I am a forty-three year old wife and mom living in the Midwest. I currently work at a local university as a secretary. This ten-months-per-year position is the best-paying job I’ve had since 2007, before I obtained my B.S. degree.
I have an M.S. in Clinical Mental Health Counseling from said university, which I obtained in 2010 after deciding five years before (when the automobile industry tanked) that the job at the factory I was working in twenty miles from home (which was dependent on said auto industry) was not worth the time, the headaches, the carpal tunnel, or listening to my brain rot.
I am now in debt to various student loan agencies by roughly $45,000. I’m in debt to my mother for another $25,000 in living expenses.
Despite the fact that there was a broken record in my head playing, “…you’re in debt…get to work…just take anything…” I stayed where I spent my internship and placement, a local hospital’s acute psychiatric unit—part time. Others in my cohort were working at other community mental health sites in the area, or in their hometown in another state—full-time. They’re all doing well, and enjoying what they do. I could have done what they were doing, and swallowed my misgivings and my pride and followed them into that game of Russian Roulette called “Find a Place to Work You Can Be Halfway Proud Of”, but I heard what happened in some of these community sites, usually firsthand accounts from patients at the hospital where I worked who were recommended to them for long-term outpatient treatment, and decided to stay where I was, in the hope that all the talk of hospital expansion would finally cease to be just talk and my place as a therapist in the community would be established. I liked the people I worked with, and I was proud to work among such dedicated professionals.
Naturally, all the talk was…just that.
I hung in there for what started out to be “just a little while…several months at the most…there are plans in the works.” Five years later I was working 16 hours a week at a wage that would have been livable if it were full-time. Instead I was making almost as much as someone working full-time for minimum wage.
I stayed because I didn’t want to lose my skills, but I quickly realized I had no place in the world of community mental health. I saw other area mental health centers tossing out PTSD and Bipolar Disorder diagnoses, like candy at a parade, to those who actually had personality disorders or a simple inflated sense of entitlement. I watched, dumbfounded, while practitioners with less education were assigned those who most desperately needed care—the actively psychotic, the poor, the criminal, the addicted—and through no fault of their own, ineptly meted out the prescribed “treatments” that look so good to administrators and paper-pushers but have no real effect on the lives of their recipients. That place in particular hosted several of my contemporaries as interns, and hearing recordings of sessions in class was nothing short of excruciating for me—rules there dictated that they type their notes while the client poured their heart out throughout the session. They are without a doubt among the rudest incidents I’d ever heard in my life.
Eventually my own workplace became unbearable. I documented lists of medications half a mile long prescribed by other area psychiatrists and general practitioners which kept patients too dopey to care about building their coping skills or working on relationships with family members. I listened, agog, while the only psychiatrist worth his salt in the entire five years I had been there spoke of an administration which complained that he wasn’t keeping patients on the unit for the seven-to-ten days they insisted they stay, regardless of diagnosis or their need to even be there. I sat in on a conversation with fellow staff as they related a story about a young woman in my cohort, with whom I had done my placement at the hospital, who actually called the unit from her current workplace and complained that our psychiatrist removed most of a nursing home resident’s medication in favor of outpatient therapy and building skills for living independently (as HIV is certainly no reason to be placed in a nursing home—and neither is a personality disorder). Within days, he was doped up again, and all hopes of independence were surely dashed. I talked with an elderly woman from Lafayette, Louisiana, who thanked us profusely for the care given to her manic brother, stating, “Most other places wouldn’t do what y’all are doing for him…if I didn’t know any better, I’d think y’all were Southern.” When did making sure he had shoes (her brother showed up without them) and a taxi to the Greyhound station become too much to expect?
