Reflections on entering the career of being a social worker

 What does it mean to be a Social Worker? I think about this question quite often as I internally struggle in choosing a direction in my life. I’m 35 years old and have experienced a lot of ups and downs, as have most people my age. I feel like I’m ‘maturing’ late in life—academically anyways— because I see all of my friends who are super successful. One, who I would argue I admire the most and is probably the most important friend to me, is a neurosurgeon and the most brilliant person I’ve ever met.

When I look at him, and others like him, who are younger than me and have done so much more, I feel like I’m just abysmally behind in life. Then I remember that comparison is the thief of joy; we all have one life to live and every person is special in their own way. I lived a lot of my twenties taking care of my grandparents, and those memories I formed with them are always going to be important to me. Sure I didn’t do four years majoring in Microbiology and then studying for the MCATs to go on to become a doctor (which I at one point had aspirations of doing), but that doesn’t mean I never can become one.

I’ve always made it a point to care about others. When my elderly neighbors needed help shoveling, I would always be out there—admittedly not as early as I should have been, I’m not an early riser—to help them. Taking care of my grandparents and seeing all the nurses and PT’s come and go made me think that I wanted to be a nurse. Taking care of those that struggle. So 2.5 years ago I set out to become one. I took all the classes I needed to take and did all the testing I needed to do to get into Nursing school, and I got into every one that I applied to.

To cut a story short, my friend who has a masters SW and does therapy told me that he thinks I would be a good therapist and to consider Social Work. There was a lull in between my semesters, where I decided not go continue in a private Nursing university because of the cost and instead go to ISU nursing in Springfield. There was an opportunity to do as he suggested and try my hands at Social Work.

I wanted to specialize in psych for nursing anyways, so this seemed logical in my mind. Getting my BSW at UIS and then doing a 1-year graduate program within U of I. It would only take a little longer than becoming a nurse, and I could still get into a master’s program for nursing while holding a bachelors in a different field.

I have enjoyed the Social Work program at UIS so far. While there hasn’t been a huge focus on therapy and therapeutic approaches to things as of yet, I think it has told me enough to get a good idea of my future in this field. But there’s that voice in the back of my head that is always there: ‘is this truly what you want to do in life?’. I honestly can’t answer that. I’ve always been an indecisive person and compare myself to others, such as the neurosurgeon who has always had a linear plan in his mind—to become a great doctor. I wish I had same perspective when it comes to a life plan.

I think you would be an exceptionally good therapist, mental health social worker, or family counselor. If you find the work enjoyable, I would encourage you to continue in this direction. The therapeutic skills are mostly taught in Practice I and Practice II. Then, in your field placement and your first job with a BSW you will learn a lot more, and in an MSW program you can mainly focus on mental health and counseling skills. 

Of course, psychiatric nursing is close to mental health social work, and is probably just as good as social work if you mainly want to focus on persons with serious mental illness and you imagine you would enjoy working in a residential setting.

I have always been interested in the life reviews of persons who have had near death experiences.  From what I gather, the things we do that may be most significant in our lives are often little gestures of kindness or love we show to someone.  Things we do that seem prosaic or incidental to the main narrative of our life may be the most important acts we ever chose to perform. 

J. R. R. Tolkien once wrote a short story called Smith of Wootten Major.  Superficially it seems a story about cakes, village life, and a special ability bestowed upon a child that allows him to travel into the world of faery.  It seems like a setting for a meditation upon the contrast between the mundane world and the world of fantastic and awesome marvels. Within this story, the King of Faery has taken on the life as a mortal, and he has lived for decades as a very low-status working-class sort of person (a baker's assistant) in service to a terrible boss. At one point, he reveals his true identity to the main character (Smith), and asks Smith to return to him the magic that allowed Smith to journey into the fantastic realms of Faery.  Smith unhesitatingly does so, and then observes that it seems unfathomable to him that someone such as the King of Faery should submit to live a low-status life in an obscure village for so many years.  The King replies to the effect that the decades of life in disguise were worthwhile, because he has been repaid for his “suffering” by Smith’s simple unselfish act of giving back the key that opens the way into Faery.  That has always struck me as a very good insight into our lives.  The great acts of our life may be simple acts of unhesitating unselfishness, generosity, or self-sacrifice. Helping a neighbor shovel snow may be as significant as being the President of the United States and signing some sort of treaty that brings great benefit to the whole world. 

