Bellevue

I have now been at my internship at Bellevue for about a month or so. It is incredible! Most people have heard of Bellevue either through One Flew Over the Cuckoo's Nest, or knowing that it is the oldest operating hospital in the nation. It's quite a fantastic place to work and I'm so grateful that I am gaining this experience.

I'm working in the outpatient psychiatry unit on an Assertive Community Treatment (ACT) team. The team is comprised of four social workers, two nurses, and a psychiatrist. We have 68 patients with a severe and persistant mental illness, mainly schizophrenia, and we deliver all services, medications, counseling, and help with daily living out in the community where these patients live. I have learned so much about schizophrenia and severe mental illness, which has forced me to confront many of my own stereotypes regarding this disease. Schizophrenia is so debilitating, yet with the proper treatment and medication many can live high functioning lives and teach all of us about the bias and stigma regarding mental illness.

Many people suffering from schizophrenia see the hospital as a "revolving door." They may not be in treatment or taking medication, and then continue to enter the hospital when they have had a psychotic break in order to stabilize. They then are discharged having no knowledge in how to manage their illness, and repeat the hospital cycle over and over again. What makes the ACT team unique is that it allows these patients to live in the community, have a house, a life, and independence. We help them learn the skills necessary to live on their own and manage their illness outside of the hospital. We visit them in their homes at least once a week and deliver their weekly meds, teach them how to care for themselves, cook for themselves, and work on social skills, employment, and activities for daily living. It is such a personal and intimate service model that is so relational. It helps these patients have a life outside of the hospital, and where many people have given up and abandoned them because of this illness, the ACT team truly invests in their lives to help them achieve the life they desire to have.

And I'm meeting some truly amazing people. Like "Andy," an extremely intelligent man that experiences some intense delusions and calls the Pentagon regarding his most recent inventions. Or "Mary," who thinks she is Queen of England, a marathon runner, and best friend of Obama (she is none of those things). Or "Lou," a cute Vietnamese man that refuses to wear his dentures, and is nervous of everything, especially the sun. Every single day I leave work having no idea what just happened. I often wonder if someone is secretly video-taping me as I have these incredibly strange conversations and experiences with these people. It is intense, amazing, and wonderful work, and I'm so glad I'm a part of it.

The thing I love the most about this model is that these patients are no longer alone. They have an entire team that cares for them and builds a relationship with them in order to see them well. They can rely on someone to help them when they need it, yet they also have some autonomy and ownership over their illness. They are no longer isolated and they do not need to spend the rest of their lives in the hospital. I absolutely love it and think this work is so important.

All in the heart of New York City. How beautiful is that.

**I wrote this post before Hurricane Sandy came and forced Bellevue to evacuate all patients due to loss of power and flooding. Bellevue, the largest hospital in the city, evacuated over 500 psych patients to various hospitals throughout New York City. Mental health workers are amazing. But, there are many patients and staff in the midst of crisis. Please pray for them. Bellevue will hopefully be up and running soon.