The straws that broke the camel’s back came very quickly, one right after the other. My supervisor and mentor of five years was written up by the administration, ostensibly because he was short with the nurses and refused to help them when asked, but probably because we were the only psych unit in the hospital chain in our state which still had a full-time psychologist. Three guesses who that was? (Anyone who has worked with this man will tell you he drops everything to help out when needed, usually to his own detriment.) He decided to work with patients in an outpatient setting at a well-established practice among the best practitioners in the area, and was gone within a month. A licensed Social Worker was hired, part-time, to “help with weekends and other coverage” instead of bumping me up to full-time work. A psychiatrist who previously worked at the hospital was courted by administration and cajoled into coming back to run the unit, and the thought of again watching him cater to sociopaths after drugs and little old ladies with money and a taste for Valium sickened me. Finally, the MBA who ran the unit (into the ground, with the blessing of administration) took a PowerPoint presentation I had sent her to keep her in the loop regarding the family education group I volunteered to run and presented it to some corporate people as her own work.
By then I had been looking for another job for over a year. The day I found out about the PowerPoint, I began looking outside my intended career path. Not only had I received more than enough crystal clear messages that I didn’t belong in that career, I could no longer stand to perpetuate the machine. The last bastion of compassionate, intelligent acute community mental health treatment in my area was gone. The lighthouse had been snuffed.
I took the job I have now, stating I could start immediately. After getting over 1000 free internship hours out of me, every holiday except Thanksgiving and Christmas, and every weekend for three years straight, I left them to figure out how to cover weekend groups, individual therapy, intakes, discharges, and paperwork by themselves—just the way I had to do it.
I took a pay cut of well over five dollars an hour, yet still manage to bring home $500 more every month, as well as participate in the university’s pension program. My husband and I are able to build a savings, meager though it is. We are slowly catching up on bills we abandoned in favor of keeping a roof over our heads and utilities on, which was difficult enough at that time. The flareups of the joint condition I was diagnosed with (and could not afford to medicate, since finding the right med requires sick time and money to achieve) diminished immediately and considerably.
After only two weeks in my new job, my husband said he noticed I laugh more and sleep better.
After three weeks, a faculty member from the committee I type notes for examined my first effort documenting minutes of a recent meeting and told my supervisor I just freed him from two hours of editing.
After four weeks, my supervisor noticed I express myself well, especially in writing, and gave me opportunities to make extra cash by composing documents and PowerPoints for his use.
By summer, because my supervisor recommended me based on my writing and organizational skills, I had secured a part-time position for the summer gathering data for a college’s upcoming reaccreditation process. It wasn’t full-time work, but it kept me busy, and we had something coming in.
Five months after leaving my job at the hospital, I saw the MBA and her husband at the symphony performance where I was working my second job as a part-time usher. She came to me and brightly but awkwardly introduced me to her husband, who glared at me as if I just punched his wife in the face. She introduced me as her “tireless weekend worker,” and I managed to refrain from throwing back, “Well, you wore her out.” I am a professional, you know. I decided later on that being observed by her in my polyester blazer and ridiculous tie and escorting little old ladies off the elevator and telling them where the bathrooms are was not something to be ashamed of. I decided that she should be ashamed. A therapist from her unit would rather wear a ridiculous blazer and tie and make minimum wage holding the elevator for little old ladies than work for her. I hope that sunk in. I really do. I realize that I’m holding her accountable for an entire system rife with ineptitude, detachment, and outright greed, but like it or lump it, she is my personal icon for all that is wrong with the morass laughingly referred to as “community mental health care.”
We’re still in debt, and there are still areas of our lives which have been severely neglected for years—medical checkups, dental appointments, eye examinations, and home and car repairs come immediately to mind—but we’ve been neglecting a lot for a long time, and it will take time to catch up with it all.
The price I paid for remaining in that career for as long as I did was too high for me. I cast aside my own self-care for it. I missed out on time with family. I worked myself into the ground for a system that didn’t care as long as papers were pushed and ever-decreasing funds were distributed.
The cost of living with myself at the end of the day is greater than I can define. I will never be that professional I once aspired to be. In exchange, I will eventually have my home, water and electricity, my sanity, and my relationships. Heck, we may even be able to get along without needing my mother to buy our groceries twice a month! I won’t dream yet of obtaining other luxuries yet such as medical, dental, and eye care or even a simple weekend vacation…don’t want to lose myself in fantasies just yet.
Such is the life of the working poor.