I'm saying, I guess, that utilitarianism only goes so far.  The Greatest Good to the Greatest Number works well enough, up to a point.  But, it seems to me sometimes that there may be ways in which the small acts between individuals are not any less important than the great acts of group leaders.  As Wittgenstein said in Tractatus Logico-Philosophicus, “no cry of torment can be greater than the cry of one man. Or again, no torment can be greater than what a single being may suffer... The whole planet can suffer no greater torment than a single soul...” (suggesting that torment is not multiplied to a greater intensity simply because many bear it rather than few; and implying likewise that benefit and joy is not multiplied into greater intensity if we do something that benefits many rather than few).  

I am a professor who teaches macro practice and social policy to social work students, so I naturally point out that political action may do a great benefit to many more people than therapy.  For example, our class has played a small part in helping to pass legislation that will help social work students in the state (with scholarships to assist them in completing their studies when they are doing field placements).  That legislation, when it is finally enacted and funded, will help hundreds of students each year, and the increase in supply of social workers will lead to more people receiving mental health care or good quality social work services, so there ripples of benefit that go out to people all over the state.  But, at some deep level, I'm pretty sure that helping one person climb out of a situation of misery and hopelessness and confusion to a place where they can feel good, and get their life back under control, may be no less important than helping pass legislation that benefits thousands or millions of people.

Police and Mental Health Training

  I believe law enforcement agencies need to increase mental health training for police interventions. Approximately 10% of all police interactions involve a citizen with debilitating mental health issues; the mental illness issues not only increase the chances of police interacting with people, but also escalate the risks.  Persons with manic or psychotic symptoms may break laws or appear dangerous or threatening to others, and depressed persons may demonstrate an intention to self-harm, and police facing people having a mental health crisis may respond in ways that harm the disturbed person.  Currently, I’m only aware of three prevention/response models used in regards to handling mental health crises: the Crisis Intervention Team (CIT) Model, the co-responder model and mental-health based responses.

CIT training is not mandated, it is a purely volunteer oriented program. The training in this model consists of 40 hours of coursework wherein mental health conditions are recognized, in addition to suggestions on how to de-escalate tense situations. Role-playing is done to get a feel for the environments that the officers in question may be up against. The offers can also refer citizens for treatment if they feel that they need it. I personally feel like mental health training should be mandated. I think that if we had the training, we could avoid a lot of issues that turn into horrible situations. 

A fairly recent example would be the Sonya Massey case. Sonya’s mother called into the Sangamon County Sheriff’s department on July 6th, 2024. Apparently, Sonya was having a mental breakdown but the department was not informed of this fact. The situation was not handled correctly, the situation escalated and Sonya Massey was shot and killed by a deputy. Body cam footage was revealed, and while she did hold a pot of hot water that might have been interpreted as a “threatening” movement, the deputy did not need to threaten to throw water in her face. She apologized and ducked before he shot her 3 different times. The entire situation could have been avoided with more training regarding how to handle mental health issues. This was just one example but there are plenty more. For example, police were present here in Springfield when paramedics killed Earl Moore Jr., who was suffering from alcohol withdrawal and hallucinations. And a Chatham police officer shot Greg Small, Jr. after his mom called for help when he was suffering a mental health crisis and running around with a knife (threatening to self-harm, not threatening others).  Mental health training should be mandated, not optional.

The co-responder model allows the situation to be handled by a mental health professional on site with them collaborating with the police rather than the local police department handling everything alone. Yet, this method has raised some concerns by the police officers, as some of them think this is not as effective as the police officers handling the situation themselves. The question is, is it effective with the population? There needs to be input from the community and family members as well as tests on this method. Without looking at all the data, we do not have all the facts and do not know how effective it actually is. One question that needs to be asked is if by adding another player into the occasion, are we hurting the officers’ egos? Staffing has also been an issue as the availability of mental health professionals may be lacking. This is because of the hours needed for these calls and the burnout that the stressful encounters can cause. These issues especially may be inflated due to the federal funding freeze brought on by Elon Musk and the Trump administration. I could go on and on about that but I digress.

