I was just out riding around the lovely back hills in the rain, looking at the newly burst buds, the lacy blossoms, all ivory and pink and gold. It calmed me down. It gave me enough distance from the week's events that I can think about them clearly.

One conclusion I came to is that nobody is going to develop a plan to help my hospital's mentally ill patients until, oh, maybe October. We're concerned, of course, with Monster Panic. (I am so sick of hearing about panic that it's become a personified cartoon demon in my thoughts. Monster Panic. What a farce. It's nothing but an excuse to maintain denial. Anyway . . . I diverge. It's been a very long week.)

So while I was riding, it occurred to me that I should simply assume responsibility for developing a prep plan for our patients (aka clients or consumers) myself. I'll just write it up and hand my boss, the Director, a finished product. (I'm privately calling it "Preparation for Loonies", with utmost affection.)

I thought about how we should frame the process as something everybody should do as a matter of course. It could even be reassuring to hear, "Think how relaxed you would be in a bad storm if you knew you had everything you would need to get you by for awhile without needing to go out."

I thought that the sooner we started to teach emergency prep, the more temporally distant and disassociated with y2k it would be. The more prepared we are for the unexpected, the less frightening it is when the unanticipated appears. We could talk about it in terms of weather events, all the usual disaster preparedness stuff. When our patients ask about y2k threats they hear on popular media, we'll be able to say, "Well, you're prepared, aren't you?"

The Red Cross has this neat activity book and video called "The Disaster Dudes" that's appealing to children six through, oh, well. . . I dunno. I kinda liked it myself. If I could get the therapists to watch it, it might break through their denial about the necessity for preparation. (The Red Cross, after all, already sold them on the idea that y2k will present only 2-3 days of disruptions, you see.) It's a good film in that it introduces basic skills to learn, and safety techniques, and common sense emergency thinking. What could we teach in an outpatient/day-patient setting? How?

Well, by the time I got home, it dawned on me that I could ask for the help of the Yourdonites. Kind of a diversion for the weekend. Help me think about content for an emergency preparedness program. Remember that it's for people who are genuinely mentally ill, with schizophrenia, anxiety disorders, bipolar disorders and such. They're intelligent. They, like us all, are doing the best they can with life. But they have some significant obstacles. I would simply like to do somethinganythingto take some of the fear from their lives, to give them more confidence in themselves.

Oh, by the way, we have a family and children's unit, too.

Ideas?

Thanks in advance, Faith Weaver

-- Faith Weaver (suzsolutions@yahoo.net), April 16, 1999

Answers

The little Red Cross book sounds like a good starting place. I suppose you would have some differences in ability to live self-sufficiently. focus on the basics...my keyboard is starting to go flooey...do not dump liquids in a keyboard. Yes, I'm computer saavy.

more later...

-- Donna Barthuley (moment@pacbell.net), April 16, 1999.

--first, I'd like to thankyou for your selfless altruistic outlook, and I know sometimes it might appear to others I don't have one myself--I do-it just doesn't extend at all to any "normal" adult dgi's, that's all. --I've broken "Survival" down into what I consider to be 4 main overviews, under which everything seems to fall, with a little spillage between. Anyway, they are Water-Food-Shelter-Security. --It's very simplistic, but the best you can hope to do is to take each one of these points, and establish a time line of your buildings and clients ability to sustain those functions independently. Draw up what resources you have now, what you can reasonably expect to get shortly, and then by the end of the year. I'd suggest starting at one week's worth, then a few weeks, then once you can "survive" for a month, you can look at a longer time frame. The number 1 way to easily have access to the resources you need to fill in the blanks of "the big four" is by location to a rural area--a work/therapy farm, for instance. I know these sorts of facilities exist already. Perhaps an anonymous though rich and understanding GI might be able to help you,a charitable donation to a hospital is quite common- if you were to locate such a farm, purchase it and equip it in advance, and then all you would have would be transportation to get your clients from the urban building to the farm. Some school busses in convoy, with adequate security maybe. Personally, I don't think many urban areas are going to be much good after a week at the most if there's even a moderate crash. Being a refugee just don't cut it, nope. Please feel free to contact me directly, this is my job, and I might be able to help you a little, anyway. Unless you think my other posts make me a touch too scary, then, well, good luck!

