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Mental Health — A BioPsychoSocial Perspective
A Praxis Course at Bryn Mawr College Spring 2002
Made available on Serendip

Mental Health Paper 2

Tracy Hills

Uncomfortableness and frustration are two feelings that immediately come to mind when reflecting on my experiences of working with 18-21 year olds with mental disorders at a community rehabilitation residence (CRR). When I first began interning at the CRR I was plagued with uncomfortableness. I was uneasy around the residents because I had never been around young adults with schizophrenia, oppositional defiant disorder, and major depressive disorder. I wasn't sure how to interact with these residents and was faced with overcoming the stigma that accompanies mental disorders. For the first few days I kept thinking of how people with mental disorders are portrayed in movies and how the stigma surrounding mental disorders is manifested by distrust, fear, bias, anger, and embarrassment. (Mental Health, A Report of the Surgeon General, 1999) There was also an occasion the first time I met the residents that heightened my uncomfortableness. The residents all knew I was a student at Bryn Mawr College and while I was helping them make dinner, one of them asked me what courses I was taking. I felt strange telling them that I was taking Abnormal Psychology and a class on Mental Health. However, the residents didn't see anything strange. Instead, they thought it was neat and kept asking me questions. Through spending time with the residents and talking with them about their lives my uncomfortableness subsided and I began to see the residents as humans with thoughts and feelings rather then adults with mental disorders.

While I have found working with these young adults rewarding, it has also been emotionally taxing for me. Every time I leave the CRR I am filled with frustration. It's frustrating for me to see young adults with potential being held back by mental disorders. I have previously worked with both children and adults with mental disorders and those experiences weren't nearly as frustrating. However, this time the residents are my age and are trying to do things with their lives that are similar to what I'm already doing. For example, they go to school, they work, and they want to live on their own. Yet few, if any of them will reach the level of independent functioning that I'm at and I wish they could all reach that level. Take Alex for example. Alex is 22 and attends a community college where he takes one class at a time. Every time he sees me, he talks about how his class is going and wants to know how mine are. Currently he is taking an English class and he is so proud of the grades he gets in the class even though they are usually low C's. For him, going to the class is an accomplishment and he loves learning. However, I see the work that he does and the level of difficulty is so low that I know he is limited in his academic capabilities, which is aggravating because he enjoys school so much.

The frustration extends to other residents, as well as their families. Mike is 24 and has schizophrenia. When Mike is upset about something he refuses to talk or acknowledge other people, which can be irritating. He also picks at his knuckles until they bleed and does self-stimulating behavior such as rocking. I want to understand what biopsychosocial processes are causing these disorders because I want to understand why the residents partake in the behaviors that they do. I wish I could do more to help them, but I know that all I can do is talk to them, listen to them, and be a support system.

The families of these young adults frustrate the entire staff. Many of the families don't understand mental disorders and want their children to be "cured" immediately. They have difficulty in understanding that there isn't a cure and that the CRR is there to teach the residents how to live independently with a mental disorder. Meetings are held with the families, the residents, and the staff to talk about the resident's progress and future goals. The staff believes in including the family in the resident's treatment because they think that the family is an integral part of the resident's transition into independent living. However, many of the families inhibit rather then support their children from becoming more independent. Many of the parents have mental disorders such as depression and others suffer from alcoholism and substance abuse. According to the staff, some of the parents try to sabotage their children's success in transitioning. Take Mike for example. Mike will be transitioning into his own apartment in the next few weeks. However, Mike's mother has become more prominent in his life and has been telling him that he should come home, she will take care of him, etc. Since this increased contact with his mother, Mike's habits such as picking his hands and self-stimulating behavior (i.e. rocking) have reappeared. These are habits that took the staff almost two years to break. At this point the staff is fed up with Mike and his mother and want him to leave the CRR for the sanity of their own mental health.

The final frustrating aspect of working at the CRR is that a lot of what I have dealt with there, I have also been dealing with on campus. The first thing I do when I get to the CRR is read the logbook to see what has happened since my previous visit. Residents often go through bouts of depression and/or attention seeking behavior and occasionally become suicidal. In the logbook, I read about residents attempting to slit their wrists, making nooses out of belts, and causing self-injury. Earlier in the semester, this was difficult for me because of similar problems occurring with somebody I knew on campus. I would go to the CRR, read about the residents, interact with them, and then head back to school where I had to deal with a very depressed person who was also engaging in self-injury. Mental Health invaded my life for a few weeks and at times it was too much to handle and I realized that I wasn't taking care of my own mental health.

In the time that I have been at the CRR I have learned a lot, not just about mental health issues, but about myself. With respect to mental health issues, I have learned how young adults cope and live with mental disorders and the challenges that they face. With respect to myself, I have learned how to separate what goes on at the CRR from my personal life and have come to the conclusion that my personal mental health comes first. Overall, working at the CRR has caused me to gain a newfound respect for people with mental disorders because some of them try so hard to overcome the challenges and the stigma that they face on a daily basis. Most importantly, I have learned that the residents are regular people, not just that schizophrenic or that person with bipolar. They are people with names and interests, thoughts and feelings, just like everybody else.

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