The mental health based responses model involves mental health professionals who are not sworn officers to assist with the calls coming from individuals who are experiencing mental health crises.  These “community service officers” (as they are called) are able to provide crisis intervention as well as social services to the population, while also diverting them from further involvement with the criminal justice system. However, while this model resulted in the most amount of crises dissolved on the scene, it also led to the most arrests. More information would be needed to see why the arrests increased during this time but as the crises were dissolved at the scene this method somewhat worked. Once again, data would need to be collected to determine how effective it actually is from those involved.

Mental health crises are no joke, and situations tend to escalate quickly when they are not handled properly. I know from experience that even minor bouts of anxiety are seen by some officers as an unnecessary inconvenience. A few years ago I was in a car accident and I got hit by a pickup truck. The truck hit my little Toyota so hard that it turned around in the complete opposite direction on the side of the road. I was having a panic attack, and having some trouble breathing. The officer at the scene told me that my emotions were unneeded and that I had to get over them quickly so that I could give a statement. My only thought process was: if that was the response to me, what are they saying to others with more serious bouts of mental issues? Therefore, I will say once again that mandatory mental health training needs to be implemented and that the amount of training needs to be enough to see some tangible results.

Work Cited

ICJIA | Illinois Criminal Justice Information Authority. (n.d.). https://icjia.illinois.gov/researchhub/articles/responding-to-individuals-experiencing-mental-health-crises-police-involved-program

I am also often wondering about this issue. Police departments typically cost about 20% to 30% of a city operating budget (when benefits and retirement pensions for retired police are added to current costs of maintaining a force).  I believe the national average is 2.4 sworn officers for every 1,000 residents.  What intrigues me are studies showing that police may only spend less than 5% of their time thwarting property crime or violent crime or catching perpetrators of those crimes, and mostly police are doing other things.  Could we perhaps divide the police force into two groups: one group would spend 20% to 50% of their time stopping crime and catching criminals, and another group would do the mental health interventions and many of the other things that police are doing?  What would happen to crime and public safety if we had 1.4 sworn officers for every 1,000 residents, but had 1 community services officer for every 1,000 residents, and all these community service officers were trained in mental health, conflict resolution, emergency medicine, and legal issues (like police)? Would that make us safer?  

As state and federal governments aren't adequately serving persons with mental illness, it seems to me that cities and counties need to step up, and perhaps city and county budgets should allocate about 4% or 5% of their revenue toward hiring persons who can deal with people in mental health crises, or caseworkers who can help people who are prone to the complications that come with serious mental illness. This might require local governments to trim 1 or 2 percentage points of their operating budgets from infrastructure, law enforcement, fire departments, libraries, and parks, so there would be some decrease in spending for those vital local government services, but would the resulting improvements in mental health care and interventions with people in mental health crises provide a benefit that would offset the loss of force size in fire and police departments or the decrease in money allocated for libraries or infrastructure?  I suspect that this would be a wise use of local public investment, but without good research and some good examples, I'm left guessing this, rather than able to claim that I know with certainty that it is true.

I have heard that crisis intervention teams and alternatives to traditional police responses have been effective in places like Portland, Maine, and Eugene, Oregon; but I'm not sure about Nashville, Tennessee; and there are controversies about whether social workers can participate in coercive enforcement of the law. 

Student wants Mental Health Crisis Training for First Responders

  I believe that first responders should undergo mental health crisis training. I believe this because there are so many circumstances in which this training could be crucial. Police officers in particular are faced with situations such as potential suicide attempts and/or people who could be having mental health episodes. They need someone who is going to be understanding and well trained on how to handle such situations. If first responders are not well-educated on how to handle persons who are experiencing suicidal or psychotic episodes, the resulting interactions could be traumatic for all parties involved. 

Unfortunately, people struggle with mental health on a daily basis. Sometimes, even those with proper training cannot prevent a suicide attempt. So, those who are going to be responding first should definitely have adequate training to mitigate the chances of violence or suicide from being higher in an encounter with a distraught or disoriented person in crisis. It is almost impossible for there not to be trauma and guilt associated with every suicide committed. If every first responder is well educated on how to respond well, they can at least have the comfort of knowing that they did everything in their power to prevent it. 

It would be a protection for everyone involved, and since it is a training that has already been established, it would not be hard to implement it in the police and first responder’s training. I also think that police officers and first responders need to be frequently checked up on especially after traumatic events happen to make sure they are mentally stable. They do not have to maintain a tough exterior. Time taken off and therapy should be a given after experiencing severe situations, especially one as severe as a successful suicide. 

