Alternative States of Consciousness, Intuition & Social Change

by | Researching Consciousness for Social Change

I’ve been interested in alternative states of consciousness, non-religious spirituality, and social justice most of my life. The first two have been inward focused, and the latter outer. So I’ve experienced and thought about them separately. In the last few years, it started feeling like they need to be brought together. They’re such different states of mind and existence though, I’ve struggled with how to do it.

covered bridge picture

covered bridge near the town where I was born

I think a lot about culture and big systems, and I notice their effects on individuals. Our political system, the economic system, healthcare, technology, education, our food and water supply, energy, social safety net. They’re so huge, it some times feels overwhelming, like we’re trapped by them. How can individuals affect those systems?

Asking that question is what connected my lifelong interests. We can’t use the same thinking that got us into this mess to get us out. Somebody who’s credible and famous said that. I don’t remember who. Probably Einstein. He gets quoted a lot.

 

Regardless, that led me to another question: Where do we find different ways of thinking? What I realized is, the thinking, the ways of knowing and experiencing the world that exist in dreams, imagining and intuition are definitely different than our usual methods–analytical, technical, linear, progress-at-all-costs mentality.

So, why not explore those different ways of knowing to see what they can tell us about how to change these gargantuan systems? Voilà! My research question was born.

Want to come along on this journey? I’m happy to have traveling companions.

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Christina Leimer, aka The Intuitive Sociologist

Women’s Rules

by | CounterSpeak, Feature 2, Personal

Women’s Rules

A female friend told me, with astonished curiosity: “I’ve never known a woman who’s so unaffected by the rules for women. You don’t even seem to know they exist.”

“What?! There are rules?” I grinned and rolled my eyes, waiving away the observation. But, it did make me wonder. Two decades later, after bumping head-long into a few of those rules, I think she was right. Somehow, I never got the rule book. Or I just never read it.

Growing up on a farm, the oldest child in the family, I was driving a tractor when I was so young I could barely see over the steering wheel. Chopping wood, feeding chickens, pushing the lawnmower, hauling hay—girls did any chores they were physically capable of doing. It was an all hands on deck environment. Lots of work to be done; few people to do it. When I wasn’t in school or working, I played in the woods and fields, climbed trees, hunted for arrowheads, and fished and swam in the pond, by myself or with neighbor kids, until I got hungry and went home. In my first 10 years, agency and independence were solidly engrained.

My favorite reading, in elementary school, was biographies. Mom would take me to the public library and I would bring home a stack of books, lay in the floor and soak in the lives of people doing extraordinary things, some overcoming extreme obstacles. All kinds of people. Colors. Genders. Disabilities. The message I got was, people do incredible things. Then, as I entered my second decade, along came the Mary Tyler Moore Show, Maude, and Helen Reddy singing “I Am Woman.”

These shows were groundbreaking for featuring independent women and the song became the anthem of the 1960s and 70s feminist movement. But I didn’t know that then. Without historical or political context, the women sitcom characters and music reinforced the conclusion I’d reached from the biographies. Women, like other people, can do professional work, live alone and say what they think.

In this context, I took my few childhood gender-biased battles as isolated individuals’ problems, not global expectations. In the fourth grade, there were enough boys in my class to field a softball team but most of them were not athletic. I was the only athletic girl. So I wanted to play on the boys’ softball team, making the argument that it was the only way our school could possibly win. When my female teacher refused to let me, I took the field anyway on game day.

She chased me inside the school building, hitting me in the back with her high-heeled shoe. Then, when the St. Louis Cardinals made the World Series, she brought a TV to school and let all the boys out of class to watch the games. Many of the boys didn’t care about sports. I did, but she wouldn’t let me watch. So I folded my arms at my desk and refused to do any school work. I didn’t know she was enforcing society’s gender rules. I just thought she was an ignorant, mean person who liked the boys better than me.

