I live in a BC Housing building. Now there are many different categories for affordable low-income housing. The place where I live mixes some of the categories. We have here a huge variety of tenants, all of us low-income. Some of us, like me, are working poor. If we paid for market housing we would not be able to survive living alone in a bachelor apartment in this criminally expensive city. Some are on social assistance, either waiting to get disability pensions or working at getting their lives restarted or both. There are university students here, and refugees from all over the world. We have seniors as well. Soon I will be a senior. Forty percent of the tenants here are members of the Coast Foundation of Vancouver, which is an organization that advocates for people with mental illness, offering social and community support, volunteer and paid employment, and of course, housing. In some ways our mental health tenants have shaped and defined Candela Place and many in the mental health professional community understand Candela Place as a mental health housing building, which it isn't, or not entirely.
I really have to juggle boundaries here and in other places. I work as a mental health peer support worker and this automatically puts me in the category of a mental health consumer. Not only do I dislike the word consumer, it doesn't really apply to me. I was never a consumer of mental health services outside of seeing for four years a private psychiatrist who diagnosed me with post traumatic stress disorder and helped me towards a full recovery. I have never been on medications and I have never been hospitalized nor have I been a client of a mental health team or of any other community mental health services organization. I work as a peer support worker because this was available to me in a job market that offers a very limited selection of open doors for a low income older male with a partial college education.
I am not complaining. Despite the low wage I enjoy what I do. I work in four different sites throughout the community so it is not hard to understand that a lot of my boundaries overlap. Five of my neighbours-- or is it six?--I have worked with professionally as patients at Venture, a small psychiatric facility where I work. At least two people in my church, one of whom is also a close friend, I have also given professional support at Venture. Some of my best friends have also had a mental health diagnosis, but we are friends and not worker and clients.
Often at church I will be spending time over coffee with people with mental health backgrounds. Although we are not close friends that possibility remains in many cases. If I was a psychiatrist or a case manager or rehab worker I would find this kind of overlap maddening. No one wants to nor should be expected to bring their work home with them, or have to come home to their work. Of course this does not really mention those psychiatrists, case managers and rehab workers with friends, relatives or loved ones who become suddenly mentally ill, or if such a misfortune should befall even them. And sometimes, I am sure, it does.
I know that I sometimes have to rethink boundaries. I try to keep the formula as simple, and as kind, as possible: What does the client really need, and how can I, or should I help? This depends on certain variables. There is a rule where I work that we are only permitted to work with our clients when our offices and facilities are open. This rule is in place for some very good reasons, primarily that we work together as a team and since any kind of unpredictable events can transpire when working in the community with someone living with a mental illness it is always important to know that someone has your back. This does not mean that if I bump into a client off site or off duty that I ignore her or try to avoid being seen by him. If the client is comfortable yes we say hi, and perhaps even stop to chat for a minute, but that's where the contact ends. This is not because I'm only doing this for the money and if I'm not being paid it isn't worth it, and really, I like and respect my clients too much to see them merely in terms of my own professional gain and advancement.
When I am not with my clients, or at work in general, I have something also known as a life. I have to get the groceries, go home and cook dinner, feed myself, exercise, clean my place, rest, relax, see other people, and unwind and rest till the next day. My client, whether she knows it or not, will have similar things to do. I have in the past explained to some of my clients that the reason we are not friends is friendship involves a burden of responsibility that would be unfair to impose on someone by their therapist or worker. In a therapeutic situation it is all about the client, as it ought to be. In a friendship it is all about us, which takes the focus off the client and his needs and seriously compromises the quality of care and support that is delivered.
When I see a former client in my building I am friendly and we chat a bit. We do not visit in each other's apartments and we do not go for coffee. In church it is much the same. The only exception is with a person who was already a friend, and a professional colleague, before we interacted professionally. This has not changed our friendship.
In the meantime I do what I can to treat my friends with the patience, restraint and support that I offer my clients, while still sharing my life with them, as well as treating my clients with the warmth, spontaneity and good humour that I have towards my friends, but carefully tailoring everything to meet their needs and goals insofar as we are working together. What really gets me through the day with clients and others is seeing the good, the value and the beauty in them. on some days and with some people it is easier than others, but seeing each person as a gift from God I think can only favourably inform and influence my way of treating them and will further enrich my own life as well.
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