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Mental Health Issues? Hate the ODSP?
May 21, 2003 - 11:43pm
The purpose of the video is to sensitize front line ODSP workers in dealing with clients with mental health issues. This is something they do not do especially well.
Do any rabblers, either themselves or through friends and family, have anecdotes, horror stories, opinions or whatever in dealing with this organisation from a mental health point of view?
There is also a report titled "The Experience of People with Disabilities in Ottawa and the Ontario Disability Support Program done by the Social Planning Council of Ottaw in October, 2001.
This is one of the things I am looking into as a member of the board of DAWN Ontario and will help you in any way I can. To start with, one of the biggest problems people with any sort of mental or perception problem has is understanding any of the papers in the application stage. After this, they have problems finding out about the benefits and programs available. One thing that would help would be having things explained in plain language instead of the jargon that is used now. There's a lot more and some of it would involve trying to find ways around what appears to be policy not to provide assistance to people who have difficulties.
Oldgoat, would you prefer to confir on this by email or here. I can likely give you a lot of information to ponder and help find solutions to but it could be rather ponderous.
[ 22 May 2003: Message edited by: verbatim ]
We're still at the stage of setting out broad parameters, and while I've done a fair bit of training, making a video is new to me. I'd be interested in anything you have to offer.
Check your PM's
Verbatim: Don't be shy!
[ 22 May 2003: Message edited by: oldgoat ]
I'm starting small. The dippy little square moustache goes first.
Actually, I was hoping you might jump into this. If you or anyone else in the wilds of Parkdale have any input, I'd appreciate it. I would retire happy if I could just get them to abandon that godawful phone menu systen they have. I refuse to use it. I use fax for every type of communication I can.
Apparently there are no longer Workers in ODSP but rather "teams" which may.. or may not actually exist?
Anyhow contact her at the following email address
dn701 at ncf.ca
Of course remove the "at" and replace with "@"
I heard about one case of a Ontario Works worker who got a desperate call from one of his clients, an older Portuguese woman (he spoke Portuguese) whose husband had just died. He went to see her and spent most of the day helping her make funeral arrangements, deal with the cemetery etc because he felt it was part of his job to help his clients through crisis. Of course when he got back to the office he was reprimanded for spending too much time (ie more than 15 min) with one client.
[ 24 May 2003: Message edited by: Mycroft ]
Truthfully though, The ODSP people can be pretty decent when you get them face to face, though that is I think largely because I'm involved as an advocate. Once they understand that there is a real individual who's really having a problem, they are often very helpful. Those who don't have someone to help them navigate the system can disappear in the cracks.
Mycroft, I don't think too many ODSP or OW workers are actually social workers. Some might have taken some vaguely related courses, and a few may have a college social services diploma, but that would be about it.
[ 23 May 2003: Message edited by: oldgoat ]
I work for the Canadian Mental Health Association as a case manager. That can mean a pretty broad range of things, but with my programme model, I work with people who have been diagnosed with major mental illness, doing whatever seems to be required to help them maintain successfully in the community. This can mean counselling, helping get or keep housing, deal with bureaucracies, life/social skills counselling, education on their illness and treatments for individuals and families, referrals, lots of advocacy, and working with whatever goals the client seems to want.
The various teams in my agency offer slightly differing types of service to meet varying needs. My team of four tries to specifically serve the unique needs of the growing multicultural community. This involves keeping an open mind, and an even more open ear.
Actually my former employer held a forum for those who had difficult interactions with ODSP sometime last year, I'll see what I can dig up.
You say, oldgoat, that the front-line workers don't deal especially well with people who have mental-health issues. Can you give us an example or two of the not dealing well part? This could help me to sort out some of my own issues.
The actual social workers I've met over the last six months have been great people, obviously very intelligent and empathetic, much sharper and snappier than I had expected -- that has been a pleasant surprise. (I think I was fearing gooey-ness -- forgive me.)
But it is obvious that they are all run off their feet. It takes a week of telephone tag to set up a short phone conversation with any of them, it appears. They are also administering a set of rules that is so complex and fast-changing that even very experienced and senior people seem not to have caught up sometimes -- getting conflicting directions can be most frustrating.
[ 25 May 2003: Message edited by: skdadl ]
A client of mine was due for a review. They phoned him to confirm his address. He is an easily confused and highly anxious person who happens to have very slurred speech. The person on the phone rudely gave up on him, sending out a letter giving him a time to show up and documentation to bring, and if he didn't, his benifits would be suspended. It arrived the day before. I had already been on it and changed his time anyway.
As a result of the review he needed to provide some financial info to ODSP. On May 20, he got a letter saying he needed to have it in by May 16 or he'd be cut off. Fortunately, I had already faxed it in on the 16th. Last wednesday, he got a letter saying he was being cut off because theydidn't have it. The letter was dated May 16. It gave him 10 days to appeal, but did not provide contact information for the sendee. I reassured my client, who was pretty scared by this, and sent off a rather terse fax.