As an adult, moving to other parts of the U.S. and entering the professional world, I began to experience some jarring. As often happens when there’s something I need to understand, the women’s rules question from years earlier re-appeared. But where do I find these rules, I wondered. The answer: look to the broader culture. That’s where you’ll find the rule book. So tuning my radar to magazines, clothing, politics and my own experiences in different settings, I found some of the rules and realized some were finding me. Here’s what I learned, and how I measure up.

Based on women’s magazines, I’m supposed to be interested in:

✔  Health                           Not
✔ Beauty                           Not
✔ Relationships               Only the one I’m in.
✔ Food                             Love to eat. Not read about it.
✔ Fashion                        Some
✔ Celebrity                       Not

Of all the things there are to learn and think about, why would these topics pervade women’s reading material? I typically see these magazines in beauty shops and grocery store checkout lines. My mother owned a beauty shop, so these magazines must have been around our house when I was growing up. Yet I was so unconcerned with these parts of life that it took a graduate course in gender stratification to realize these topics reflect women’s traditional domain—home and family. And celebrity and gossip reflect women’s interest in people’s personal lives. Still? It’s 2016. I am an alien.

Based on clothing for adult females, I’m supposed to be:
Size  4-16

or maybe up to size 18 depending on the store or brand, or down to size 12W. Does the W mean woman, or wide? Based on an internet search where others asked this question—we’re not sure. Some say woman. But that makes no sense, since men’s and women’s clothes typically aren’t on the same rack or even in the same section of the store. Anyway, all sizes above this range are considered “plus.” I’m a plus woman. The plus size clothing is usually separate from the regular sizes, often on another floor. In one store, it was in the basement, next to the carpets and furniture. Can’t ignore the symbolism of that placement.

I’m inclined to take this “plus” moniker as meaning I’m a super woman or more than a woman. But that’s not the feel, when the salesperson silently points me to the basement. Why? The reality is there’s tremendous variation in women’s bodies. So why be accepting of such a limited range? Clothes sizing and labeling too is all over the map. Some adult females’ sizes are referred to as Junior or Misses. Does that make these females not yet women? Perhaps many of us are not regular women.

Based on women’s voices, I’m supposed to:
Speak softly, obliquely, in a high pitch.

But I’m loud, direct and tenor, or to use the gendered categories of classical music, contralto. Wikipedia says a contralto female voice is rare, maybe one percent of the female population. It’s in about the same range as the male countertenor. So, the reality is, some women’s and men’s voices overlap; they’re indistinguishable. Why then, must we assume people’s gender based on their voice? On the phone, people who don’t know me call me sir. I’ve been hung up on, told to go into a bank to get my business taken care of, and transferred to the fraud unit. Often, even after I’ve corrected the person’s mistaken gender attribution, if the conversation continues long enough, they revert to calling me sir. What’s up with that? Why does anyone even need to say yes sir, no sir, or thank you sir? Why isn’t yes, no, and thank you sufficient? Why do we need to genderize such speech?

Direct. If I was running for political office and asked about my hair, makeup, clothing, or spouse’s role, I’d respond Bernie Sanders’ style: “Do you have a serious question to ask?” Having received feedback, a.k.a. negative reinforcement, I’ve tried to be less direct, but then I find it annoys some men, makes me lose track of the point, allows others to miss the point, and makes my stomach turn at my own rambling and muddledness.

Loud. I enjoy wit and humor and laugh full-bodied when something strikes me as funny. When it’s just amusing, I only smile. When I’m impassioned, when I’m talking about something I strongly care about, my voice and bearing rise. Combine that with my plus size and contralto, and it equals, for some people—intimidating. Throttle back, was the message from a male supervisor. I’m to notice the space I take up, and take up less of it. “You could do something about your size,” was the advice of a petite female supervisor, conveyed with an undertone of, if you were only willing to. Hhmm, then I guess I should get bigger.

At work, I’m supposed to:
Bring the snacks, take the notes, and fetch anyone who hasn’t shown up on time at the conference room. I don’t. I’m supposed to allow men to restate my ideas as their own and not call them on it. Sometimes, I do, just to get along.

