Working through social services and the mental health system is overwhelming; I promise, you are not alone nor are you not able to meet the challenges they present despite the challenges. The simple answer is that it wasn’t designed to be simple and the more complex answer being that it was designed to be simple and now, you may be questioning those two statements that rival each other but soon enough you’ll see they are copisync to each other in how they build, and our rival was never the basis, but the execution.
Working with many families and services, I have found basic elements between the two and how they funnel, which I will discuss in other posts; for now, we are going to focus on the common barriers which will assist with the foundation and hopefully, help you lay out the plot to your goals and move forward with a solid structure that is prepared for everything to come next.
1. Forgetting services are run by humans.
So, you didn’t exactly forget – hopefully Susan on the end of the line is, in fact, human and not the subhuman from the cursed world you are certain she hails from with goals to destroy your sanity or, in the least, your day.
But you did forget that Susan is more like you or I than her role or title, which means we need to save the pitchforks for other beasts of burden and contemplate how that defines your role in it.
More often than not, there is a lack of real training and more of a, “You see that cliff? Awesome! Good luck with that!” and off they go, thrusted over without any real knowledge on how to fly. When you step into services, realize that often times these professionals you are working with are likely learning with you. Sometimes, you may get lucky and find someone who had the drive and time to learn to fly, but generally – most are somewhat lucky to obtain one who knows how to coast enough to keep their title and, minimally, help you.
Those titles? Roles? They are trained in how to bill. Training requirements? The most in-depth training is based on company policy, regulations, and general overview because company liability trump’s actual role training. Role training? Short video clips and review of basic logic that count as required hours fulfilled.
That service coordinator or case manager is limited to what their supervisor’s and team members know which is further limited by what they actually know; I know this because I worked in the field with others with years under their belt and somehow, I knew more than them within months and eventually, knew more than the services I reached out to when I had to tell them about their own programs.
Another fun fact: you can call a service and ask a question, get one answer then call back and speak to someone else who will tell you a completely different answer. At this point, with my experience, I can tell within a few minutes if the person I’m speaking with understands or knows what I need or what they lack in knowing overall about what I am asking and will get off the call, only to call back and speak with someone else.
I’m sorry, but yes, this is what you’re working with and it’s important to remember – there are far less people like me and to succeed here, you need to look to yourself and take control of the services you receive and demand results to what that service states.
That often means finding handbooks with the program, they are usually available online, or reaching out to multiple sources, in the least, to get a general overview of rules or guidelines with qualifications; I have seen services actually state incorrect data and had to pull up their policy stated in their service guidelines and even this, at times, getting push back and having to then report the service to the right administration to get the results my client needed.
Some service roles, by their title and service statement, are suppose to be this leg work but again, that person you’re speaking to or working with may know no more than you and if they lack the drive to figure it out, the results stop when you accept them and possibly miss out on the opportunity that could have been or that win you actually needed.
2. Accountability – you’re too nice.
Which brings us to our next barrier in which you have simply been too nice. I’m not saying you need to get the pitchfork out, but you need to have a standard at the very least and threaten to pillage some villages here.
This is your life and you’re putting it into the hands of a service and representatives who are verbally stating a commitment to assist and, in truth, nice will get you no where here because if you’re easy to put off – Susan with state maximum caseloads or Frank working 50 hour weeks that he is paid only for 40 hours of will put you off when he can, why? Because the demanding ones are taking that time.
Now, there is a balance here and secretly, I appreciated the stories of clients coming into the office cursing up a storm and demanding results when they were continuously being let down because I understood what they spoke, and they were standing up for it. Do I recommend that strategy? No, the lack of understanding from staff actually not doing their job and supervisors not actually thinking their staff need to do it and finding solutions to assist them in learning how to speaks volumes and you will be labeled “difficult,” despite having actual logic to the issue here.
If you’re working with a service provider stating commitments and they aren’t following through on them, missing appointments, leaving you all the leg work to do and not having any real results then you need to step back and re-evaluate what you are doing with the service. These services are paid for, and they are in a position they are paid to fulfill; you wouldn’t go to the market to purchase a pound of cheese and accept one slice with an excuse and still pay the pound price, so why would you accept the same results with something as important as you or your loved ones needs?
If you are working with a service provider that assigns staff members to your case, you can request a different staff member, and this may resolve the issue in itself. If it doesn’t?
Your first step is finding out who is funding the service because this is who you will report to – some are run by state agencies or federal programs and others are private with overhead at an office. You don’t always report to the supervisor because the supervisor may be just as lacking in their credibility in their role and if it has been a long time dealing with situations and reporting issues, then trust me when I say the supervisor is lacking credibility. I had a situation with a supervisor that was actually in on insurance fraud and when reporting above the heads that be, it was unleashed and handled in a way I left no choice for it to be otherwise.
Learn the sources that run the programs and have a standard because if you don’t, you’re following someone else’s and that may be the difference between succeeding and failing to obtain the results you need.
3. You didn’t follow up.
Now, let’s go back to Susan or a service and that sediment of a role again – assuming a role assumes Susan or the service is handling everything she or they said they would, is, and good intentions pave a nice view of what one aspires to, but unless that road to tomorrow is paved with actual bricks – you aren’t getting far.