-- zog (zog@avana.net), April 16, 1999.

Hi Faith Weaver:

From what I gather by reading your post the mentally Ill you are concerned about are in-patients at a hospital, is this correct? Is this a state or county hospital? Or is it private? In any event the management of the hospital is responsible for the well being of the patients. This is a legal requirement. To ensure the hospital met it's legal requirements I would write them a letter explaining the Y2K problem and reference and enclose hard copies of the Senate Report and any other offical documentation you can lay your hands on. Also include a copy of the Y2K Red Cross Brochure.

In the letter ask them to stockpile at least a month's worth of food and water. Also ask them to give you a copy of their contingeny plan. If you are an employee and you cannot gracefully do this ask someone outside of the circle to do it for you such as the local Alliance for the Mentally Ill. Faith, just re-read your post and saw that you are an employee. So yes, write the plan and give it to them. However, if you want to ensure it gets it's proper attention, ask someone outside of your circle for help.

The reason I'm suggesting the above approach is because once they realize that they are legally liable they will probably be more inclined to help.

My son is mentally ill and was on a locked ward in a state hospital for over ten years. He is now much, much better and live at home with us. So believe me, I understand your concern.

-- Watcher (anon@anon.com), April 16, 1999.

Funny, I thought all the mentally-ill people were on this board!

-- nospam (nospam@nospam.com), April 17, 1999.

I'll second that.

-- Nurse Ratchet (nuttytimes@thecuckoosnest.com), April 17, 1999.

no, just you and me, nospam.

-- sue (deco100@aol.com), April 17, 1999.

The clinic I work for is an outpatient unit that serves over 900 mentally ill adults. Our patients come in for counseling and medication, and some come daily to our day-hospital. They are not residents.

The clinic is part of a huge, multi-hospital, university affiliated group whose administration is aware of, and working on, y2k. We are currently developing contingency plans--based on the assumption that disruptions will be scattered, minor, and last about a week "because that seems to be the most prevalent assessment of the situation now." Units are being asked to determine how they would operate without computers, phones, and power for a week. Key staff have been told they will spend New Year's weekend on duty. We're planning to keep our Emergency department open at our clinic; we will have extra fuel for our generator. We'll have some extra food and bottled water on hand, and so on. In other words, they're making some effort. The main hospital itself is still developing contingency plans and isn't my concern.

My concerns revolve around our clinic's patients. Right now the plan is not to do anything until October, and then to identify the most vulnerable and to help them prepare. The main concern among the managers seems to be preventing panic. The dominant belief is that y2k has been hyped, that only extremists buy major disaster scenarios, that there will be scattered disruptions for a few days, but it will be only a short-lived problem. And to suggest otherwise is clearly politically incorrect. (But I smile and suggest otherwise anyway. Ha!)

Listen, these are good people running this clinic. Over and over, I see that the patients' best interests are genuinely the guiding factor in decision-making here. But life in the medical world is pretty high-stress these days, you know? Mergers and licensing and HMOs and government regs and all. The ever-present threat of lawsuits. Overseers everywhere. To keep the patients in mind as your top priority in the midst of all this is a good trick. And these folks do it daily. I love them. But they don't want to hear about y2k being a big deal.

It's classic denial. Nobody wants to look at the naked truth: Bad things could happen. That's the truth. Bad things could happen. If you look at that sentence another way, bad things could happen if you look at the truth. That's called fear. The antidote is not to look at the truth and to discourage others from doing the same. That's called panic prevention.

So that's where they are, anyway. And that means they won't get around to thinking about a prevention program for their patients until it's too late. Like now, the target date for focusing on this is October. They just don't have the capacity or time to focus on this now. The classic management reaction, you know? BUT if I went to my dear friend and boss, the clinic's director, with a practical, well-thought out, well-presented plan for educating our clientelle in a way that would be helpful to them . . . it would have a good chance of being implemented. AND it would help the staff overcome their own fears and empower them to be better guides and models for their patients. See, preparation is a win-win activity. Scouts' creed: Be prepared. Sound advice.