This sort of thing is not untypical. Here's an interesting link provided by Trisha.
http://dawn.thot.net/odsp.html
Here's a little exercise for any babblers in the Toronto area with too much time on your hands. Pretend you are someone diagnosed with a major mental illness. Your powers of concentration are really lousy, and your mental abilities have been made slow and mushy because of the meds you need to keep the demons away. You are by nature anxious, and maybe a little paranoid because the world has never been a very understandable place for you at the best of times. Experience has taught you to expect things to go badly. Even with the meds, there's always a statticy buzz going on about 10 inches behind your head. On a bad day it can swell to a dull roar. Most days aren't too bad. You have a subsidised bachelor apartment, which means if you don't spend too much on smokes you may eat ok. You've started to make a few friends at a community programme, and earn a bit of extra money by working there. They're teaching computer skills. ...
...OK now. You've just gotten a letter in bureaucratese that you don't really get, but the gist seems to be that your benifits are being cut off. You'd loose your housing and go back to the beginning of a 5 year wait list. Your transportation subsidy to the programme would be gone. Your drug benifits will be gone. You see yourself loosing it all and going back to a time when things were pretty dark. Even on a good day life hasn't been all that worth living, and this isn't a good day. The statticy buzz is filling the room, you can't think straight and you're in a cold sweat. There's no contact information for the person who sent the letter
The only number you can call for help is this: 416-325-0123
Your task is to put yourself in this person shoes, and then navigate this phone menu. Once the phone menu is over, there have been a couple of times when I have gotten a real person after only a few minutes of waiting while I listened to "easy listenin' " music punctuated by recordings saying how inportant the call is and please be patient in both French and English. My record for sitting on hold is 52 minutes before I gave up. If a decision has been made in another office, chances are the person won't be able to help you beyond telling you to start an appeals process you won't understand.
[ 26 May 2003: Message edited by: oldgoat ]
But oldgoat: that person finds you. How does he find you? Or do you go out and find him?
A five-year wait list. Five years. God, that's worse than the CCACs. A lot worse, actually. The newest homes have two-year lists, but some very good ones -- maybe better, if they have good OT programs -- are maybe six months.
Except, it is also true: make one mistake, and not only are you at the bottom of the list again -- you are off altogether for six months.
Moralizing reasons are given for the hassles -- but the truth is, necessity is pompously being claimed as a virtue. Or in straight talk: it is the shortages, Tony and Ernie and the rest of those guys.
Quite confused about the whole thing, she suggested I speak to somone else. The good news is, she gave me some phone numbers that actually ring on peoples desks!! Those are gold. They don't always give that out.
In answer to your question, referrals to me often come from hospitals or families. My Somali and Tamil team mates do a lot of outreach in their communities.
My issue is, I've had a number of clients who ONLY need me to apply to ODSP. They get by ok otherwise. That's not really justification for a community case manager. Why can't ODSP have people like me.
Receiving requests for information after the required date is a big problem and becoming worse all the time. People can have their benefits frozen or removed for missing a date. It often takes up to eight weeks to get a makeup cheque once they prove they didn't just ignore the message. That leaves someone with no income for some time.
The phone system is very difficult for people with perception problems to navigate. Many people with mental disabilities have short attention spans, so may end up hanging up. Being able to understand questions on the phone is also difficult for many people. If someone has a problem, getting someone to get back to them often causes extra anxiety as they can wait for days.
One thing that the government has refused to take into account is that a lot of people on assistance do not have phones because there is no payment allowance for phone service. The same thing applies to computers, which the government is trying to push more people to use for access. Waiting for a call back on a pay phone just doesn't work. Also, even by using a friend's phone, you never know when the call is going to come and you can't be there all the time. This is a problem that needs to be approached somewhere along the line.
This is a double outrage. Or it is insult added to injury. [img]mad.gif" border="0[/img]
The first outrage, of course, is that it is impossible to fill out government forms oneself. Trisha and oldgoat, I don't know the specific forms you are dealing with, but I know that it is not possible for a native speaker still in possession of (most of) her faculties, with degrees in the language and multiple contacts and resources ... it is still not possible for her to fill out much of the CCAC forms by herself.
The difference in the system I deal with is that I was told from the beginning by CCAC social workers that I wouldn't be able to do it myself, and they would help. It took three of them plus me (and a doctor, of course, but that's separate) to do it, over the course of weeks -- !!! -- but at least they helped.
It took three of them because there are so many rules and some so new that no single worker knew them all. Now, I thought that was bad. But at least they were doing much of the work for me.
I suspect the difference in the systems is that the gov't knows that most of the people heading for the CCACs are middle classers and they dasn't outrage us too much. Whereas, the ODSP ... ?