Most police departments, sheriff departments, and fire departments in Illinois have serious training requirements, and have all their staff engage in on-going training to keep up their skills and build their expertise. Suggesting that professionals in these occupations have a certain number of hours of theory and simulation practice to enhance their ability in handling people who are suicidal or suffering a mental health crisis makes sense. That training would not be too difficult to implement, in the sense that this sort of training could be incorporated into existing training programs.  After the two deaths in 2022 where emergency medical technicians essentially killed persons they were supposed to help (Leonardo Guerrero killed in Chicago on August 31st and Earl Moore Jr. killed in Springfield on December 18th) I looked into the training that EMS workers must have, and I read the minutes and agendas of the advisory board that advises the Department of Public Health on certification of EMS staff and ambulance services in Illinois (there is an administrative code for emergency services and it dictates the level and scope of training for EMT and EMS system professionals). I had my students join me in sending letters to the members of the Emergency Medical Services Advisory Council urging them to mandate training that would help EMS workers avoid the sort of burn-out and demoralization where they would become abusive against people in mental health crisis or intoxicated people.  I spoke with people who worked as first responders, including Kainan Rinaberger (president of Springfield Firefighter Local 37) about the issue. 

Leo Guerrero and Earl Moore Jr. both had problems with mental illness and substance addiction. Police and EMT workers who encountered them did not treat them as they should have done. I can think of other examples. Greg Small, Jr. (of Chatham, Illinois) was suffering a mental break-down related to schizophrenia, and he had a knife in his hand, so his mom called for help, but officer Adam Hahn saw that Greg had a knife and would not drop the knife when ordered to do so, so when Greg approached Hahn, Hahn shot him several times. The Sangamon County State's Attorney Dan Wright charged Greg Small, Jr. with aggravated assault for approaching Officer Hahn with a knife in his hand, but Greg was found not guilty by reason of insanity. The fact that Officer Hahn hadn't received specialized training in dealing with a person in a psychotic crisis holding a weapon led to Greg Small suffering four gunshot wounds and Officer Hahn becoming a public example of incompetence. Dan Wright said he had to bring charges so that the courts could order Greg to get mental health treatment he needs.  

Generally, what I gather is that first responders are, as you suggest, traumatized through their work.  I’m told firefighters tend to encounter two or three dead persons each month, and I suppose the EMT workers and police would see a similar number.  Any encounter with a victim of an accidental death, a suicide, or homicide, or even just a natural death can be traumatic, but imagine encountering such situations on nearly a weekly basis!  And a significant number (although a small minority of all cases) of persons who need emergency medical or police protection will be hostile, abusive, or even violent against their rescuers and helpers. It can wear down people.  In Springfield, the police and firefighters are well-trained, and I think that some of them would accept referrals to professional counseling as a way to help them cope with the stresses of their jobs. As for the EMT staff in the private ambulance services, that is often a transitional job for young people who aren’t old enough to become firefighters or police, and the pay is very low, the training requires dedication, and the job can be dangerous and stressful.  

It seems to me that law enforcement professionals facing the anti-police bias widespread in the community (and sometimes well-founded on experiences with unprofessional or brutal/corrupt police) and dealing with regular exposure to traumatic situations and people engaged in anti-social or threatening behaviors could easily turn some fraction of the workforce into an us-versus-them mentality where suspicion and contempt would inform their interactions with the public.  Not only do police, firefighters, and EMT professionals need help dealing with the traumas and stresses of their job, they need idealistic rituals or processes to help them commit themselves to their missions. They need help feeling the support that comes from actually committing to service to others, and respect for human rights. 

Without help and training, first responders may easily dehumanize difficult patients and members of the public (e.g., persons freaking out and having a suicidal attempt, or just generally disrupting the community as they suffer from severe intoxication or a florid psychotic episode). What do we do with people who wander around in a busy area during a community event screaming and shouting threats and obscenities and generally making a nuisance of themselves as they act in a disorganized fashion?  The impulse to treat such people harshly, locking them up and removing them from the community, may appeal, but harsh treatment can exacerbate the problem. You can see how mental health professionals help the angry and violent man (Todd) threatening the doctor in the documentary "Bedlam" (you'll watch it later this semester).