But snacks? We’re all capable of going shopping. No one has to make food from scratch anymore, so why would this task still fall to women? Taking notes? Often, I would prefer to take notes, because I like them short and concise, and it gives some power when you craft the record of the meeting—but that’s not the way it’s perceived. If men take notes, they get kudos for their egalitarianism; women get perceptually demoted. Fetching someone who’s late? Start without them, and don’t recap. Next time, they’ll arrive before the starting gun. It’s risky, as a woman, to set such boundaries and hold to professional expectations, especially when the colleagues who are late are men. Women are supposed to coddle. If we don’t, you know what we’re called.

Now that I’ve read the women’s rule book, it’s clear how misaligned my interests, thinking and behavior are with the expectations for American women. But why, I wondered, was there such a contradiction between my upbringing and societal expectations. At least a partial answer came, serendipitously, when my mother bought a new car. She called me, excited about her red Camaro. I returned the excitement, went to see it and went for a ride. Then she repeated her story the following week, and the next, until finally I said, with a bit more exasperation than was tolerable on the other end of the phone, “I know, mom, you told me! I saw it.”

She exploded. “You don’t understand!”

“Understand what?”

“This is the first car I’ve bought on MY own!! In MY own name!! With MY own money!!”

I was shocked. My strong-willed, business-owning mother, who was then nearing 50 years old, had always driven a car (my family had at least two) and earned money. I had no idea this all existed only because my dad allowed it. That the U.S. financial systems at the time would only lend money to men.

From my child’s vantage point, my mom was strong and independent, just like my dad. Neither of them ever told me I couldn’t do things because I was a girl. My dad taught me to drive the tractor, and before I started to school, I was his constant companion. My mom always told my brother, sister and me, “Be what you are, no matter what people think.”

This incident was such a revelation I started peeling back the surface. When I did, I saw a different world, one with a set of perspectives and experiences I perhaps should have known by the time I was an adult, but didn’t. Neither of my parents was politically active. I never heard them use the word “feminist,” yet that revolution was going on all around. While even today women’s parity is still far short of the goal, the impact of the 1960s and 70s women’s movement was so great that by the time I was living on my own, I could take for granted credit cards and car loans. I just got them when I needed them and could afford it. The fact that, had I been born 15 years earlier, my father, brother or a husband would have had to sign for my financial needs, makes me shudder.

Throughout my life, I’ve not identified much as female. I never doubted I was a girl. My body has the requisite feminine parts. But I thought of myself as human, or androgynous, and reveled in all the variety and contrasts that entails. Even now, if I pictured my version of my identity as a four-slice pie, woman might be one slice, maybe a slice and a half. Yet, regardless of my way of thinking and feeling about my identity, the world identifies me as a woman, and therefore, subject to women’s rules.

It’s this forced identity that chafes me. Women’s interests, women’s clothes, women’s voices and work expectations, what I see when I look at what our culture shows us about women is so narrow. Even when your exterior is granite, over time, with frequency, the feedback works like acid rain, either we chip away parts of ourselves or others do it for us. Some of us elbow the box, squirming and trying for more room, finding our niche within these broad social constraints. But what do we, and the world, lose in the process?

What we see and experience is how we learn. It gives us our framework for interpreting meaning, making sense of the world and our lives. In the world of my dreams, we nourish the diversity that’s in each of us. The complexity that is human. We give our daughters, and our sons, more ways of being in the world, more opportunities to express their innate talent, vision and ideas. And we celebrate and display that richer picture. If that happens, there will be different lessons. Instead of women’s rules and men’s rules, perhaps they, and we, will learn the rules for being human.

Sanctuary

by | Feature 1

Sanctuary: Connecting Mind, Heart and Spirit through Nature

Spending time in nature can reduce our stress, open us to a broader perspective on life, and prompt gratitude and joy. This mini e-book of nature photos and reflection is meditative, appreciative and a bit mystical. May it bring you pleasure.