A slight tangent: I confessed above to being ashamed at being surprised at how effective all the social workers I've met (CCAC and also workers attached to medical clinics) have been. The one I talk to right now is just so snappy (by that I mean she is fast and practical, no nonsense, no syrup). I really like her. [img]smile.gif" border="0[/img]
The down-side of our experience so far this year has been nurses. Not all nurses, no -- but the most uncomfortable confrontations I have had as someone who is being an advocate for a vulnerable person have been with nurses. We've been in several situations where, I've slowly realized, nurses are running the show, and many of them seem to me most impatient with advocates. They have seemed to me to be behaving, actually, more as administrators than as nurses.
I would be more than happy to be told that I'm wrong here, that I've just had a few bad experiences or I'm being unfair to overworked caring people. My mum was a nurse back in the dark ages, pre-antibiotics, eg, and I know what she thinks good nursing care is (it's the way you save lives if you don't have antibiotics around). I know, eg, that she was proud of doing a lot of the care that is now handed on to a new class of careworkers, many of whom are wonderful people but most of whom are, I suspect, overworked, severely underpaid, maybe facing problems with their legal status, and thus sometimes come with attitude problems. I have every political sympathy with people in that situation -- but I tell you, handing over the care of someone you love to someone who resents his work is not a happy pickle to be in.
Och, we're all being set against one another. It makes me so angry.
[img]mad.gif" border="0[/img]
Our government has cut the availablility of workers to such an extent that the jobs are harmful to the workers in many cases. The screening process are insufficient, which sometimes results in unsuitable job placements. While nursing should still be considered an honourable profession, for many it's now just a job.
Understandably, careworkers are more likely to treat such patients as pariahs. In my experience and reading, researchers and specialists and advocacy people have gone far in thinking about how to respond helpfully and positively to the intense distress of those who become agitated ... and yet conventional medicine and conventional practice still deal with agitation mainly by drugging it. Or, as you suggest, by actively abusing people who can't help what is happening to them.
I tried to qualify my comments about caregivers to include the fact that their actions are often unavoidable due to the actions of their patients. Unreasonable force and out and out abuse, however, needs to be corrected.
Have you been reading the nurses' protests over the impact that the SARS epidemic has had on them? For one thing, some at North York General had apparently been trying to warn about the patients there who slipped "under the radar screen," as I believe Tony Clement (and others, probably) put it, at the end of the first outbreak.
In the course of protesting, though, they are going public with all the stats about how much of nursing is now (expensively) hired out to private firms, and how much is now part-time. It's a real tangle, and you can see how little flexibility there is in the entire system, should real trouble come along.
I hope that people are reading the news, and remembering how this all started. What was Mike Harris's famous line about nurses? He compared them to something transient -- as he fired a bunch of the full-timers and started to auction off homecare.
Good for you! I think very highly of the CMHA. [img]smile.gif" border="0[/img]
After procrastinating through the summer, and being swamped with work since then, we were finally ready to tape something when I got a call from the training co-ordinator at ODSP saying they had changed their focus, and didn't need the tape after all, so thanks much, and never mind. Well you can imagine how I chuckled over the whole thing!
Actually, it's not so bad. Based on a number of things, including feedback from one of their own staffers who sat in on one of our final meeting they decided that having people just watch a tape wouldn't have the desired impact. They felt that a face to face small group format with time for discussion and Q+A would be more effective.
So, I still have the project, and it looks like I, along with a consumer spokesperson(s) will be doing training sessions in small group formats periodically for the indefinite future. Their goal is to train all workers in Ontario, and that will involve bringing people in the farther regions to Toronto. I have to say I'm impressed as I doubt my agency's training budget is more than four figures.
Parenthetically to this, I did a presentation to ODSP adjudicators as well as sundry other programme people last Oct. This included those who design their form letters and determine how and when the computers will spit them out. I was rather shocked to discover that that day was the first time these different groups had actally gotten together and talked. My presentation was part of a larger initiative on their part to examine and improve how they provide services. I have to say I found them to be very open and eager to hear how they could be more responsive. Their questions were good, the discussions felt productive, and I felt I was being heard.
I would like to thank those who responded to my initial post, both here and in email. It hasn't gone to waste!
[ 16 January 2004: Message edited by: oldgoat ]
Shame on Mike Harris and Ernie Eves. [img]mad.gif" border="0[/img]
[ 18 January 2004: Message edited by: DrConway ]
Funny earlier today I was thinking I wonder how Oldgoat is doing with his ODSP project.
I'm glad you've got them looking into those bloody letters. Did you ask them why they send letters that tell people they're benefit has been cut off(before it has) because the person failed to provide information they never requested, making sure also that the information still isn't specified other than a reference to legislative regulation.
by the way did you ever talk to the good folks at Parkdale legal?
keep up the good work.