The Things They Carried

Because we can’t see our patients in a timely fashion, they are at-risk for all kinds of bad outcomes. I got an idea in the shower this morning about how to portray the depth of the problem to the greater public.

Imagine a photograph alongside a newspaper article. Kaiser mental health workers  on strike. The image shows two therapists side by side, one facing the camera, one with her back to the camera. Each wears a placard. The message on one side, worn by the therapist facing the camera reads: If you see me today, I can’t see you again for 6 weeks. The one on the therapist with her back to the camera reads: Even if you’re thinking of killing yourself.

I imagine us all walking around, picketing with these placards, carrying this heavy wooden burden. Because it is a burden. When I see someone today with suicidal thoughts, (often labeled “passive” to indicate there is no active planning, no collecting of pills or buying of guns), I am often uncertain how well they’ll fare in the intervening weeks. It’s a heavy load for us therapists. We care about our clients, even after one session. Did I miss something in our hour-long interview? Did I make a bad judgement call? Maybe I should have sent them to our intensive outpatient group instead of a skills group designed for people who are higher functioning.

And then I wait, at least a month, to see if my intuition, one way or another, was correct.

Kaiser has been dragging its feet in negotiating a new contract with the NUHW-represented therapists. Because we’re out of contract, we can strike. We need to give ten days notice, but we can strike. In Santa Rosa many of us voted that we were willing to enter into an open-ended strike if necessary. And I know from our stewards council that many other Kaiser mental health clinics have staff similarly ready to walk out. Maybe this  idea of wearing  placards  could be galvanizing.

Even as I say this I’m torn. Imagine someone in distress, maybe even thinking about suicide, who has never spoken to a therapist before. On the eve of calling in to make an appointment, having found the courage to take that great risk, they come upon an image in the newspaper that deflates their courage. And just give up.

The whole thing is so sad. We must find a way to do better!

(86 days to go)