Download Sanctuary

Nature’s Power

by | Book Excerpts, Feature 3, Society/Culture

Nature’s Power

Excerpt from Christina’s book, Natural Urges:

A year before I left Houston, a tropical storm dumped two days of unrelenting rain on our city. Hundreds of us walked, biked, or skated in the drenching downpour to lean over the bridges and watch Allen Parkway and Memorial Drive below turn into roiling rivers, submerging cars, vans, buses and delivery trucks under 30 feet of water. An evening newscaster was perplexed by why we were out in the storm. “It’s dangerous,” he fretted. “They should be home where it’s safe.”

Didn’t he know? We were feeding our souls.

Stock Photo

 

At first, I thought this was a Houstonian urge, so deprived are we of nature’s moods. On the Texas Gulf Coast, there’s little distinct seasonal variation, and the day-to-day changes are imperceptible unless you look closely. Mostly, it’s sunny with shades of hot all year. Air-conditioning, in buildings and vehicles, is life. In the nearly 20 years I lived there, the natural world became a constant, steady drone, a taken-for-granted backdrop for human activity.

In Seattle, my post-Houston home, the sky, water and mountains change continually. They are palpably alive. From my window, downtown Seattle’s 50-story buildings look like a Lego village, dwarfed by white-haired Mt. Rainier in the background 75 miles away. When that mammoth mountain erupts, it could wash us all into Puget Sound. Yet a native Seattleite complained, as we walked to a restaurant in just enough rain to bead on our jackets, “I don’t like this drizzle. I like hard, pounding rain and thunder, the kind of storm that lets you know it’s there. It rarely does that here.”

This desire for natural extremes is widespread. In Arizona, a line of lightning rods and cabins attracts vacationers hoping to witness nature’s electricity sizzling from pole to pole, even though they could get barbecued. Visitors from around the world brave 40 degree below zero weather to catch the aurora borealis streaming across the Alaskan sky. People hunker down with hurricane parties on the coasts, and camp out on Oregon’s ocean beaches to watch Pacific storms roll in.

It’s a soul thing, this thirst for nature’s power displayed. Now that we humans have trashed the earth’s skin, sucked the water, oil and minerals out of its veins, and insulated ourselves from its heat, cold, wind and rain, we seem to want evidence that our control over natural forces isn’t absolute. That nature is still alive, still bigger and more powerful than we are, and still part of us.

Our culture has nearly eliminated the natural in human systems. Separating the elderly and the young destroys our natural source of wisdom and of rejuvenation and growth. By living with our elders, we learn to accept the natural course of life. We see aging first-hand. We understand and expect that our bodies too will replace suppleness and firmness with wrinkles and sags, that our energy and our perspective on life will change with time and experience. By segregating the elderly from the young, we cut off our elders’ natural means of revitalization, their immersion in the heart of life, and their place in the natural progression of generations. We stunt our own sense of history and belonging and leave the elderly lonesome, bored and waiting to die.

Nor do we have a natural way of dealing with our dead. With contemporary burial practices, we’re embalmed and vaulted. The decomposing that naturally takes a decade or two could take a century or more. With cremation, decomposition takes only a few hours, so we’re rushed away and may even believe that we have no right to lay our bodies in the earth when land is needed for the living.

The conscious awareness that we live on a living being that possesses the same life energy we do is growing. Some people are finding ways to live lightly on the earth. Many are trying to re-integrate the natural into existing systems, growing organic food, eating vegetarian, moving to rural areas, using wind and solar power, and struggling for limits via the WTO protests and biotechnology resistance.

But these attempts can get distorted when we try to do them within systems not conducive to them. For example, we move to the country and start trying to change it. We bring urban amenities, get rid of pests, ants, dust, and odors, and instead of becoming part of the existing community, we create a separate one, or keep to ourselves. We’ll buy hormone-free meat, eco-fish, shade-grown coffee, and organic vegetables, if we can afford them, while the rest of our food system gets pumped full of hormones and synthetic substances.

