The House of Hope psychiatric wing was kind of a dinosaur in the mental health industry. It was a large facility that housed twenty-two men at capacity. All of the persons admitted to the program had to be referred by a psychiatrist or other mental health professional. The House of Hope gave preference to clients who had a history of being hard to house and hard to manage. They usually had a number of places in the community that they had been evicted from for a variety of reasons. The clients mostly suffered from severe and persistent psychiatric disorders. The majority of the residents of The House of Hope psychiatric wing were men with schizophrenia. There were also some who presented with bipolar disorder, schizo-affective disorder, severe anxiety disorders and rarely with treatment resistant depression.
Schizophrenia is a severe and persistent psychiatric disorder that is characterized by hallucinations, usually auditory but sometimes affects the other senses also. People with schizophrenia often present with delusions or fixed false beliefs as well. These could be delusions of grandeur or most often delusions of persecution. These are what are known as the positive symptoms of depression. The word positive, does not imply something good. In this case, it means something added on that was not there before the disease started to manifest. Most medications used in the treatment of schizophrenia worked more effectively on the positive symptoms of the illness.
Schizophrenia is also characterized by negative symptoms. Theses include things like blunted affect, poverty of speech, social isolation, extreme fatigue and lack of motivation. The counselors and residential care workers at The House of Hope faced constant challenges in performing the daily duties of their jobs. The House of Hope was considered to be a dinosaur as the “best practice” had changed in the view of the mental health experts. The new paradigm was to get as many consumers of psychiatric medicine as possible living independently and successfully in the community. This is no doubt a worthy goal but as Rick knew this was not going to be a feasible goal for many mental health consumers. Each client had to be assessed on an individual basis.
Adjusting to living in the community independently would be especially difficult for the long term residents. Many of them had lived in an institutional setting for twenty or more years. They had learned how to successfully live in hospitals or large residential treatment centers but did not know how to live on their own. They could be called “institutionalized men”. These clients were used to having most of their life choices made by doctors, social workers or residential care staff. To make a difficult decision on their own was very frightening to many of the men.
The death of one of their peers would be especially traumatic for the clients. As many of the men had lived together for years, The House of Hope provided a built in family. Most of the men thought of their fellow residents and even the group home staff as their friends if not their family. Residents rarely died in this facility but a fatality was likely to occur every two to three years. When one of the residents passes away it leaves a big emotional hole and the dynamics of the group have been changed.
Rick met with Holly while she was still in the RCW office. He told Holly to let the men know that there would be a mandatory group meeting at 11:00AM this morning. He asked her to emphasize that all residents must attend and that those that were still in bed would need to be woken up at 10:30 AM to get ready for group. Rick then went back to the supervisor’s office to make some phone calls. He was able to get a hold of his two week day residential treatment counselors. Both said that they would report to the center as soon as possible. After he finished his call to one of his counselors Rick heard a knock on his door. It was Detective Barnes.
Rick let the detective in and prepared for an update and another round of questions. “Were you able to find anything out detective?”
“No, nothing really helpful. Some of the staff on the other floors of the building knew Brett but others did not. The ones that did know him all thought that he was a nice kid. How did Brett get along with the other residents?
“Brett was well liked by the majority of our residents. Many of them respected Brett and looked up to him,” Rick answered.