So what I want help with is program content. How do we go about training our clients/patients to prepare for unanticipated emergency situations without alarming them unduly? What's the right attitude, the right approach? I think preparedness training should be right up there with personal hygiene training in terms of the counselors' comfort with it. Just practical, simple guidelines that we pass along. What should those guidelines be?

Will welcome any input.

Thanks again. Oh, and GREAT to see you again, zog!

Faith

-- Faith Weaver (suzsolutions@yahoo.com), April 17, 1999.

faith, make it a game. with kids, i would suggest you would play "pioneer days" and every kid who ever enjoyed playing cowboys and indians would enjoy it, also the fans of "little house on the prairie" books and all the legions of little girls who are mad about "american girl" historical dolls.

it doesn't matter if it's kids, regular adults, or mental patients. in any case, make it fun. i recommend regular drills, but of course you don't label them drills. just have a regular games night set up, and spice it up by using alternate sources of heat and power. get them used to the idea of possibly doing without, but don't make it onerous or depressing. if you try a games night like this, with popcorn made on a coleman stove of course, please let me know how it turns out.

-- jocelyne slough (jonslough@tln.net), April 17, 1999.

Susan:

As I read through other responses to your request for help some things occured to me. One is to enlist the aid of your local chapter of the National Alliance for the Mentally Ill (NAMI). When I was a volunteer at a state mental hospital in Massachussetts, I also was active in the local chapter of this organization. They were very vocal and proactive in accomplishing beneficial changes in the system at the hospital.

Secondly, why not enlist volunteers from the community--churches, community groups, volunteers already at your facility, members of the local chaper of NAMI who volunteer or would volunteer at your facility? Local food banks are another source of volunteers as well as a source of food (as one component of risk management). I like the response that mention keeping things to the "basic four." With this as focus, perhaps you could find other community resources to help in those areas too. Then your information about volunteer help could be included in a written proposal to your hospital staff (as suggested by another responder). If you write it in terms of benefits to the hospital and its supporters, as well as the patients, it may go farther than you anticipate (in a good way). I speak about volunteers because I was one for many years and found great peace and enjoyment in helping other. I also think that using the term "risk management" at every opportunity could be positive.

Not having been on the adminstration side of hospitals/treatment facilities/clinics, this is what comes to my mind in light of your situation.

Let's continue to chat about this topic. I am interested if you are. I would like to know what action you finally take and the outcome.

Blessings, Kathy Bitschenauer

-- Kathy Bitschenauer (eagles@pacifier.com), April 18, 1999.

Hi Faith,

Schizophrenic, Anxious, and Bi-Polar. Well since you work around these people all day, you probably understand much better some of the personalities on this forum than many of us do. :-)

I actually have some experience meeting people with that "category" of often related symptoms... diagnosis I guess professionals call it... I hope people took you seriously when you said "They're intelligent," because some of the most intelligent people I've met have had one of those disorders. Although if you're in a hospital setting I'd guess you are working with hard-core cases and not the millions of borderlines walking around and thinking they are only, for example, the boss or the neighbors. ;-)

One thing I'd suggest, assuming they're mostly adults, is to ask THEM to come up with some creative ideas for how to prepare. We had a thread talking about the many uses for newspaper, of all things. I mean you can really get creative when you start thinking about the materials most really could acquire or do have at hand, and how they could be made into something useful.

IMO the hardest part of Y2K is that if you don't get it, it's usually either denial or stupidity, and if you do get it, it can cause some really difficult emotions to deal with, and these people -- feeling probably MORE vulnerable than many of us, and having a tendency to be MORE worried than many of us -- might display those symptoms even stronger than the average person. So coming up with lots of things for them to immediately start DOing once you tell them about it, so they feel they're doing something constructive to help themselves and their group, would be really good for the psychology I would think.

PJ in TX

-- PJ Gaenir (fire@firedocs.com), April 18, 1999.