Connected by spirit, we are not separate and cannot isolate ourselves. The wounds we create or leave for others will eventually return to us in one form or another through this connecting cord. Our systems need to change so these ways of living become the policy and practice of our society.  When we create social systems that support and nourish the natural cycles, processes, and characteristics of life, they will support our physical, emotional and spiritual needs. If we don’t, we’ll make human life more vacuous, more vicious, and more toxic.

We may ultimately destroy ourselves. But we won’t destroy the planet. Mother Earth will shudder and shake us off, swallow us up, crush us under our own constructions. What naiveté or hubris to think otherwise! In the struggle for life, we’re no match for the forces of the universe.  We can learn to live in harmony with them, or they will live without us. Like all children, we are testing the limits.

The Human Cost of Taking Care

by | CounterSpeak, Society/Culture

The Human Cost of Taking Care

Every time there is a mass shooting, like the one at the social services center in San Bernadino, California, politicians claim more mental health services are needed. But the community mental health system has been deteriorating for years, despite increasing need, and Congress is aware of it. For several years, I worked in community mental health, until the pressure of its collapse drove me out. This is what it’s like and why we must fix it.

Every morning there’s about a half hour of quiet before the vans start arriving, dropping off residents of group homes and halfway houses for their appointment at the community mental health clinic on the edge of downtown of a major U.S. city. Since this was their only form of transportation, patients spent most of their day at the clinic waiting for the late afternoon vans to return to pick them up. Others came by city bus, some by private car. Most came alone. Some came with a friend, family member or social worker. They were all people who had nowhere else to turn for help.

 

They waited in one large room for hours to see us for 30 minutes. A few waited uncomfortably among people they never expected to encounter and in a setting they never knew existed before they lost their job or insurance.  With caseloads of 100 or more, we saw each person once every three months, unless there was a crisis. If there was, we got them in to see the doctor. But with such limited time and treatment options, there was no guarantee it would help.

Scenarios like these are common in community mental health.

Scenario 1: John’s mother called; she was scared of him. He broke a window and threw a knife at her. He thought airplanes were shooting bombs out of the air-conditioning vents in their house. He was off his medication. It was a crisis, so we scheduled an emergency appointment. His brother brought him to the clinic by car. John ran into the bathroom, ran out and smeared feces on the hall wall. He cursed and flailed.

People waiting in the lobby were watching, wary. We knew we had to physically restrain him, and get the doc to give him an injection that would calm him. We cleared the lobby, moving everyone outside, until we could isolate him. No hospital bed would be available for at least a week. So John would be returning home.

Scenario 2: A colleague was doing paperwork with a patient in my office, multitasking to keep up the pace, when the woman started crying. She put the papers aside to talk to her, to look at her, to listen. But that took extra time. The doctor, who had just finished with his last patient and was expecting another, came looking for his next patient. He opened the door to the clinician’s office. The patient immediately pulled herself together and they went back to the paperwork, wrapping up quickly to make up for lost time in the schedule. They never got back to why she was crying.

Scenario 3:  Some clinicians brought packages of crackers to give away because people sat in the waiting room so long, they got hungry and irritable. A colleague gave crackers to an elderly woman who wouldn’t eat them until she was assured it was not charity, but something we provided because people have to wait so long.

Scenario 4: Though caseworkers were never trained to do group therapy, we had to run groups because more people could be seen in less time and it cost less for unlicensed professionals to do the work. Everyone who was waiting for a particular doctor comprised the group. In one group of two people, neither would talk. One of them walked out. Immediately, the other convulsed in tears, clasped her arms tightly around her chest and rocked toward me, telling me, in choked bits and pieces that her son had been murdered on the street in front of her, while she begged for his life.

Scenario 5: I checked my mail cubby, usually filled with routine confirmations and notices from the central office. An appointment reminder sent to a young man who hadn’t shown up was returned to me marked DECEASED. He had a tendency toward reading dark books and at our last meeting shared with me his angst about the meaning of life. He committed suicide, and we didn’t know it.

