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Social
Work in a State Psychiatric Center -
A Bridge to Recovery
Marie Volpe, LMSW, Social Worker, Manhattan Psychiatric Center
At Manhattan Psychiatric Center, a State facility on Ward’s Island in New York City, the Mission Statement “A Bridge to Recovery” reflects the goals, hopes and dreams of patients, their family members and staff. In conjunction with the quality psychiatric care offered to patients, MPC offers several specialized units: a Diabetic Ward, a Research Ward, a Spanish speaking Ward, a Polydipsia Ward, a STAIR unit (a cognitive rehabilitation program) and two programs to treat sex offenders. Referrals are primarily from Central New York Psychiatric Center, other OMH hospitals, City hospitals and Rikers Island.
Social workers in this environment are part of an interdisciplinary team
exposed to diverse populations and an assortment of tasks creating an
interesting and fulfilling work experience. On our specialty wards social
workers are often responsible for admissions in addition to leading groups,
counseling, preparations for discharge and required administrative functions.
My work on the Admissions Ward differs from other units in that there
are two teams and each provide services equivalent to a small independent
setting.
The Team Approach
On admission the patient meets with all members of the Treatment Team.
The social worker is responsible for preparing a comprehensive social
history and assessment. Background information regarding the family, substance
abuse, exposure to abusive situations, previous hospitalizations and treatments,
and criminality is gathered. Also, the patient’s perceptions as
to why he/she was referred and an exploration of the individual’s
religious orientation, spirituality, ethnicity and culture occur. The
team develops a treatment plan with the goal of preparing the individual
for a successful return to the community.
Treatment at MPC is based on a Treatment Team working collectively with
an individual receiving psychiatric care and medical oversight, as well
as rehabilitation, recreation, vocational and social work services. Social
workers participate by collaboration with other disciplines in formulating
an effective means to prepare an individual for successful community living.
A primary function is to contribute to the patient’s ability to
return to the community by encouraging the patient to recognize a need
for treatment and to prepare to care for oneself in aftercare. Individuals
are prompted to practice social skills and self-advocacy; they are encouraged
to discuss hopes and develop self-esteem.
Families are Important Treatment Allies
With the patient’s permission, family members are notified of the
admission and provided with team members’ contact information and
hospital visiting hours. Families are encouraged to meet with the team
and actively participate in the patient’s treatment. Inclusion of
family and friends is considered a vital contribution to treatment. A
most satisfying example of family reunification after 25 years of separation
recently occurred with one of my families.
Mr. A arrived at MPC via Rikers Island after being arrested for swiping
his MetroCard and charging riders a fee. This was not his first arrest
for this type of infraction. He was confused and disorganized during interviews
after his arrest and was deemed “unfit to proceed”. During
his MPC admission interview and in subsequent counseling, Mr. A revealed
he had a family, employment and a home until his drinking became problematic
causing his divorce many years ago. He further told how, over the past
25 years, he had lost jobs, lost apartments resulting in homelessness,
and lost contact with his children and siblings. He explained that he
swiped the Metro Card “for extra cash because one’s got to
live”.
Although Mr. A could not recall the address or phone number of his two
daughters, he did remember the address and phone number where he once
lived with his ex-wife. She was located and kindly provided information
about his children and a sister who moved out of State. The family members
were contacted and reported concern for him, but that they had no knowledge
of how or where he was. Ultimately, his sister and brother visited as
well as his two children; he discovered he has several grandchildren.
The family brought photographs and verbally shared the events he missed;
they continued to visit and maintain phone contact. A few months ago,
Mr. A was discharged to an adult home in the borough where he lived in
the past. His family was involved in his discharge plan and report they
will not lose contact again.
Immensely Satisfying Work
Social workers’ unique contribution here is creating a treatment
setting affecting clinical, concrete or practical, social and personal
aspects of an individual’s needs. In addition, the most pressing
challenge in this setting is to effectively manage one’s time to
meet patient’s needs for counseling, groups, and family contact
as well as maintain NYS OMH documentation requirements. Idealistically,
as in any private or public setting, increased staff or having less diverse
responsibilities would be helpful. However, State resources are currently
limited, leaving social workers to utilize the myriad skills developed
during education and training. In spite of restraints caused by too few
dollars, too few staff, too few hours in the day and too many responsibilities,
I believe being a social worker in this setting is challenging, rewarding,
educational, sometimes sad, often cheerful but most of all immensely satisfying.