BY BOB FRISBY, M.S.
There is a critical service needed for anyone with a severe and persistent mental illness; that is a "Case Worker". Some programs call them "Case Managers" but my Hindu buddy said management sounds like your controlling somebody. The reality is that the worker is helping the client proceed in life in a healthy and safe manner.
This was part of a letter to the editor I sent to our local press in March 2018:
The concerns these days about persons with severe mental health issues having access to weapons such as the AR-15 rifle are well founded.
I worked with these people for forty years as a case worker. A major part of my job was to make sure the person assigned to me wasn’t a danger to themselves or others. These people need a case worker assigned to them that will monitor them on a monthly basis at the least and more frequently as crisis situations arise. When services to the person are closed, we need to be sure the support system stays in touch with the previous case worker; and that the previous case worker makes contact with the client and the support system every three to six months minimum. We need to make sure the health plan is still going in the right direction.
Making sure these case workers have no more than twenty-five on-going cases assigned to them, should allow the case worker to include in their services the closed case monitoring.
The case worker with the trusting relationship already previously established has to be the one contacting the person and the support system. This service will give the person and public the best hopes for a safe and healthy life.
In most cases the case worker develops a trusting relationship with the person and the person sees the case worker as a caring person, trying to be helpful to them as they pursue their life goals. This caring/trusting relationship is critical to the person accomplishing their goals in life and staying healthy. Just sending a person to a psychiatrist or therapist, may not be enough; just taking medication as prescribed isn’t enough; sometimes you need to add the services of a case manager. This service will cost the taxpayer but save money and lives in the long run. How much is an ER visit these days? How much for the SWAT team to do a housing intervention?
How much does a court commitment and following hospitalization cost? How much money goes out to treat those with PTSD following a shooting event?
Let’s make sure our case workers for these people have good morale and feel they can handle what they’ve been assigned. I’ll count on the our local county commissioners to keep tabs on this situation in my home town......end of newspaper write-up.
For you very wealthy folks, you need to purchase the services of this case worker from an agency in your area. Making sure the case worker has at least a four year degree in a human service field and at least three years of experience working with these seriously ill clients; including the provision of "adult protection services", where they go to court to make sure the client gets treatment. Anything less than this and your putting the client at risk of hurting themselves and others. Make sure the worker gets my book and follows most of my advice; I assure you, this book will save lives. $20 for forty years of experience in this field; you can't lose. You can hire a psychiatrist to do this job if you wish, but most of them won't want to go visit the client at their apartment or help them move to another apartment, or help them get connected to employment counselors, etc. I think this would be a good thing for a psychiatrist to do, at least take on one case and do the job of a case worker, adult protection worker. It would give them invaluable experience!
Remember that the long term relationship between the case worker and the client is the super critical part of keeping these folks healthy and as happy as they could expect to be. You don't change case workers every few years and when you do change, you make sure the new worker has met the client with the current case worker and that the client agrees the new connection could work for them. If there is any hesitancy within the client, the case worker needs to talk to them the week after the meeting and make sure all is going to be OK. If not, look for another worker and start the transfer process all over again.
And for all who read this, here's a final piece of very important advice: keep all guns out of the home of a person suffering from these serious mental illnesses. Locking them in a gun cabinet isn't secure; they will just break the cabinet to get to the weapons. Locking them in a gun safe would be fine, if only the healthy owner knew the combination. Better to store your weapons with a relative and get them when you plan to use them.