After a decade of working in systems that allow so little caregiving, I could no longer do it. I stopped liking my patients and dreaded having to see them, so I knew I had to go. Nursing homes, hospitals, mental health clinics, schools, these were the places to which I was naturally drawn. It was work I loved and found worthwhile, a way to contribute to the greater good that gave me a sense of purpose. But looking in the mirror, I saw the beginnings of an apathetic, hostile social service worker. The kind of colleague I occasionally encountered, and disdained. I was earning very little money, there were so few places to turn to for the services my clients needed and none for my own well-being. The situation created quandaries that tied me in knots.

So, for my financial and mental health, I quit the job, enrolled in graduate school and learned to work with computers and statistics. In the two plus decades since, this career route has been financially rewarding, intellectually challenging, and respected. It distanced me from the social systems that ground down my compassion, gave me a reprieve from responsibility for helping people with their problems and allowed me time to heal from what I eventually realized was burnout.

Now in my fifties, I’m still scorched, but the personal and social costs of such destructive systems and the needs of so many Americans are too great for me to keep my distance forever. The social systems that overwhelmed me have become ever more necessary and even less nourishing, to both caretakers and people needing care. I was able to leave that system. My patients couldn’t.

The nation’s community mental health system has been floundering for years. In January 2013, the U.S. Health and Human Services (HHS) Substance Abuse and Mental Health Services Administration gave Congress a formal report on the status of the mental health and substance abuse workforce at the request of the Senate Appropriations subcommittee on Labor, Health, and Human Services, Education and Related Agencies. The report references previous reports in 2006 and 2007, which led to some changes in technology, training, resources, staff recruiting and integrating primary and behavioral healthcare.

Report from U.S. Department of Health and Human Services on the status of the mental health workforceHowever, their report says, these long-term concerns about staff turnover, training needs, compensation, and shortages of qualified professionals persist and even greater demands are being placed on the system as increasing numbers of Americans need these services.

After a decade of wars, many returning veterans need mental health and substance abuse treatment. The Affordable Care Act is giving more people healthcare coverage and requiring that mental health issues be covered comparable to physical health, which will bring more people into the mental health system. So will screenings for mental illness and substance abuse by primary care physicians as this practice becomes more common. In addition, to alleviate mass incarceration, many States are implementing re-entry programs to reduce the prison population, many of whom need mental health or substance abuse treatment.

In the U.S., if we need physical, mental, or assisted living care, we expect that care should be available and provided with some degree of compassion. But equally widespread is the fear that it won’t be.

With the persistent and severe problems that plague most of our human services systems, there is good reason to worry that these systems will not adequately help us when we need them.

By and large people working in these systems are humane individuals, with a desire to nourish and a willingness to confront and try to help alleviate suffering. Many believe that people who enter a human service profession do so for intrinsic rewards, the emotional satisfaction of helping a child learn, contributing to the next generation, healing wounds—physical and emotional, or comforting the dying. While the work does offer such compensation at times, more often it’s grueling and demanding. People are scared, in pain, and they lash out. Their families hover and complain, uncertain about what to do and getting little attention, and sometimes their loved ones die. Because caretakers have opened themselves to the suffering, they too must deal with their own human responses to such events. But frequently, there isn’t time. They must move on to the next crisis or person who needs them. And often, there is no way to process the experience with others, so the tension and emotional pain accumulates.

Supervision and debriefing are what should have happened when I was trying to help the mother whose son was murdered. Putting people in positions to do work for which they have not been trained, that involves human lives, is irresponsible. Without expertise in trauma care, and in my shock, all I knew to do was listen and try to comfort, holding her hand and hugging her as she sobbed. She deserved better. I should have been able to call in a licensed therapist and I should have been able to debrief myself with a similarly trained supervisor. But I didn’t even know that, until long after I’d left human services work.

Sometimes though, even when trained professionals are involved, caseloads, schedules and other organizational practices preclude them from being able to use their skills to help people and take care of themselves. A colleague told me, after having to restrain a client who was physically aggressive, the supervisor immediately called in all staff involved to debrief the crisis. But the caretakers were anxious and had difficulty participating because other patients were still waiting for their appointments and paperwork had to be completed. The supervisor’s instinct was on target, but the system’s practices did not allow it. Caseloads were too high, and schedules too tight. For these reasons too, clinicians’ one-to-one time with psychiatrists are often taken up with routine administrative work rather than training and discussing cases.

