Saturday, March 26, 2016

Open Letter to the People I Work With Who Want Me To Do Social Work

Dear ER Colleagues,

This is your friendly mental health worker, the one who meets with suicidal, homicidal and/or psychotic patients to screen them for admission to our psychiatric unit, or who calls 50 other hospitals in the state with psychiatric units, hoping they have a bed when we don't.

I really enjoy working with you, and I really enjoy my job, since it is completely focused on mental health and it is not really social work.  I would just like to remind you some of the things we in our department do, and the social work department doesn't, and vice versa.




What we do:  Mental health evaluations.  This includes substance abuse assessments and handing out lists of counseling agencies to people who do not need an entire evaluation, but who are interested in treatment.

I know this is difficult to remember, but if you call the social work department to have them do mental health evaluations, they will happily tell you they don't do it and to please call us.

What we don't do:  Social work.  This includes but is not limited to the following:  Placement in extended treatment facilities for non-psychiatric medical problems; finding an oxygen tank for someone; finding a ride for someone; finding clothes, toothbrushes, diapers, loose change, gift cards, amusement park tickets, Toby Keith CDs, computers, lottery tickets, or a place for their abusive son to live so that he will move out and leave them alone; calling the electric company to get them in the elusive program that lets them have electricity for the computer and their TV without paying for it; referring them to an agency that will give their kids Christmas presents, etc.  I acknowledge those are fine things for social workers to do, it just has nothing to do with psychiatry.

OK, I know what you're saying.  You see the "MSW" on my badge.  Yes, I went to school for social work.  But I only did it because I knew it would be a shorter route to my own private practice than a PhD in psychology.

And because I was a Marxist.

But I sincerely, sincerely regret having done that and if I were to be able to do it all over again---along with the knowledge that Marxism is a steaming pile of bear poop--I would definitely not be a social worker.  In fact, I spend a lot of energy pretending I am NOT a social worker.  Which says oodles about my own psychiatric condition but we're talking about ER patients here, not me. 

Anyway, little did I know that having a private practice was 90 parts boring and 10 percent bill collecting.  Hence my job here.


What I do really love is  the sturm and drang of the ER.  And having patients who politely (well usually) go away after I see them, to get on someone else's caseload.  I love everything about it.

 Except for being asked to do things that social workers do.  And being mistaken for a social worker.

Thanks for listening.

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