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Reaching Out

rowofkidsReaching out and helping youth and young adults is very important. To give us attention shows us that you really care. Reaching out and helping is one of the best things that anybody can do. Look at all the trouble that happens to youth on the streets every day or that’s caused by youth and young adults.  We search for support with our actions. We speak out to you with no answer. It’s our cry for help.

I am amongst the youth and have done things in the past in an attempt for attention and support. I have set fires and even fought at school. I’ve been to different programs in three different systems. I stuck with a few programs for a while but eventually ran or decided they were not for me. One program has been helping me for five years now. I think they will always be there for me.

I have been going to PPAL and Youth MOVE for five years. It is a wonderful placed to go that reaches out to you. They talk to you, ask you how you’re doing, and offer you help whenever they can. PPAL has helped me a lot. Helped with things such as getting my ID, helping me find a job, and given me people I can talk to.  PPAL has groups every week for youth and young adults. It’s a good place to talk because it’s not run by doctors or people sitting in the corner with a clipboard, it is just youth talking to each other. We have dinner together. I can also hang out with other youth and young adults that are around my age group and listen to their experiences. I can get feedback about how I can deal with some of my experiences in the past or even problems I have now.

Before coming to PPAL I was really scared to talk about anything and when I opened my gates and started talking, I felt so much better. I began coming constantly and kept getting support emotionally and now I help as well. I help set up the groups and run parts of the meetings. Sometimes I stay away for a while and am worried about going back. I worry about how I might be judged. PPAL doesn’t judge me for why I was away. They welcome me back and help me get back on track. They offer to help.

I am a troubled youth just like a lot of youth. Many of us feel alone and like we have it the worst, but you are not alone. Talk to somebody. Open up. You might find somebody who is reaching out to you. I can personally say that a lot of people at PPAL know what they are talking about. We don’t fake it. We know how you feel. We will help.

 

This blog was written by a 19-year-old young adult member of Youth MOVE Massachusetts. They have lived experience in mental health, child welfare, and juvenile justice systems. Their strengths include leadership skills and writing poetry to name just two.

Have you experienced patient profiling?

emergency roomHave you ever heard of patient profiling? It takes place when medical–and mental health–professionals make an assumption about someone seeking care based on their appearance, race, gender, financial status or even the kind of illness they have, such as mental health or substance use problems. The first time I came across this was in an article written by Pamela Wible, MD, who recounted patient stories where the personal judgment of a medical person resulted in poorer care. She worried that, similar to racial profiling by police, patient profiling is more common than we want to admit. And it undermines care.

When I first heard about patient profiling, I immediately thought of my younger son. A few years ago (when he was in his early 20s), he woke up on a Sunday morning with horrible vertigo, He couldn’t stand, couldn’t focus and couldn’t drive. I took him to the local emergency room where they asked a series of routine questions: Are you on any medication? (No.) Have you ever experienced this before? (No.) Have you had anything alcoholic to drink? (Yes, one beer last night with friends. I was the designated driver.) Unfortunately, the questions stopped after he said he had had that beer the night before. He was given intravenous fluids, allowed to rest and sent home. The next day, his very irate primary care doctor sent him to a different emergency room where he was treated for inflammation of the inner ear.

For my son, staff at the first emergency room decided that a young adult in his 20s experienced vertigo because he had been drinking. They made a snap judgment and his treatment was delayed. To this day, he feels a general mistrust of emergency room staff.

For children and youth with mental health needs and their families, patient profiling happens far too often. It happens in the emergency room and it happens in visits to medical specialists. One mom, whose daughter had both a diagnosis of depression and frequent migraines – for which she was seeing a specialist – waited four days recently in the emergency room because no inpatient beds were available. She was told that her daughter couldn’t receive migraine medication while waiting because that was drug seeking behavior And it was probably part of the bipolar anyway. The mother was frantic when she called us and very frustrated that her daughter’s care was all being lumped under mental health. She felt the emergency room staff had stopped their assessment of her daughter’s needs after they heard about the bipolar disorder.

This doesn’t just happen in emergency rooms. It happens with medical specialists who think that mental health concerns have caused medical symptoms. It happens when doctors call parents “enmeshed” or “co-dependent” and don’t see them as a resource and partner but instead as part of the problem. It happens when young people are seen as their diagnosis and not as a valuable self-reporter and critical thinker.

That said, there is a fine line between patient profiling that can help or harm. Doctors, nurses, therapists and other workers often form an initial impression based on their experiences or their training. They often need this starting point to determine a course of action. But – and this is the crucial piece – that starting point needs updating as new information comes in. A second impression or a third is often in order. When the initial judgment is incomplete or inaccurate and it is not revised, it can be harmful.

A cornerstone of good care is excellent communication. While this is often characterized as the doctor or medical professional communicating to the patient, it should be a two-way street. Mutual exchange of information is critical but so is mutual listening. In any human interaction, the only way we can truly connect is when we get past our snap judgments and see who is actually there.

When a child is in crisis or when her need for care is urgent, parents are rarely at their best. Most often, there have been many stressful days or weeks before this point which have worn them down. We rely on medical staff to see beyond the diagnosis to the whole child, teen or young adult. We trust them to see our committment and strength in the midst of the frenzy. We hope they will see us as a key member of the team, not as a “less than” parent to be held at arm’s length.

When this doesn’t happen due to patient profiling, we all lose.