People who don’t seem to get better -Why?

[Ramblify]

Hi, I have lived experience with depression and anxiety. I consider myself lucky that I received good help from health professionals. I knew from a young age (16/17) that I didn’t want to be like my parents; and I wanted more from life.
Recently, I’ve done a basic course in Individual Support (Disability); and have been working with people with disabilities and more recently, people with mental health disabilities. What I see a lot of is people who aren’t able, or just don’t want to, engage in their goals. Most have very bad living conditions - mostly dirt and hoarding. Basically they buy things and don’t clean, or have any organisation system. I also have lived experiences with these issues. The difference I think??? Is I was able to ask for help and if I didn’t get the right help or person I could look elsewhere.
Im just rather perplexed at what happens to people to get in the states’ I’ve been witnessing? Have they given up on life? It seems like they don’t want to get better. Are they medication resistant? They don’t seem to like any doctors, Psychologists or Psychiatrists - they think they’re old dinosaurs and they find them pretty much useless. I have certainly had a few experiences like this myself, but I just found someone else. I guess I am lucky I have openess as a trait?
mother people I have know who have had eg: a diagnosis of anti social personality disorder, and once they got the diagnosis they pretty much decided they were f&$@ed and nothing could be done; and stayed in their bedroom in their parents house for 20 years.
I can’t totally relate to fear of failure (or success), low self esteem, low self worth, being and feeing overwhelmed and paralysed, procrastinating. But I guess I am (by nature??) somewhat resilient. I just wanted to get feedback about the notion of people who have mental illness who can’t be helped (usually because of their mental illness). How do people become stuck? Is it a lack of insight? And personality traits!? Are they just a lot sicker than anyone ever knew… I’m struggling to comprehend.
thnaks

[Guest_1643]

*OCPD

Obsessive compulsive personality disorder

[Ramblify]

Hi Hanna,

I'll try to answer these in dot point;

• Yes re: the clients. some cope better than others. A lot are too sick to get help and it is very frustrating to watch - (hence the post title). Also, funding gets chewed up pretty quickly. A 'specialist' charges $100-$200 per hour. I am struggling to deal with what I see. I'm on edge and cranky a LOT more and most evenings I lock myself in the bathroom - sometimes sit in the car just to be alone and not bothered by anyone. - I feel aggravated.

• No, I don't feel I have enough support myself, what the managers have to offer I don't find that great - some are better than others. it also takes time to build a relationship with a manager.

• No assistance at home or family or friends (they don't understand mental health) - I see a private psychologist once a month just so I have someone to talk to. Yes, my work is very emotionally challenging - also psychologically challenging and physically demanding at times.

• Dissociation - thanks! - I didn't know anything about it. It sounds fitting, that particular client is very unwell. There probably is trauma there. But I have not been told anything by the client or anyone else.

• a professional cleaner - yes, I have been talking with my manager. it's not really up to me - I can try to organize it with my client but they don't want anyone coming into their house. My Manager is thinking of putting a new support worker in with the client who does a bit of cleaning. I've been put in a difficult situation where I have to try to convince my client to give the new support worker a go. (its actually a very hard task), my client won't talk to any of her other 'team' of professionals - they only want to deal with me and me only now.

• yes sad that this is what is happening in society. - Psychologists and Psychiatrists seem to have a different approach where if the client/person is not willing (because of mental health reasons), they say they cant help them. I think because they're well trained and they can pick who they want to see and it's probably a lot better to deal with people who want help.

[Ramblify]

Hi Sleepy,

I'll try to answer your questions in point form (word count ect)

trauma sensitive - is that a thing? Are you saying I should try to be TS? I try. I have experienced trauma myself and understand a little bit about it. I've had times when I find it very difficult to be empathetic - I'm aware and mindful of it. I don't think I'm 'unempathetic'. I don't react, I just don't want to be involved. I've had enough drama and trauma in my own life that I just don't want to 'be there' for a lot of people because I find it too traumatic myself. I've burnt out, and feel I really need to protect myself. I dont have the strength.

I don't like the word 'lazy' - I think it is overused. In regards to 'bad qualities' in one's character - I think openness is the main quality that I see stopping people. And I totally understand that people put up walls to protect themselves without knowing why they're doing it. but no one can help if someone is resistant to help.

The reference to people living in their parent's house at 40 was actually a personal reference to an old friend of mine who struggled with mental health and once they got diagnosed as having 'anti-social personality disorder', they gave up on living in normal society and never sought any other professional help (that I know of). They recently passed away and I can't get any information from their family. I'm not sure if it was suicide. but it was a sudden death and they were only 45.

yes, I agree every person's circumstances are different. My frustration or perplexity comes from individuals who have been hurt and as a result, have put up walls so that nobody can get in - it makes any type of treatment for MH seem impossible for me. I struggle with this and have times I feel like I hate my job because it feels pointless and I feel like I'm wasting my life doing a silly job that isn't achieving anything - except a paycheque (which is often enough for people).

Yes, I also agree some people are very lucky to have supportive families and people who understand them or who are just willing to accept them for them. I didn't get that from my family but I was able to cultivate it from outside sources.

No, I'm not looking for data. But what you said about your first step for you was being believed is uplifting for me. I find I have a very hard time keeping hope with a lot of my clients, - not all, but a LOT of them. It's very difficult to process and easy to lose hope.

[Guest_1643]

Hi,

Trauma sensitive is an approach employed by the more successful mh treatments out there, in my opinion.

It is a thing, and most mh workers in the public system that I've met are, or claim to be, trauma sensitive. There is also a lot of discussion in the peer work community about how some mh professionals and services reteaumatise users. For me, one example was when I sought coles vouchers froma Church. The social worker asked me so so many questions regarding my history and I had to describe my history including my SA....it was not trauma sensitive, her questions were invasive.

