I lovingly fist-bumped two murderers, and then I walked out of work to protest the Hogan administration. I am a forensic social worker at Clifton T. Perkins Hospital Center, Maryland’s maximum security state psychiatric hospital. I provide therapy and case management services to the criminally insane, and I am struggling to do this job satisfactorily or even safely under current working conditions.
Standing in the rain and chanting slogans outside of fundraiser events isn’t the only way that I’ve tried to address the problems at my understaffed hospital. I’ve also made numerous calls and written letters to the Maryland General Assembly, traveled to Annapolis to meet with delegates and state senators, and testified at a labor management staffing meeting, giving explicit testimony about the prevalence of violence in my workplace, the deleterious impact on patient care caused by not having enough social workers and the difficulty we’ve had hiring new employees.
I went back to Annapolis in October, and from a few feet away I watched Secretary Robert Neall from the Maryland Department of Health discuss my working conditions with the legislature. When they asked him why social workers at Clifton T. Perkins Hospital don’t receive hazard pay for working with a dangerous population, Secretary Neall said that the social workers are only at risk “to a degree” because “they have offices, and the patients are brought to them."
I thought about Secretary Neall’s response a lot on Nov. 13th, after I asked one of my patients to meet with me and he threatened to crack a chair over my head.
I want so desperately for my patients to get the treatment that they need and deserve. They should have ample opportunities to go off the ward for gym activities, art therapy, anger management, whatever. The distant lure of getting discharged years down the line isn’t enough, they need chances to get positive stimulation every single week. Without having groups cancelled because there isn’t enough security coverage, or because there aren’t enough nurses to dispense medication as scheduled. They should be able to get individual therapy without going to the bottom of a 35-patient waitlist because there aren’t enough therapists to go around. And hell, my wish for sufficient time to run psychoeducational groups is also selfish, because that’s the best part of my job.
I relish chances to connect and learn from my patients, especially when I get to facilitate therapeutic opportunities. One of my groups uses Touchstones materials for structured discussions, during which the patients reflect on writings and engage in a careful exploration of each other’s perspectives. I call patients in and pass out materials in hopes of helping them to grow their capacity for cognition, leadership and communication, and often feel that I am the one edified by the ensuing conversation.
Earlier this month I had them read an excerpt from Homer’s epic “The Odyssey” about the reunion between Penelope and Odysseus after he spent 20 years away fighting at war — the test that Penelope gave him to make sure that the haggard stranger she beheld was truly her husband. I was blown away by the ensuing discussion, as my patients presented sound rationales for Penelope’s caution, voiced compassion and understanding, and also drew parallels about the interpersonal difficulties people in their situation might face, returning home to loved ones after being hospitalized for years. Some people might look at this group of patients and see Maryland’s “Most Wanted,” but anyone willing to listen will perceive participants and guardians of a thoughtful and nurturing space, who are fully capable of engaging in brilliant, beautiful, and meaningful analysis.
As a side note, I cancelled the Touchstones group session last week, an unfortunate response to the multitude of issues that arose on the unit. I used to have an idealistic excitement over this job, telling myself that my ability to do amazing work was only limited by my own ability to be creative. Now I realize how many other limitations I face — however creatively I dream of ways to do therapy, my ability to provide that therapy is constantly chipped away as demands on my time mount in a dysfunctional environment.
I need time to do the work that I love. And for that I need my hospital to have enough staff to provide the therapeutic environment that our patients deserve and that the state of Maryland has mandated for them.
Miriam Doyle is a Baltimore native, graduate of the University of Maryland School of Social Work and proud union member of AFSCME Local 557. Her email is email@example.com.