Note: client names have been changed to protect their privacy
I’m sometimes asked about a ‘typical’ day on the job. I could describe 365 days and they would all be very different, but to give you a taste of what my days are like, let me tell you about today!
It is a good day because my client Maria is being discharged after a four month hospitalization to terrific new housing – a partnership with Regeneration Community Services and Reconnect Community Health Services. I check in with Maria to see how she is doing, review the discharge papers I prepared, and I also give her a goodbye card. She is so grateful that she gives me a hand written recipe for salsa. This last meeting is the culmination of lots of work – meetings with community providers, CAMH outpatient teams including Occupational Therapist Courtney Brennan, who has been her primary worker for many years, and developing a strong transition/discharge plan. It was a good collaboration.
Next up: My daily rapid rounds in the nursing station at 9:30 where we discuss red flag issues and a new client who was recently admitted.
Next housing issue to deal with is a lack of housing issue, which is unfortunately a more common issue we experience. I call the Safebed registry and Gerstein Centre in search of a temporary bed for Miriam who is ready for discharge but can’t move into her housing until April. There are no beds available.
An inpatient social worker does a lot of discharge planning, which starts as soon as the individual arrives on the unit. Well, actually it starts before that, in collaboration with the social workers in the EAU (Emergency Assessment Unit), GPU (General Psychiatry Unit)/ACU (Acute Care Unit) and on unit 2-4 – the units that my clients are usually transferred from. Planning for discharge involves OW (Ontario Works) /ODSP (Ontario Disability Support Program) applications, housing applications through Accesspoint and Housing Connections, contacting service providers (probation officers, community agencies, shelters, etc.) and planning with family members.
A critical early step in discharge planning is building rapport and trust with clients as soon as they arrive on my unit. Today I sit down with Mark, the new client, in the TV lounge after checking in with Kwasi Boateng, Mark’s assigned nurse. Although Mark is quite delusional, angry about being in the hospital and wants to leave today, we talk about many things – food, friends, the cost of living and the steps to discharge. I will continue to meet with Mark to build rapport.
My next task of the day is to introduce my client Tony to Joan Foote, who’s a clinician with CAMH’s Downtown East ACT team. She’ll be his primary outpatient worker when he’s discharged, and he’s scheduled to meet her today – except he is off the unit with Occupational Therapist Jessica Bryson and a group of clients. We catch up with them in the CAMH mall at an exotic animal demonstration. Tony is easy to find – he has a talking red parakeet on his head!
Tony was very sick when he came onto the unit several weeks ago but he is responding well to treatment under Dr. Nourhan Mohamed, PGY4, working under Dr. Justin Geagea. Social workers work closely with doctors as well nurses, OTS, RTs and other allied staff to give our clients superb interdisciplinary care. The other elements of Tony’s recovery plan include housing, community follow up, employment, and a Community Treatment Order (CTO) – none of which he had before admission.
Another important role of an inpatient social worker is providing support and education to family members. This happens in family meetings, on the phone or through personal interactions with family members visiting the unit. Today I meet Tina, who’s just returning from a walk with her daughter, an inpatient at CAMH. Tina is worried her daughter won’t get better, as she hasn’t responded fully to her prescribed medication and is beginning a trial of a different medication. Tina is also confused and hurt by her daughter’s paranoid fears about family members. It’s hard for parents to see their children struggle with mental illness. Families are integral to our clients’ recovery, and social workers are essential in providing support and education to families.
A day in the life of a social worker also includes numerous phone calls, umpteen emails and endless Powerchart notes. While this was merely a slice of what a typical day looks like in the life of a social worker in mental health care, we go through each day knowing that the clients and families we help and the work we do is anything but typical.