Go ahead, mail that documentation requested in with no mail tracking or better yet, drop it off at the office and get no confirmation written on documentation being handed in or put it in the outside drop box and watch how fast it is stated that it was never turned in and even better, how fast you lose benefits because staff never called to let you know it wasn’t received and benefits were ending. Oh, you want them back now? Oh no, you’ll need to appeal and go through a whole process or even at times meet with an adjudicator now and best of all, because you can’t prove you actually did everything right, well…now you didn’t and you’re at fault because the service is never wrong unless you can prove it. Those benefits? They are stopping unless you know the loopholes to keep them continued when they have them, which you’ll have to know because staff doesn’t.
You track everything you send in either by faxing, mailing with a tracer, or obtaining a written confirmation in person and keep all receipts. This way, when a statement comes of not receiving items, you can then levy HIPPA concerns if they don’t have the documentation and your proof of completing the task will force the issue on their end to resolve, not yours.
Referrals? You call to confirm the referral was received; I had a case in which I had to complete multiple calls back to back because one service used a digital fax system and the other didn’t use it and had to argue with the original service provider to simply fax it despite their general way of doing because the provider being referred was never getting the referral which cost a loss of time in obtaining the client’s needs and only finally figuring out the issue by raising hell and figuring out the issue myself.
This happens so often, it’s just standard if you want to confirm your care is being handled how it needs to be because there are many barriers in that referral being received and when there is issue, either both parties don’t know or they know and are simply waiting for response from the other provider who, guess what? Possibly didn’t get that update, either, and all along – you are waiting, assuming roles, and just lost weeks of valuable time and still are at square one.
Always track. Always check in.
4. You’re not organizing efficiently.
To be fair, the more barriers there are and the more family members in a unit, the more data sets that are going to need to be collected and retained. It can be hectic but once started, it will be smooth.
Every service will have guidelines, especially for low-income families where programs are income dependent, which means you will be submitting verification documentation. Your first and most important need is to have those data sets stored somewhere you can retrieve them when needed and doing this consistently will help keep everything running smoothly.
If you have a staff member you are working with and it is within their role to assist, they can help you obtain what you need – a psychologist will not take time to help you order a copy of a birth certificate, but that case manager can and it should finalize with a result of you completing the steps or having the steps in hand with ability to do the tasks independently.
You will always need a copy of your own and loved one’s birth certificates, social security cards, a state ID or equivalent, less often for those under eighteen, and income statements. If you don’t have at least a base here, then you need to obtain these first as nothing can move forward without them.
If your income is SSI, SSDI, Retirement or death benefits, you need to keep a copy of your awards letter and if you don’t have this, you can create an online account to obtain one instantly or call your local office and request a copy mailed.
Some programs require a certain time frame of bank statements or current account balance – you can obtain this from your banking institution or if you have an app, download a statement; some programs will allow a screen shot so long as your name and bank account information is in the same photo.
If you rent, you need to keep that copy of the lease and if you own the home, you need a deed copy. Staying with family and paying rent? They can write a statement confirming you live there and pay whatever amount and their contact information. In-between living situations? Apply as homeless – you don’t have to be sleeping on a bench to be homeless; if you are not in a long term, stable housing situation then you are homeless.
Utility copies may be needed, as well, or the account information – keeping a copy of something with account information and knowing how to obtain a statement is generally suffice.
A major component in mental health and social services is a diagnosis which is better coming from an official mental health evaluation, or as we call them, psychiatric evaluations. They’ll generally need to be within the year of, but this is not true for every service. You’ll want a copy of this and save all copies of any mental health evaluations and medication history; if they fight you on giving you a copy, go above them as you have a right to your information. Do I recommend reading your psychiatric evaluation? No, not unless you feel comfortable reading other’s statements about you. But having a copy, yes, because it will be requested if needed.
If you do not have a diagnosis yet, you can start with a PCP for general diagnosis with depression or anxiety in the mental health sphere or find a provider covered by your insurance and request a psychiatric evaluation – you can still have one even if not interested in medication management.
If you don’t have insurance, there are options here as well, but it is more dependent on other factors related to you.
Having everything organized and available will speed the process up and help others help you as no one is authorized to obtain them for you, nor is it their responsibility to.
Overview
While this is certainly not a comprehensive list nor representative of all the angles that interchange between all the services and programs, it’s a good start for a foundation that will empower you when mitigating through the framework.
When we look back at our earlier statements between the system with simplicity intended to the design, one has to look also at what that system compromises of both on a macro and micro scale; between human ran systems, loopholes that found their way in when other systems changed or needs appealed and the original needed to adapt, funding barriers and multiple other factors – the system itself is breathing and a living growth. It was designed to be simple to answer a societal need, but it wasn’t designed to be simple because society is not simple and everything that branches off the original branch is still connected to an even bigger system.
Luckily, for the most part, you only have to focus on your interchange and what that means but this awareness allows you to ask yourself if something makes sense or seems rational in the results, which with skills, allows you to take these basic strategies and answer it.
I found most of my wins came from me looking at what was spoken and thinking, “that doesn’t make sense,” then pulling up the rulebooks myself and looking at data and finding, well, Susan didn’t know or was just bad at her job. And because I tracked everything and organized everything into a well-defined resolution, I pointed the arrow at the right head and hit the target I needed.
It’s not magic, despite some families thinking I pull rabbits out of hats and while it may very well look like this at times, it was always just a matter of deduction and sourcing and possibly, very possibly, my secret desire to pillage villages and run around with a pitchfork.
I hope this information has given some window into the circus that certainly is and empower you through it – there is always hope and solutions, you will find them!