Tbh even what u write about openness....let's look at it from a trauma sensitive perspective...I'm betting ppl aren't open for a reason. I'm guessing their boundaries had been stepped over before.

[Guest_1643]

Hi Rambkify,

Being diagnosed with personality disorders does a lot of damage to a lot of ppl,

I'm not sure I believe in personality disorders, but I accept they can be useful for some. The health system makes ppl at times feel sick and incurable. There is a new approach called the recovery model of mental health, which challenges the medical model. It says that as you journey through the mh system u are on the road to recovery.

the sad thing is that openness isn't a good or bad quality.

I was open, and it harmed me, I happily took meds and saw different drs and was harmed in the health system.

I wanted help desperately, but the services let me down. It's not just luck, the truth is sometimes ppl reach out for help and dhe help isn't there. Do we blame them for this? At what point do we understand that the system often now and even moreso jnt eh past, fails ppl.

after I had my SA, many years ago, I agreed to and accepted help from the hospital. The help was poor quality and badly done. For many years I would not seek any hospital help after this.

I was trying to protect myself. Why wouldn't someone who was harmed try and do what they could to stop that harm repeating? I know u say u have been through it and had lived experience, but some of what u write does t sound to ,e like u understand or can identify with ppl in the mh system currently.

[Guest_1643]

Hi, another word for trauma sensitive, that you probably have heard more, is trauma informed,

Ppl call it trauma informed care.

[Hanna3]

Hi Ramblify,

If you're ever day dreamed or got lost in your own thoughts, dissociating is a bit like that only moreso, and it's usually an escape from trauma. So that person probably doesn't even notice the food going off as their mind is somewhere else.

I think you just need to understand these people probably are simply unable to get better, it's not that they don't want to, they have an illness and for some of them when they needed help it was probably unavailable.

They need compassion and understanding.

I don't know what training you have been given. It doesn't sound like it's been sufficient..

I hope you continue to get support for yourself.

I'm sorry there's not much more I can do but I hope this has helped a bit.

Best wishes!

[Ramblify]

Hi Sleepy,

yes I think the labelling part of a diagnosis seems to not sit well with people. Personally, I don’t find it offensive, I just see it as a label for Doctors to use to treat a client. Thought the word disorder might imply there is something ‘wrong’ with someone. I think people are sensitive to this notion. Where as I see it more as a unhelpful pattern of coping that people have developed over time.

Yes! I’m starting to realise there is a different ‘model’ that I’m not familiar with - the recovery model. I only know of the social model and medical model. And for most of the help I have received it has been the medical model - And talk therapy. I’ve worked mostly in the community and have only started with home care.

The social model is ‘ok’ but what it really comes down to, I think, in regards to disability, is that it’s society that has done this to people - through stigma. Really it’s society as a whole that needs to change its thinking and approach. And the same thing has to happen with mental health. The system is very broken. You don’t sound like you got the help you needed, I’m sorry to hear that. There seems to be a lack of staff and a lack of trained staff.

in regards to re-traumatisation . I’ve found writing down my experiences and handing people I had to deal with a copy of my experiences was a way I didn’t have to retell the same story over and over. Because it’s hard for them if they don’t know what they’re dealing with.

There are many crap government services and I mostly went private and somehow found a way to pay for it myself. Found therapists that bulk billed ect. I didn’t have help from parents and my friends weren’t going through want I was (well they never let on if they were)..

there are some massive holes in the government system!

[Ramblify]

for example, the client whos not able to clean their dishes, can work a 9-5 job. So I guess they are not considered ’high level care’, but as a support worker the highest level of care we can provide is physical prompting- it’s when say, I take their hand and put it in the water and wash a dish with them. The client was not able or willing to to do this for whatever reason (that doesn’t matter).

Higher level of care than this is 24/7 care and supported independent living. Where support workers are always at the home and do all the basic living needs. This isn’t seen as an option for mental health disability - why? The people living in these arrangements are people who are never going to get better. They may improve slightly, but they will always need 24/7 care - our government and society only have the option of mental health hospitals (sorry I know there is better term), and they just want people in and out. The people I’ve met who have been in hospital for 20 years or more, still manage to be out in the community- I’m not sure if the sneak out? But they really shouldn’t be out on their own because they’re vulnerable but they also course a lot of problems in the community- the same as people in SIL - even with a support worker some people are violent and abusive or have compulsions that aren’t appropriate in social settings …. It makes me question this ‘social model’ because they really are not able to enjoy the freedoms other have,
this ‘recovery model’ (this is guess for me - will look it up though - thanks btw); seems to be the model that is also used in prisons and criminal settings. The theory that Sex offenders or other crimes can be rehabilitated. Also used for drug addiction and domestic violence… my supervisor is a recovery coach.
I guess that is the answer I was looking for; this is the model being used - it also has good intentions but is highly idealised and suited for people on the upper end of the scale… the people on the lower end (the people who are really very sick), get left behind and don’t get the help they need. It is very unfair and an epidemic. The training I did for disability, I found to be the most over the top study and unnecessarily detailed Paperwork heavy bc I’ve even experienced. Then when you get out on the field you can’t use a lot of stuff and the things you use are things that keep the clients restricted from the ‘model’… so yeah, I dunno … it doesn’t make a lot of sense to me and maybe I’m in the wrong job

[geoff]

Hello Ramblify, I agree with Sleepy about OCDP, not all psychologists or psychiatrists are able to cope with this illness, although they might be trained, it may not interest them because hoarding is one symptom that is related to OCD.

Geoff.