saddest case ever

this is a couple months old now. I cut and pasted from when I shared with some friends from the mommy-board I belong to:
So I evaluated a lady in the ER last night, put her on a mental health hold and hospitalized her. Here is her story: 22 years ago she was home alone with her 6 year old daughter. Some men broke into her house, raped her in front of her daughter. Then proceeded to rape her daughter. They then shot the daughter in the head, killing her. then they shot her in the head, leaving her to die. she didn't. the men left. she took her dead daughter and barracaded (sp?) themselves in the bedroom until police could arrive. she's obviously been extremely messed up since. she's been hospitalized "at least 30 times" and honestly, I don't know how she hasn't killed herself already. she has a traumatic brain injury, is blind in one eye, and suffered a stroke, all from the gunshot wound. she also recently had a brain tumor removed, has seizures and now has a terminal kidney disease for which she needs a transplant. the same kidney disease killed her sister and mother. she also has schizophrenia. so, she took herself off all of her meds a couple months ago because she thought they were making her fat. in the past couple days she has been hearing "these men" (the ones mentioned above) in her house, she's been waking up with her panties down and she just knows that they've raped her again, and she's been basically reliving the whole experience. oh, the voices have also been telling her to just kill herself (and her niece whom is her caretaker, which is a whole nother story). the part that almost had me in tears was when she was telling me how her "little girl" visits her often, telling her not to listen to the men, that it's not time to come to heaven to be with her yet, and that she needs to remain strong and keep fighting. so, anyway, she called Medicaid yesterday telling them that the men were in her house. she was watching her 3 year old nephew (the niece leaves her kids with this woman knowing that she can't care for kids and knowing that this woman has stabbed someone in the eye before and lit them on fire because they didn't believe that these men were after her) and she was trying to protect him from the men so she barracaded herself in her bedroom with the men just like she did with her daughter so many years before. she told them that she had a knife and that she was going to kill her niece when she got home. eventually the cops came and took her to the hospital. (this was getting way too long so i kindof cut it as short as possible). when I get to work I also have to call social services because the niece is abusing her kids-knocked the wind out of the 3 year old, hits them in the face with shoes leaving marks. she also doesn't take care of my client-steals her meds, lets the kids steal her belongings, doesn't take her to any of her appointments. sounds like an evil woman. but, i also have to call her (the niece) and tell her that my client is having thoughts of killing her. I've never had to make a call like that before. okay, enough. I'll hush. thanks for reading.

Can I play with your insides?

I saw another kiddo yesterday at Children's. She is 15 and has a very lengthy history of mental illness. She is diagnosed with Schizophrenia and has been in and out of hospitals and treatment centers since she was 6. For the past week she has been particularly depressed though she couldn't tell me why. She had a relapse in her cutting the week prior and had been thinking about hurting herself and her mother. The night before I met her, she ran away from home for 4 hours where she proceeded to get drunk on vodka and go on a stealing spree. The police found her and brought her home. Yesterday morning, she finalized her plans of how she was going to harm her mom and herself: She was going to take a "pretty knife" that she had in her room (the one she uses for cutting), cut her mother's stomach, rip out her guts and "play with them." She was then going to take the knife and slit her own throat. Lukily she told her PE teacher about her plan and he made sure she got to the emergency room. She begged and pleaded for me not to hospitalize her, but there's no way I was about to send her home. Sorry chica, your fun is going to have to wait for another day.

The dog sitter

I was called to the emergency room last night to evaluate an 11 year old boy who was there due to "out of control" behavior. When I arrived, one of the hospital's clinicians was standing outside talking to a security guard. As she walked with me into the hospital, she explained that mom "flipped out" on her coworker and stormed out of the ER cursing and yelling. She wasn't sure exactly what happened but was concerned that the situation could become "volatile." The other clinician explained that mom was telling her how Johnny was initiated into a gang last Saturday by being severely beaten. The following day, mom allowed him to go to the store alone and he was beaten again. The clinician was asking mom if she thought it was appropriate for Johnny to be allowed to be unsupervised after he was just hurt the day before. I guess mom took offense to the questions, and showed her short fuse. So, when Johnny indicated that he was afraid to go home, we had some genuine concerns that his fears were legitimate. But, why might he be punished and why was in the ER?
Johnny and his 7 year old brother were home alone after school and got bored. They decided to play with the dog. They put nail polish on him, dressed him up, and ....stuck a tampon in his anus. When mom returned home, she apparently got mad and Johnny locked himself in the bathroom. He then threw a temper tantrum, breaking the towel rack and punched his hand through the window. That's when mom called 911 and he was transported to the hospital for an evaluation. Though his behaviors were very concerning, he was not suicidal or homicidal and unfortunately I can't hospitalize him for endangering animals. A report was made with social services however, and though the caseworker felt it was safe for Johnny to go home with mom, the other clinicians and myself have our doubts. Somehow I don't think that is the last time I hear about little Johnny.

Disclaimer

I hope it goes without saying, but just in case: All identifying information has been changed to protect the privacy of the client.

Intro

Hi, my name is Beth and I've decided to start a blog dedicated to my professional life. When I was in college at the University of Florida, we were required to do some volunteer work for one of my classes. I signed up to work at the local homeless shelter and liked it so much that I continued to volunteer there long after my required hours had been met. After getting my degree in English (I have no idea why-I think I heard it was an easy course of study), I decided to go to Grad School and was so happy to discover that there was actually a profession where I could get paid to help others. I wouldn't be paid much, but alas, I had discovered my future career.
I received my MSW from Florida State in 2002, all the while working full-time for the Department of Children and Families where I took child abuse reports. After graduation, I moved to Colorado with my new husband and got a job working at a residential treatment center for severely abused and neglected children whom had been removed from the home. This was the most difficult yet rewarding work I've ever done. Unfortunately, I had to quit after a little youngster kicked me in the stomach while I was pregnant. Yes, she did it on purpose. One day I hope to work with this population again, but not while my own children are so young. I just feel so passionately about this population that I am unable to "leave work at work" and it would negatively impact my personal life.
I then got a job with a local organization where I helped them open a homeless shelter for severely mentally ill women. I loved this job but was unable to use my clinical skills as the organization was/is not certifed in the field. So, I got a position at our local mental health center where I've been for close to 5 years. For the majority of those years, I worked out of a medical clinic providing mental health treatment to homeless adults. For the past 2 years I've also worked for our off-hours Emergency Services Team where I respond to the emergency rooms and assess both children and adults for suicidal/homocidal/grave disability criteria and put them on a 72 hour hold if necessary.
After my recent maternity leave, I transferred to the Emergency Services Team during the day as well. Needless to say, I come across some very interesting people and I always find their stories fascinating. It is my hope and intention that through this blog, I can share a little glimpse into the lives of those suffering from mental illness and perhaps even break a few barriers and stigmas of those afflicted by the disease.