Wednesday, December 31, 2014

A shift at the Crisis Centre

I’ve been working at the Crisis Contact Centre in St Kilda for about six months now. Lately, it’s been a particularly intense experience – the level of need out there is higher than usual during the Christmas holiday period, partly because a lot of other services close, while we remain open 24/7, and partly because it’s an emotional time of year for a lot of people. I’ve noticed we’ve been getting a lot of calls and drop-ins from people in various levels of not just housing, but also psychological crisis.

Our main role is to provide immediate crisis accommodation, mostly in cheap motels, basic material aid, and referrals to appropriate services for people who have fallen (hopefully temporarily) into homelessness. We don’t have resources to deal with any serious level of mental illness – you can’t place someone in a hotel if, like one of my callers last night, he says he needs emergency accommodation because he fears for the safety of his flat-mates, his head feels like it is “ticking like a time-bomb,” and he “goes off” at night and starts kicking the walls.

An even more distressing case last night was a caller from a town in regional Victoria, who rang saying he had slept in a park the night before and had nowhere else to go. He was in a very fragile state, crying through much of the call, and reporting that he had tried to self-harm during the day. He’d recently been on a bender, using methamphetamine (ice) eight days straight, plus some cocaine. He repeatedly said that he felt "lost." Again, booking him into a hotel was not a safe or viable option. I persuaded him to allow the police to take him to the local hospital to spend the night there, and get some medical assistance. I’m told that cases like his are clogging the emergency departments of hospitals throughout Victoria – increasing abuse of methamphetamine has placed considerable strain on mental health and emergency services.

I will relate just one other, more unusual, case from my shift last night: early in the evening, I took a call from a volunteer from the Asylum Seekers Resource Centre. He was calling regarding a Burmese man, with little English, who had been discharged from hospital in a country town near Melbourne, only to find that his landlord had evicted him in his absence. Apparently he was two weeks in arrears with his rent. I pointed out that the eviction was illegal, and the volunteer agreed, but said it may well have been a pretty dodgy tenancy arrangement from the start. In any case, the client had left the property and was now at the train station. I immediately rang the local housing service, and minutes before they closed managed to get them to agree to fund the client for the night. As usual, this was conditional on him presenting to their service the following day.

Bagan, central Burma (Myanmar)
Feeling pretty pleased with having achieved this, I then spoke to the client through a telephone interpreter. This was an interesting, somewhat frustrating experience – the contrast between the softly spoken, somewhat tentative female interpreter and the strong, rapid speech of the client was marked. As often happens, there seemed to be a lot more said in Burmese than was related to me in English. 

During the assessment, it emerged that the client was now on a train, on his way to a station in outer east Melbourne. I couldn't get a straight answer about why he was heading there, but he seemed to know people in the area. He told me he had a history of drug use (ice and marijuana) but hadn't used for over a year, and had no mental health issues. It was unclear why he had been in hospital, but he said something about chest pain, and receiving an injection. He said he was OK now. He also reported that he was on a Bridging Visa which had expired, but was getting Centrelink payments.

We always ask people contacting us by phone to present at a police station for an ID check before we place them in accommodation. This client agreed to go to straight to the police station on arrival at his destination, and call us again from there. I was concerned that his limited English might make this process difficult, so I rang the station to let the police know he would be arriving in the next couple of hours, supplied the client's name and date of birth, and asked the police officer to call us when he turned up. One of the other workers in the Crisis Centre had told me that Burmese people only have one name, which explained why his first and last names were the same, an interesting piece of cultural information that I also took it upon myself to share with the officer.

So far, so good. I considered scoping out hotel vacancies in the area, but decided to wait until I heard from the client again – we were busy, and it seemed possible he had friends in that area who might end up helping him out. In a certain sense, that did turn out to be the case.

Several hours later, I got a call back from the police officer to inform me that my client was a missing person from the psych unit of the local hospital. By this stage he was back in the ward. The officer said I should call the hospital to get further information or to make contact. I said that wouldn't be necessary, as our role was to provide emergency accommodation, and this client now clearly had some accommodation available to him. "Yeah, I think they'll be keeping him in there for quite a while..."

Although my input had very little to do with it, that was one of the success stories of the night – a client who had somewhere to go, and judging by the fact that he had voluntarily returned, seemed to have some faith that his mental health needs would be effectively addressed there. 

This was a contrast to the first caller I mentioned, the one who was kicking the walls. He’d already had pretty extensive experience of the mental health system in Melbourne, and was reluctant to return to a hospital where the drugs he’d been given had reduced him to a state where he said he had had trouble walking. In any case, given the lucid and polite way in which he spoke to me, escalating into anger only when he spoke about a brother who had died overseas, it was unlikely any overcrowded city hospital psych ward would have admitted him. He told me of one mental health service that he’d had good experiences with. The best I could do for him was to urge him to contact them the following day, and to impress upon him the fact that his mental health problems needed to be addressed before his housing issue could be resolved.

I’m beginning to think the same might be said for the entire state of Victoria. May 2015 bring some progress on this front...