Archive for the ‘Issues of Interest’ Category

In each of my social work classes, in both graduate school and in undergrad, my professors have mentioned self care as an important facet of professional life. I found it easy to disregard self care. I always told myself that I simply don’t have time to do self care. In one sense, I did myself a disservice. In another, I did myself a favor.

Through my experiences, especially recently, I’ve learned the necessity of intentional, well-planned self care. I am what you might call a “perform-aholic”, because I am bent on doing absolutely everything I can, even to my own detriment, in the time that I have. In fact, I spend all of my conscious time thinking about things. It could be anything, but there is very little time I spend with my mind in an absolutely neutral zone. I spend very little time watching television or film for this reason. If the television is on, I am likely not the primary one watching the program, or I am multitasking, which isn’t the most effective use of time. I think until I go to bed at night, at which time I have to distract myself and immerse myself into a book, an article, or a game that is unrelated to anything serious in my life. I do this so that thoughts of my life and all the tasks I am working on don’t plague me and keep me too alert and on edge to sleep. Needless to say, I need to do self care very meaningfully and very intentionally. It won’t work to do something halfway because it won’t be enough to pull me out of my element.
The act of relaxing myself is very difficult to do. Even when I am “relaxed” I am normally somewhat tense. I recently went and got my first massage ever. I was happy and it felt great, but the poor massage therapist repeatedly had to tell me to relax myself and various muscles. I consistently carry tension and rarely relax my body.
I need self care just like other social workers do. The chosen activity is much less important than the act of treasuring yourself and your own mental health, so the activity does not have to be the same each time. The beauty of a routine, however, is that it becomes habitual.
While I figure out a decent routine I do know of a great self care exercise to try. It’s called progressive muscle relaxation.  Those who practice it are guided through a track of soothing sounds and step by step instructions to contract, then relax, each muscle group throughout the body. The practice requires great focus to be effective at training one to relax and to distinguish the difference between holding tension and being in a relaxed state. When I do this exercise, I often find I am already halfway tense when I begin and must focus greatly on the relaxation. However, it is a worthwhile and effective exercise to wind down and distracts the mind from worry and stress.

In a 2-day substance abuse assessment and intervention course I took last weekend, we were discussing access to good substance abuse and dependence treatment and good mental health treatment. One student, named Steve, made a comment that illustrated the disparity between access to medical care and access to mental health and substance abuse treatment.

“We know exactly where to go for cardiac care and where the best cancer treatment centers are and where to go for all of the medical services we need, but we don’t know that there’s a group home just down the street. Access to mental health services is extremely limited.”

Mental health and substance abuse treatment centers do exist all over the nation, but aren’t used or advertised as frequently as more biomedical settings.  In addition, insurance companies are less likely to cover mental health and substance abuse services than other services. Evidenced-based practice is not as much of a factor, we didn’t theorize, as much as the scientific model of the more biomedical treatments. There is a quantitative value to most of these treatments and a predictable, measurable cost and course of treatment. Mental health care stands at a stark contrast. There is not a dose-response relationship with mental health and substance abuse treatment options. No physician can prescribe a set amount of therapy sessions and know that the issue will simply “go away.” Many therapies teach clients to cope with life situations and help to manage and reduce symptoms. Therapy comes in many types with different methods in each type, and each individual responds differently to treatment. Some mental health diagnoses are pervasive and require different types of care throughout the lifespan. These factors make it nearly impossible to create a “dose/response” equation for mental health and substance abuse treatment.

Is mental health care something that you think about often? Do you think access to mental health care is an issue? What would society look like if mental health access were increased, with stigma stripped away? Which would have to change first? Share your opinions and discuss below.

Special thanks to Steve, for letting me use his wise words. Thank you, Steve.