I'm enjoying my placement with the community team. After the tough placement on the dementia ward, this seems like a holiday by comparison. Very stress free.
Today and tomorrow I'm with a different team, based within the same building. This is the Assertive Outreach team. A specialised unit who were set up about four years ago, to cater for those clients out in the community who were difficult for services to engage with. You're always going to get a few clients who refuse to accept input from the mental health services, for all sorts of reasons. Many people simply don't have the insight to know that they need support, and they may not be compliant in taking their medication, or just dislike people interfering with they lives. I've heard it jokingly said that Assertive Outreach are licensed stalkers. There're able to make repeated efforts to contact clients, and will ring or visit them numerous times a day if necessary. They also keep in touch with the family of the client and even quiz neighbours for information if they can't get access.
Assertive Outreach have much smaller caseload than than the regular Community Mental Health Teams (CMHT), so they're able to spend more time with each client. The team is composed of a mix of community psychiatric nurses, social workers, support workers, an occupational therapist, and most impressively, a psychologist. There is talk of the team getting their own consultant psychiatrist, which will mean greater autonomy for them, and a faster service for clients if there is a crisis.
All good stuff. I'm very impressed with the service they give. They'll often take clients out to social events: to the cinema or bowling. In some ways Assertive Outreach act a little like a befriending service.
All Assertive Outreach clients have to be referred to them by the ordinary CMHTs, and have a serious and enduring mental illness, and will have had to have been in hospital over the past twelve months.
Today I went out with one of the support workers, and we visited a couple of clients who have had recent relapses and are now in hospital. One young lad, very poorly, is on the intensive secure ward. We took him out for a walk in the October sunshine and sat in the hospital cafe for a time. He was very distracted and silent throughout, but appeared to appreciate the input.
We also tried to visit a client out in the community, but he wasn't in, even though he knew we'd be coming. That happens sometimes, but we will track him down before long.
In the morning, I got the chance to give another injection. A client needed his monthly anti-psychotic drug injection, so I bravely volunteered to do it, and the client, even more bravely, allowed me to. It went OK, but I look forward to the day when injections are second nature to me. I was less than quick, and pushed the needle in too far. The injection point bled quite freely when I pulled the needle out (which I've not seen before). However, the supervising nurse told me that I'd done fine and the patient himself said that he'd not felt a thing. That's good enough for me.