In these systems, you have to work to keep your humanity.

Policies, practice, pressures and culture conspire to take it away. According to the HHS report, anywhere from 21%-67% of mental health workers experience burnout. These are extremely high rates; damaging to both caretakers and those who need care. When such a large portion of the workforce is affected, strong institutional factors are at work, producing unrelenting stress.

Caregivers suffering from burnout experience emotional exhaustion, depersonalization and reduced personal accomplishment. They may feel like a failure and doubt their competency or compassion, become pessimistic and feel trapped. They may develop a sense of detachment, isolate themselves or take their frustrations out on others. Absences from work increase, and they can become more susceptible to illness, changes in appetite and sleep, and drug or alcohol use as a coping mechanism. Even though the percentage of mental health workers who experience burnout is already high, that percentage is expected to rise as systems become increasingly stressed by reductions in budgets and increased costs that are addressed by requiring staff to produce more billable hours in an already jam-packed work day.

Patients and the system suffer when experienced professionals leave the field.

Staff turnover rates are in this range as well, from 15-42%. Leaving for a better opportunity is one reason why; burnout is another. Patients and the system suffer when experienced professionals leave the field. According to the HHS report to Congress, a majority of primary care physicians attempting to find mental health services for their patients were unable to do so due in part to a lack of mental health professionals. The regions of the nation where shortages exist cover 91 million people. Providing adequate care would require 1,846 psychiatrists and 5,931 other practitioners.

In addition, the HHS projected that 12,624 child and adolescent psychologists will be needed by 2020 but only 8,312 are expected. Employee turnover disrupts continuity of care, makes it difficult to assure consistent use of evidence-based practice, severs patient-caregiver relationships if they have been formed, and creates patient dissatisfaction.

Community mental health is seriously underfunded, but the cost to our humanity is far greater than money.Inadequate financial compensation contributes to both turnover and burnout because it puts employees’ own security and health at risk. I know clinicians who cannot afford to replace their 10-year-old car, who put off trips to the dentist or doctor because of what it might cost, and worry about whether they will be able to support themselves in retirement. Some even qualify for food stamps. For example, on average, an experienced licensed social worker earns less money than a fast food restaurant manager. Direct care workers in residential treatment centers may earn minimum wage or barely above. And behavioral care professionals earn substantially less than their counterparts in physical healthcare, a phenomenon the HHS report attributes to our society’s social stigma surrounding mental illness and substance abuse that bleeds onto those who work in the field.

Market-based approaches to everything have been the reigning paradigm for the last three decades. But

if the market rewards what’s needed and is in short supply, why do we pay our caretakers so little and take so little care of them?

We cannot simultaneously destroy people’s ability to care for themselves and expect that they can care for us. In addition to needing organizational policies and practices that promote staff wellness and attract sufficient qualified professionals, we need to realistically understand and face the policies and practices in our society that create so much need for mental health and substance abuse treatment. The cost of taking care includes not only money. It requires a humanity and sense of responsibility for the common good, an ethos of looking out for and supporting one another.

In 1977, U.S. Vice President Hubert Humphrey said “the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped.” In today’s climate, so steeped in public-private partnerships, the responsibility not only reflects on government, it reflects on business and us all.

Sources:

Hyde, P.S. Report to congress on the nation’s substance abuse and mental health workforce issues. U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration, January 24, 2013.

Morse, G., Salyers, M.P., Rollins, A.L., Monroe-DeVita, M. and Pfahler, C. Burnout in mental health services: A review of the problem and its remediation. Adm Policy Ment Health, September 2012, Vol. 39, No. 5.

Thomas, M., Kohli, V. and Choi, J.  Correlates of job burnout among human services workers: implications for workforce retention. Journal of Sociology & Social Welfare, December 2014, Vol. XLI, No. 4.