Friday, May 13, 2011

Daring to hope

Gabriel had an appointment with the psychiatrist today.  He remarked on how much quicker we got in and out, compared with our appointments at MHMR in Texas.  That made me think of the many differences in the services he gets here in St. Louis, compared with those in Texas.

At Texas MHMR, we usually spent 3-4 hours, to get his blood work, meet with a case manager who did nothing but mechanically fill out the required paperwork, and see the doctor for 5 or 10 minutes.  When Gabriel entered that doctor's office, she almost always turned on a fan so she wouldn't have to smell him, and she often took personal phone calls while she met with us.  I had begun reading about the Clubhouse movement, which is a worldwide movement with mental health clubhouses in 30+ countries from Japan to Israel to Poland to South Africa to Kosovo, but whenever I mentioned the need for a clubhouse to the staff at MHMR, not a single one of them had ever even heard of a clubhouse.  Getting his prescriptions, one of which is very strictly controlled, often required 3 trips to a pharmacy downtown, including a wait of an hour.

Here in St. Louis, mental health services are provided by Barnes Jewish Behavioral Health.  Today Gabriel got his blood work, met with the psychiatrist for 30 minutues, worked with his case manager for another 30 minutes, and turned in his prescription at the on-site pharmacy (we'll receive the medication in the mail on Tuesday), and we were in and out in an hour and fifteen minutes.  The nurse who does the blood work knows Gabriel by name on sight.  The doctor actually talks to him, asking probing questions about his symptoms, his activities, his goals.  She tries to educate him about schizophrenia and related health issues.  Gabriel told her today that he thinks he's doing better, because he only thinks about the Russian mob trying to kill him once every hour, rather than every five minutes.  He was able to explain that his hallucinations seem real, like dreams, when they're happening, but he can understand that they're not real.  Then he worked with his case manager on practical skills, like keeping a log of his blood sugar readings.

As we left, rather than feeling defeated and hopeless, as I often did when we left MHMR, I dared to feel hopeful, dared to feel that Gabriel isn't just spinning his wheels any more.