My first week of placement

This week was my first week of placement and a pretty exhausting one, coming straight after a pretty relaxed 3 week Xmas holiday.

I am working in a residential home for adults with mental illness. Most of the clients have had many other placements that have broken down and this one comes after a difficult journey.

I need to set the context for my blog in that I have virtually no experience in mental health and many of the views expressed might come across as incredibly naïve or downright stupid, so apologies for this in advance! I welcome all advice, criticism, suggestions or anything else!

I knew from my trial day that there would be some aspects of the role that i was less sure about and I has concerns as to whether there was enough social work esque roles to do to help me really learn and develop.

After my first week, I have quite a different opinion. Those tasks do still frustrate me and there are some days I don’t particularly enjoy, days where I barely see a client and only do the above tasks but, the amount there is to learn about mental health is truly incredible. Being in an environment like this is so different to going on weekly visits to service users – it really feels like you see people in all different moods/spirits, you observe different interactions between clients and staff and the pace of the place is quite unreal. Although cheesy, I actually feel quite priviledged to meet some of these people and engage in the way we are able to, joining in community lunches, listening to clients open up about the voices they are hearing and the struggles they are coping with.

I particularly enjoyed Thursday when I had my first proper interactions with clients, one particular session involved myself and another student taking a client to the café as part of “leisure group”. Although it was only 1.5hours, it felt incredibly intense and draining but I also really enjoyed the time I spent with the client. I did notice emotions I felt a bit ashamed about too – while X was engaging with members of the public, talking to them on the street or walking into shops, I was anxious and felt relieved when we left. I think there was a part of me that felt I wanted to protect X from how these people might react to them, or whether they might embarrass themselves – and I felt very guilty for these reactions after.

I had a similar experience one night when on the way home from my shift I encountered a client pleading with a member of public for money. It was for us to decide whether to interact as we were officially “off duty” – it brings up interesting questions around our roles and our boundaries.

Similarly, I think the issue of choice and responsibility within mental health is one that is at the forefront of my mind at the moment. You can’t force people to engage with groups, or therapy or take medication, but at what stage are there consequences for certain types of behaviour? Should there be consequences for not taking part in cleaning the house, or playing music too loudly? We have started to have discussions about what this might look like. (I am obviously presenting this in a very simplistic manner, clearly there are reasons why someone is not engaging but equally is there a point when sometimes it can be used as a scapegoat?)

Today a new referral joined and I will be starting keywork with them in 3 weeks which I’m really looking forward to. I have been reading a lot about task-centred practice and person-centred, strengths based approaches – the humanistic approach is one that I really value.

The staff are great and every Friday there is a staff meeting all afternoon including a staff therapy group with an external facilitator. It’s an intense environment but I can totally see the need for it as even in the short time I have been there so many incidents have occurred. It seems like an open and transparent way to vent frustrations is very useful. I think in many ways its quite incredible how some of the staff are able to challenge the manager about decisions they feel uncomfortable with in this kind of setting.

In all I think I’ll learn a great deal from this placement. I already feel like I want to question so many of the practices and think it is an environment that really encourages reflection. I also am looking forward to having the freedom to research things that feel important to me or to the particular clients I’m working with, and opportunities I can take to carry out the most effective keywork, rather than work strictly around a university syllabus.

The first part of this will just be getting an understanding of some of the main diagnoses in the house; bipolar, schizophrenia and schizo-affective disorder.