Thursday, July 10, 2014

Numbers: a Thursday Thirteen.

Me, at six

Dear Diaries,

1. SIX. Does anyone being six? I have a vague recollection of being given a Barbie, which was boring and stupid and was immediately put in all manner of peril for me and my friends to rescue. I wore Sears Tuffskin jeans, which made climbing trees easier. I was loved. The world was a safe, predictable place. That was pretty much my world.

I ask you to hold onto the idea of being six for a moment while I share a little about where I work.

2. FOUR. In the state of New Mexico, there are four acute-care hospital units where children under 18 go when they are out of control, psychotic, or suicidal. There used to be more, but nothing is more non-profit than children’s behavioral health, so they’ve all shut down, until just four are left, for a state of over a million people, a state with the seventh highest youth suicide rate in the United States.

3. TWO. In New Mexico, only two of the four acute units are non-profit. Both in Albuquerque, each takes patients from Albuquerque and most of the rest of the state.

4. TWELVE. We have twelve beds total, on the unit.

5. SIXTEEN. We would like to have sixteen beds, but that requires remodeling. Re: above and non-profitability of children’s behavioral health. We make enough to pay the bills. Nothing's left over. Every corner than can be cut has been cut. Most of the children we see live well below the poverty level--New Mexico has the second highest child poverty rate in the nation. Many are in state custody, having been abused, and many have mental retardation, or autism, or both. Every staff member in the unit has bought toys or other supplies out of the their own pockets.

6. ONE. We are the only private non-profit acute psychiatric unit for children in the state. The other non-profit, a university medical sciences center, sends us kids they don't feel they can handle.

7. ONE. I used to be puzzled as to why a major state university health sciences center couldn’t handle a pediatric behavioral patient. Then, one day as we were considering whether to take a patient who required one-to-one staffing, I realized that we needed only to consult one suoervisor, and then a staff member is called in, usually within one day. I suspect that at this other, university-affiliated hospital it requires several requisitions, forms, and an act of the state senate to get more staff.

8. EIGHT. The entire hospital system I work for is run by a foundation. They use extra money to build other hospitals, and now there are eight.

9. EIGHT. I have an ER list set up on my computer that gives me the ages and reasons for being in the ER. No names—just age and reason for being in the ER. It keeps me prepared for possible admissions, because I alone on the unit am the therapist, social worker, and insurance reviewer.

10. ELEVEN. Eleven people are on the board of trustees. Every year they hold a major fundraiser, which benefits some part of the hospital. This year, they chose our unit. The benefit is held in August of every year, and includes a fancy sit-down dinner, comedian, silent auctions, and raffle. Here’s a link.

11. SIX. Remember six? Last week I received a call from a local therapist asking me if I could do a suicide assessment on a six-year-old who is in child protective custody. This child is in treatment foster care and had been hoarding knives and threatening to kill himself. I told the therapist to take him to our emergency room for an evaluation.

12. SIX. Before I left for the day, I consulted the ER list to see if any six-year-olds had been brought in. There was, indeed, a six-year-old who was in the ER for a suicide assessment.

13. In fact, there were TWO.




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