Written by: Peter Hill – The Pro Forum Community of Practice

Background

I spent 25 years as a chef and 25 years in various roles in the community sector the articles that I am going to focus on are in the period I was a case Manager for a large NGO community organisation in Canberra for Five years as a mental health case manager in supported accommodation and an outreach worker case manager in the homeless program. On reflection after saying that the 25 years in the kitchen working with some very temperamental Chefs provide me with some interesting experiences in how to handle challenging clients. Out of the very many jobs I have had over my career the one I miss the most is those five years I am going to write about and I wish I could be back their warts and all.

Experiences

For The last five years of my working life, I have been a Trainer/Assessor in community certificates, Disability, and Mental health and I told my student that most important in working with clients is building relationships, no piece of paper will give you this, it comes from within a person non-judgmental and empathy. If you build up a good relationship with your client your work is more likely to beneficial to the client and yourself.

Our workplace

Our office was a unit at the base of a 3-storey block of housing commission units just minutes from the city centre there were around 120 units in the complex we had 30 clients on our books and a community room that was open to all people. We also had another site close to Queanbeyan with a similar number of units and client’s. A large number of  Residents on both site’s had  comorbidity issues Mental  health and substance use issues. We were there Monday to Friday 8:30-4:30. The program was based on providing support for people living with a mental health condition ,the idea was providing accommodation for up to 18 months and in that time we would work with them on their issues and help them find permanent  accommodation usually state  housing. That is what the ACT government contract says, however we were working with clients who have very complex issues that don’t just fit in neatly with contact requirements.

There were two case managers at each site and a looking after both sites. The coordinator was the most amazing person who her staff could not do enough for and for this reason she kept stable staff for over three years, which is not easy with your client base where verbal abuse was common and potential physical depending if client was under influence. She was always there if you needed support and we were there for her, the executive branch of the organisation offered little to no support to her or other staff.

An example of her management skills

The team was feeling down as our clients appeared to be getting nowhere their behaviour at times was very poor with more involvement with police with the use of drugs and alcohol on the increase, and us case managers asking ourselves if we are just enabling them to keep on this track, if so, what good are we doing for the clients and the organisation. The coordinator called a meeting and got a number of our clients to speak to us about the difference we are making in their lives they realise at times that they can be difficult to work with however without the case managers they said they would more than likely be dead and they did appreciate us.

 

Monday morning

You were always wondering what you would face on a Monday. We had a brunch on Mondays for the whole community and that is where to get to hear about the week end episodes on site that often involved a police presence. One of the housing tenets was being hunted down on one occasion as he sold crushed up Panadol, for ICE guys walking around with baseball bats was not an unusual site so we try to calm things down. Using humour was a vital part of the engagement process, we needed to know our clients to spot when we’re becoming unwell and early intervention by contacting their mental health clinical that most of our clients had. In general, we had a good relationship with the Mental health outreach team. Suicide was always a risk and if we did not see a client for a couple of days, we carried out health cheques. I only lost one client in my time that was drug over dose, while my colleagues on the other site had three by hanging that had an effect on them.

While we had to know the clients diagnoses to be aware of signs of them becoming unwell, it did not have any bearing on how we worked with them on a daily basis. A psychiatrist once asked my colleague how did we work with them after he had a couple of difficult sessions with clients the answer was simple “We work with them at where they are at on the day” we were there to support them  the best way we could we were not clinicals, we worked with them as a person not their condition. Mental health philosophy is built around recovery, which can mean so many different ways to suit the persons needs and it is about the journey rather than the destination as there can be backward steps as well as going forward. With some clients who had been living with a mental health condition since childhood through trauma you talk to them about recovery and they will tell you “What have I got to recovery from” because this has been their existence for most of their lives, and I was certainly was not in a position to tell them differently.

 

On the next article I will talk about some of the amazing clients I had the pleasure to support.
Remember we all have mental health and it is important to look after that as well as your physical health.

 

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