The rewards of life on the front lines

After we read over CMHC’s Annual Reports from the past 40 years, we felt like we’d eaten 40 boxes of Rye Krisp. There’s nothing like reducing an institution to a four-page bureaucratic report to drain the life out of a place. This was a particular problem for me, because I wrote most of them.

The reports told of our annual caseload of 5,000 patients and initiatives that organized and reorganized people and programs to accommodate a burgeoning caseload and limited resources. The line that captured it best, perhaps, was “We are doing more and more with less and less.”

If I had it to do over again, I’d write about the day-to-day life of the place. I’d start by reminding the reader that mental illness is a wide and subtle confluence of factors, of genes and stressors, which can be countered by strengths and supports. Our understanding of the causes of mental illness is still evolving, and our treatments continue to evolve as well.

The life of this place is on the front line of a struggle with a terrible illness, played off against the possibility of health, comfort and normal life. It’s a struggle that occurs with each interaction that attempts to fine-tune reality, ability and acceptance. How do you keep score? Ann Joy, our director of psychosocial rehabilitation services, once said that Professor of Psychiatry Michael Hoge had explained, “For some of the people we treat, just being able to sit with other people for 15 minutes is a success. Small steps are big gains.” Happily, there are also those for whom success has meant much more, including joining the ranks of caregivers.

CMHC’s vitality is where the caregivers of all kinds—physicians, nurses, psychologists, social workers, mental health workers, occupational and rehab therapists—champion their patients in countless ways.

This is a time to acknowledge every clinician who has called around the state to find a bed; every doctor who has weighed the benefits and costs of medications for his or her patient; every case manager or peer advocate who has worried where someone’s next meal or coat would come from. We acknowledge every clinician who hoped a shelter could overlook this one last outburst; and every clinician who tried to keep a released prisoner out of trouble. This is the time to thank everyone who has taught us to understand the nuances of human spirit and behavior.

We thank our researchers for their work on the complicated pathways to the causes and treatment of mental illness and addictions, as well as those who prepare the endless grants, and who keep the labs and clinics running smoothly. We thank the many agencies of the Community Services Network of Greater New Haven that give life to the phrase “a network of services.” The very nature of our work requires the highest degree of collaboration.

It is a time to acknowledge the CMHC environment itself: our able public safety department, our switchboard operators, our computer and records staff, and the myriad of people—carpenters, electricians, housekeeping and building crews—who keep the place clean and safe, warm and even welcoming. And there is the true front line of our work: the secretaries and administrative supervisors, who are often the first responders to crises of all kinds. The place would close without you.

CMHC exists because of everyone who comes to work each day—or night—to meet whatever surprising developments his or her shift may hold. The remarkable thing about CMHC is that regardless of the thinking, the funding or the treatments available, for 40 years we have been here to help steer a difficult, sometimes heartbreaking, often hopeful process.

Hardly a box of Rye Krisp at all.