Wisconsin

Transinstitutionalization

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While looking at treatment models in other states, I ran across this unfamiliar word. But it represents a sentiment and belief that I have had for a while. First of all, transinstitutionalization is the movement of people from traditional institutional hospitals to other institutional settings. So nursing homes and prisons have become the new institutional settings and thereby allowing people to continue to push an agenda that says that society has moved away from institutionalizing the mentally ill.

In fact, I saw Disability Rights Wisconsin tweet out a story about a Milwaukee institutional hospital shutting down their long-term care departments. In one way, it is good to be able to celebrate that people are able to move into the fold of society. In another way I think it’s tragic to see a disability rights organization flash this at their followers and clients. What happens when you leave an institution? Is a nursing home or group home not just a community-based institution?

Yes, there has been much progress in keeping people in the community; however I continue to run across people who get trapped in nursing homes because of the level of care they require. The general public continues to believe that we are progressing in not only our attitudes of mental illness but also in our treatment. Institutionalization is a trigger for me because I was almost sent to Central Wisconsin Center when I was little. A nurse tried to force my mom to sign papers to have me committed because of my complex medical needs. I now have a Masters in Social Work and an APSW license. My parents also had to fight relentlessly to prevent the school system from putting me into special education.

I have experience working with youth with autism and behavioral issues that would get them released from other programs or even temporarily institutionalized in a hospital. But then, here is my issue with crisis intervention and people not understanding how less severe or invasive it is to use a physical hold on someone rather than putting them in straps inside a hospital. Which one seems less traumatic for the client or the family? Which one could the state or county use in trying to push their agenda that says that they don’t institutionalize people anymore? Are hospital wards, nursing homes, and prisons not institutions in their eyes?
We must do more, we must hire more qualified staff, and we must remain client-focused.
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Snow and Public Transportation

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Tonight and tomorrow, Northeast WI is expected to get between eight and twelve inches of snow. I rather enjoyed not treading or driving through snow.
For the longest time, I used public transportation as my means of getting places. It was convenient at the time, it fulfilled my need to be independent, and it wasn’t expensive. For the longest time, I also had anxiety about driving which I unfortunately listened to.
With the snow coming in a pretty impactful storm, I think about all of the people who continue to require public transportation to get to work or to school or various appointments. I also think about the businesses and services that are not mindful of the bus schedules and weather delays.
I used to volunteer at the Green Bay animal shelter which is located in an odd spot, nowhere near a bus stop. It was quite the trek in the snow. I would volunteer on mornings when I had afternoon classes at UW Green Bay.
I also used the bus when doing night classes for my MSW. Classes would end at 9pm and the last bus would come at 9:30pm. I would get home at 10pm. Bus go-ers sometimes have to stand in driveways and streets in the winter because of snow piles, which can cause issues of safety especially when visibility is low.
When I worked at the Boys and Girls Club in the evenings, I would often walk the 8 blocks through downtown to the bus terminal to catch my bus, rather than waiting an hour to catch it a mere few feet from work.
Public transportation seems to be a dwindling service in our area. They have raised prices and cut hours and bus routes. There is little effort being made to connect people between the different city bus systems. Now there are more hourly routes and less thirty minute routes.
So I would ask that agencies and services be mindful of the transportation limits that clients and consumers have to deal with to hold on to that same level of independence and dependence that I once had to work around.

Current Social Work Trends

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I stumbled onto a blog post/article while looking up some of the current trends in social work. The link to the original post is below. But it caught my eye.
http://www.goodtherapy.org/blog/the-important-role-social-workers-play-in-mental-health-1214157
I think this article really speaks to people who want to get into the profession who aren’t enrolled in the educational requirements or licensing requirements yet.
When I wrote my admission essay for my MSW program, I talked a lot about some of social work’s key values. I focused on self-determination, social justice, and dignity. One of my main topics was the feminization of poverty, which I do not believe gets nearly enough attention in just basic awareness campaigns. You can link so many issues to the feminization of poverty, such as pay equity, non-subsidized child care, comparable worth, child support, and economic support services.
As someone with an MSW and an advanced practice license, mental health is still an increasing but also still developing issue in the field. When you combine mental health with trauma or the ways in which people react to crises, there are several varying beliefs or intervention techniques among professionals. We are seeing a lot of hot button issues surrounding trauma-informed care, crisis intervention, and institutionalization. (Note: I love words that end in -zation)
In a future post, I will further discuss what I have been researching and interviewing other professionals about in regards to reactions to client traumas and crisis events.
However, one topic I have really focused my attention on is addiction and prescription drugs in relation to the correctional system. As I have mentioned in previous posts, I am working on getting my Substance Abuse Counselor certifications (SAC-IT/SAC). And I currently volunteer in a peer support group for formerly incarcerated adults on and off DOC supervision. Prescription drugs are a very big business in the prison system, as is addiction. Since the 1970’s, the US has been trying to move away from institutionalization. However it does not appear that way when focusing on incarceration rates.
The WI DOC’s 2015-2017 budget is just over $1.2 billion.
(page 14 in pdf below)
http://doc.wi.gov/Documents/Web/About/DataResearch/Budget/Final%20Biennial%20Budget%20request-091514.pdf
And in the additional document below, WI’s current prison population is just over 22,000 inmates. The capacity however is around 16,000.
http://doc.wi.gov/Documents/WEB/ABOUT/DATARESEARCH/NOTABLESTATISTICS/FRIDAYREPORTS/fri_12_18_2015.pdf
So we are seeing some definitive needs when it comes to community support programs and agencies that keep people out of the prisons and remain in the community.

Getting Back to the Roots of Social Work

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The La Crosse Area Family Collaborative officially launched back in September.

Source: “http://www.wxow.com/story/30736637/2015/12/13/la-crosse-area-family-collaborative-adds-social-workers-to-neighborhoods”

La Crosse, WI is putting social workers into community neighborhoods as community resources. In my work with minorities and people who need assistance locating beneficial services in the community, this a a great thing to see. It is so challenging sometimes to see how many people do not know that resources in the community exist and specifically for their specific needs.

Most of the people I went to school with are now in private agencies that do not necessarily fulfill the roots of social work and address community needs. I find it very rewarding to be able to volunteer my time to community groups that address economic support, and hunger, and mental health services. I am glad that people are bringing social work back in to areas of the profession that have all but vanished. Such is the case with medical patient advocates. I wanted to be a patient advocate at a children’s hospital because I was a long-term patient in a hospital and there were not enough advocates for the needs of children and their families. When I graduated with my MSW, patient advocate jobs were virtually eliminated. Now you see patient advocates as phone operators in insurance company customer service centers.

You empower people when you allow them to tell their story. Then you provide them the tools to change. It is their choice in how they respond to being given the info and the tools they need but when they know where to go and how to acquire it, you have empowered them to improve their situation.

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