discharge into the streets on his own to fend for himself...but this client is AS MEDICALLY DISABLED as the previous example!
Thank god we got him into a locked inpatient setting on 14 day hold. They'll be following through on conservatorship and compelling him to treatment in a locked and safe setting for as much time as it takes for him to compensate.
Case #2. Man, if you ever get caught trying to set someone on fire (as in dousing victim in flammable liquid and throwing a match at said victim) after having assaulting an absolute stranger at a video store for no apparent reason, say you're schizophrenic and your chances are good that all charges will be dropped,...hey, you're incompetent to stand trial. It is absolutely ludicrous what you can legally get away with while in a psychologically decompensated state. Now how is THIS situation NOT a case of malingering while the former IS? WTF!
Gotta go. Just to re-cap and in the service of "covering my ass": as you can see, NO names have been used, not even initials. NO mention of dates and locations have been made. All details have been slightly tweaked to further conceal identities. My name and employment capacity is not disclosed. And, what the hell, I made it all up anywayz, got it?
Later
Case #1. Our system has completely failed this "consumer", to use the present most politically correct term. Over a span of 6 weeks, he's managed to get hospitalized 8 times. For several completely idiotic reasons, our system continues to believe he is able to fend for himself in a skid row shelter. I and several other strong advocates in the community have followed this situation and pleaded our case in the most professional way. I've decided to change tactics and challenge our hospital's clinical determinations.
What it comes down to is that our system sees him as Axis II, a personality disordered individual who malingers in an effort to find and gain housing. They see his psychosis as factitious and instead see his bizarre behaviors as affected. Hmm, lets look at his behaviors, shall we?:
1. Found on the street corner by police swallowing rat poison and eating his own vomit. "Wow, he's faking it I guess."
2. Found naked in a supermarket aisle eating the white part of wonder-bread because "It's never been touched by human hands...therefore it's clean". Sounds like fun!
3. Taken into custody for assaulting a hospital orderly. "People sometimes get angry, don't they?"
4. Cut his arms and wrists and painted his eyes, cheeks, and nails with his own blood. "But isn't that what all the kids are doing now-a-days?"
5. Assaulted and mugged three times by skid row drug dealers over a 2 week period, the last assault requiring a 1 week hospitalization stay. Now suffering from trauma status post his assaults and coupled with his pre-morbid psychosis begins to scream the "N" word repeatedly every time an African-American looks at him. "My goodness, what a racist!"
6. After each of his 6 most recent hospitalizations, he is deemed to be appropriate for discharge into a shelter...but walks out each time within the hour he arrives only to disappear into the community for days without bathing or eating. Each time he emerges at the hospital, he is filthy, with signs of exposure, and is losing and average of 8 pounds a week for a total 55 pound weight loss over a 6 week stretch. "No No No, he's on a diet."
7. He refuses medications, refuses to wear clothing, masturbates ceaselessly, is frightened when approached, completely delusional, totally tangential, NO money, NO resources, NO family, NO friends, NO home, with the slimmest grasp of reality. In his most lucid moments, he knows to go to the hospital for help...that's about the extent of his grasp on reality. "Did I mentions he's racist?"
NO YOU FRICKEN MORONS!! This poor soul is GRAVELY DISABLED! One could imagine that our system would NEVER allow a sight and hearing impaired man in a wheelchair with an IV stuck in his arm to discharge into the streets on his own to fend for himself...but this client is AS MEDICALLY DISABLED as the previous example!
Thank god we got him into a locked inpatient setting on 14 day hold. They'll be following through on conservatorship and compelling him to treatment in a locked and safe setting for as much time as it takes for him to compensate.
Case #2. Man, if you ever get caught trying to set someone on fire (as in dousing victim in flammable liquid and throwing a match at said victim) after having assaulting an absolute stranger at a video store for no apparent reason, say you're schizophrenic and your chances are good that all charges will be dropped,...hey, you're incompetent to stand trial. It is absolutely ludicrous what you can legally get away with while in a psychologically decompensated state. Now how is THIS situation NOT a case of malingering while the former IS? WTF!
Gotta go. Just to re-cap and in the service of "covering my ass": as you can see, NO names have been used, not even initials. NO mention of dates and locations have been made. All details have been slightly tweaked to further conceal identities. My name and employment capacity is not disclosed. And, what the hell, I made it all up anywayz, got it?
Later
posted by supergoober at
12:44 PM
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