Beyond Concurrent Disorders: The power of faith
By Donna Alexander, Social Worker in CAMH’s Substance Abuse Program for African Canadian and Caribbean Youth (SAPACCY)
“How do you continue to do this job?”
This is a question that people often ask when they find out what I do for a living. This is not because my job poses any sort of immediate danger or risk, but rather, due to the amount of stress it can place on a person. For the past ten years I have been working in an ethno-specific service with Black youth that are concurrently disordered.
The clients I work with are vulnerable on so many levels, with multiple layers of oppression. While mental illness and substance abuse are what bring them to us, these are often just minor barriers in their development. These youth have endured so many traumatic experiences. Some are still recovering from the physical and mental effects of gang and gun violence. They have experienced loss and death at a scale that 13-24 year olds should never have to experience. Others do not receive the services they need until it is too late and they are significantly over represented in Forensics Services. Many continue to deal with poverty, hunger, inadequate housing, and a variety of other social issues.
Working with these youth really drives home the importance of addressing the social determinants of health – a place to call home, food to eat, proper education, safety and security, social support – before we can even consider tackling their mental illness and substance use issues. Yet this doesn’t even account for other factors: the intense anxiety some youth experience when they are singled out for being young and black and just happen to be larger in size than others their age; the immense stigma that those coming from a culture where having a mental illness is considered taboo have to contend with; or even the intense fear and misunderstanding when someone is brought to a mental health hospital where people are treated for complex mental illness and psychosis. I always have to remind myself that these are still kids I am dealing with, after all.
So how do I deal with it? How do I continue to do my job? Especially when I look at my life and I am reminded of all of the things I take for granted.
I tell myself that my role is to believe, at a time when our clients are not able to, that they will get better. It hurts to meet youth at some of their lowest points but I feel very privileged when I see them turning it all around. I believe that who they are at that point in time does not define who or what they can be, or what they can achieve.
Providing assessment and a treatment plan for their mental illness and/or substance use issues is often not enough. Meeting them in the community, working with our partners in the effort to meet other crucial needs is also very important. What kind of needs, you ask? For some, it can mean facilitating a meeting with a mentor in the community. For others, having a responsible adult to be on hand to speak to their case workers, teachers, police and social services, or the courts to help advocate, explain and advise is crucial. Beyond this, for some of our clients a crucial component of care can be very simple – explaining to the youth simple concepts that would be considered common sense, because they never had the role models to show them the ropes.
You won’t believe the number of times I have contact with clients that were lost, hanging with the wrong crowd, addicted, and seemingly broken. Yet when I see them years later, they will come up to me, saying “Miss, I never believed I’d stop using, drinking, smoking… but I did!” Or the clients who we have served that are now teachers, have MBAs, or are striving to become social workers themselves so that they can help people who were just like them. I cannot t help but ask myself, “Is this the same kid?”
It is a wonderful feeling.
I am an eternal optimist so I always have faith that it eventually does work out… and I am sometimes pleasantly surprised when the outcome is even better than I imagine. This is what propels me and fuels me to continue to do my job.
So how do I continue to do my job?
With a smile, knowing that tomorrow will be a brighter day.