Sep 19, 2007

One Afternoon at the Mental Health Clinic

I have on occasion the opportunity to visit one of the area's largest mental health facilities, which also serves as one of the largest providers of services to some of the poorest segments of the population. As I am not a client at the center, merely the chauffeur for one, I get the privilege of spending a fair amount of time people-watching.

You see quite a variety of people while sitting in the waiting room, ranging from people with manageable disorders such as moderate depression to folks with serious mental health and substance abuse issues.

Now, normally for me the idea of sitting in the physician's waiting room is not appealing, as wireless signals are not often a featured amenity and I find this to be dead, unproductive time. The hour I spent on Monday, though, was a fascinating look at the dysfunctional people who live on the margins of society.

"Nancy" was a 50-year-old cocaine addict who lives at home with her mother, and who has maintained at least three residences in the last year all over town. I know this because the chattering Nancy was wired, either high as a kite or coming down. She paced the floor of the waiting room, complaining out loud to her friend about how long the wait was, and keeping up a steady conversation about her screwed-up life.

"Mother f**kers better give me my prescription today," she said of her antidepressants. "I only have enough to get me through Friday."

Nancy engaged in a stream of consciousness monologue about the thoughts that ran through her head. Cocaine Anonymous (CA) only made her "want to go out and do more crack," while Alcoholics Anonymous (AA) was "full of a bunch of old bastards who don't want cross-addicted people spoiling their litle party."

Of special focus of Nancy's ire was the Lucas Metropolitan Housing Authority. The LMHA, it appears, has been taking too long to meet Nancy's housing needs. Perhaps they should also help her find a new set of golf clubs, too.

"I have my food stamps and my medical, but I have to have a place to live," she said. "If I have to spend another month with my mom I will f**king go crazy."

Of course, the phrases "get a job" and "go through rehab" went through my head, but far be it from me to interrupt a performer on stage.

After Nancy was called back, my attention turned toward a group of people seated across the room. There was a nineteen-year-old mother of two toddlers, both of whom were in tow, and along for the ride were the young woman's brother and grandmother. At first I made a snap mental judgment about people who feel the need to bring the entire family on a routine medical appointment, clogging up the waiting room with screaming kids and loud talking.

After the young woman went back with her brother - and the grandmother began talking to the receptionist - I learned a bit more.

"Reba says she is going to kill herself and her babies, but they won't let me back," she complained. "They say I'm 'not on the list.' How do I get on the list?"

The receptionist explained that the young woman maintains the right to tell the agency who can and cannot go back with her on appointments with the psychiatrist. This did not pacify the grandmother, who reiterated her conviction that the young woman and her children were in danger.

A woman across the room suggested that the grandmother contact Children's Services.

"Children's Services? Hmmmph!" snorted the grandmother. "They are the reason we're here in the first place!"

The young woman's children, meanwhile, wandered around the waiting room while their great-grandmother vented her frustrations. Another person waiting attempted to keep the older child from digging in the planter that housed the plastic tree, while the younger child whined in its stroller.

So I sat and watched these mini-dramas around me, both repelled by and morbidly curious about the sorts of folks for whom life is an endless struggle, and whose concept of the word "normal" must be quite a bit different than mine.


Anonymous said...

Hi Mike,

I worked for years at a community mental health center. It was some of the most meaningful and stressful work of my life.

Anonymous said...

My whole neighborhood is like that waiting room, Mike. I see hopelessness, addiction, and poverty every day. I'm sure that daily view from my window affects my own mental health.

I sympathize with those I see, but due to circumstances beyond my control I also feel trapped in their world. Every ounce of my being longs for escape to a better place, and I'm not talking suicide here. I'm talking about geographical location.

The condition of a significant slice of Toledo's population mirrors the condition of our neighborhoods, and vice versa. How do we even begin to address this overwhelming challenge?

Robin said...

Your story makes me thankful for my boring life.

historymike said...

Anonymous #1:

You are a special person for doing that work. I think I would lose my patience and turn into a drill sergeant:

"Listen up! Stop being a whiner! Get a job, stop smoking crack, and quit being a goofball!"

historymike said...


Yes, there is much to be said for "boring" and "normal." I like it when there is little in the way of drama around me, and I must confess that I tend to avoid people who are too filled with chaos and drama.

They tend to bring you down with them, and I have enough on my plate as it is.

historymike said...

Anonymous #2:

You raise an important question about one person's ability to make a difference.

For me, I start with my own house and our work as foster parents. We have provided a home for over forty kids in twelve years. Some stayed short-term (emergency placements for a week or two), while others stayed with us many years.

While not all were success stories, and while I sometimes was not the most patient parent, I know that we made some difference in the lives of quite a few kids.

However, the immensity of the problems in American cities can be overwhelming. It's better to focus on doing what you can within a stone's throw of your own home, even if that is only keeping your lawn well-manicured, a fresh coat of paint on your house, and sweeping up the liquor bottles and heroin syringes that get tossed nearby.

Barb said...

good comments --interesting post.

I've worked with some like this through my church connections. It is frustrating to see people who were poorly parented repeat the cycle in their lives --so that their children continue the pattern.

Foster parenting is a wonderful ministry when done for that purpose --to make a difference. I've often thought more of us should be doing it.

mud_rake said...

mike- thanks for the insight. As you know discussion of mental illness is still regarded as taboo in American society, a society that desperately needs all of the mental help it can get.

Of course, as usual, mental health workers are some of the lowest paid folks in America. And Congress does not want to deal with this enormous problem.

You have to wonder just how many more folks are out there who are not coming in for treatment or who cannot afford the treatment.

The Toledo area has only 3 child psychiatrists for a population of 500,000. Do the math and weep. Wait time is months to get in for a first visit.

What kind of nation operates like that?? And we think we are the greatest nation on earth. Fie!

Kooz said...

And thats what are tax dollars are paying for? Crack addicts getting medication. Socialism at its finest.

mud_rake said...

This Kooz guy is all heart. No doubt he's a card-carrying member of the GOP.