But I can't mention the specifics of my work to anyone due to keeping confidentiality with clients. There are many jobs like this so here is an example of my day. None of these six clients are real but are typical.
Liz is 23. She is homeless and has been addicted to alcohol since she was a teenager and has a diagnosis of chronic psychosis, experiencing hallucinations daily ("hearing voices") and clinical paranoia- a complex web of conspiratorial, persecutory organisations that are constantly watching her every move. Her addiction and illness has made her aggressively defensive against perceived slights and she has been barred from every service that helps homeless people except mine. In my office she mistook someone's laugh as a sneer, thought they wanted to harm her and she attacked first. This wasn't her second chance, it was her eighth. She had to be barred from the building.
Conor is 48 and has been transient for over 20 years since being evicted from a cult and losing his wife, children and all his friends. The stress caused a long-term breakdown in his mental health, he has engaged meaningfully with no service since and carries a box of sharp pencils to defend himself against nurses and social workers who, he believes, all want to detain him and inject him with poison. I need to develop a connection and a relationship with him to complete a more detailed mental health assessment and, thereafter, suggest possible treatment. He has never lived in permanent accommodation and never lives in a city longer than 4 months.
Lucaz is 29 and from Lithuania. He doesn't speak any English and we use an interpreter to communicate. He is legally entitled to almost nothing, benefits or housing-wise. After rough-sleeping for weeks he developed a hip problem and was admitted to hospital. He actually had a complex infection that took months of aggressive therapy to clear up due to his newly diagnosed liver failure. He has developed fibromyalgia and may have become addicted to the opiate-based painkillers he was prescribed. He was discharged from hospital with an inadequate care package and is now homeless, on crutches and with a big paper bag of medication available to abuse.
Rachael is 34 and has acquired a brain injury after an assault from her father when she was a child. She has a long history of childhood sexual abuse and exploitation. She has four children from four different men, none of whom she has any contact with, and all four children are in care because she has been deemed inacapable of coping with most adult responsibilities. She has recently started a relationship with a known all-round nasty piece of work and multiple violent offender. She knows his history and doesn't appear to care. They are both homeless.
Ahmed is 24 and from Somalia. He had been seeking asylum for eight months and has been a refugee (received five years leave to remain) for five months. In those five months he has been "sofa-surfing"- moving between friends, friends-of-friends and charitable strangers- and he has been on the streets for a few weeks here and there. He has developed complex Post Traumatic Stress Disorder after his experiences that forced him away from his home country and experiences daily symptoms of a heightened state of persistent anxiety ("hyper-vigilance"), reliving (recurring violent nightmares and horrifying flashbacks) and auditory (noise) and gustatory (taste) hallucinations. As we talk, using an interpreter, he is distracted by the screams of his family and the persistent taste of their blood in his mouth ("like sweat and rust"). I notice he is missing three fingers but can't bring myself to ask why.
Harry is 28 and had been a bar manager for years. He had no health problems, is on no medication and, up until a year ago, considered himself fit and healthy. Then he got curious and sniffed some cocaine. He now sniffs or smokes cocaine every day. He couldn't cope at work, lost his job, couldn't pay his rent, was evicted by his landlord and has told no-one about his problems due, entirely, to embarrassment. He finds it hard to picture his future.
All these clients were assessed using a complex-needs, multi-disciplinary assessment tool that takes an hour or two. Their needs were identified, plans were put in place and issues addressed. Five of the six walked away in a better state than when we first met, with a clear plan of support in place and a roof, albeit temporary, over their heads.
Again, none of these cases are real but the symptoms, issues and experiences described have all been mentioned to me over the years. These are very typical clients seen on a very typical day in my typical week.
One of the many reasons I enjoy my job is because it is extremely interesting. I meet a very wide population demographic and I am amazed, almost daily, by the strength, courage, dignity and kindness of my brothers and sisters in my human race.
I am one of millions of workers all around the world who can tell no-one about my job because all cases are extremely confidential. How fascinating it would be to be privy to the specific details of a day in the life of a spy, a psychotherapist, a governmental policy-maker, a prosthetic limb maker, a publisher with a new book, an artist on commision and any other number of quiet, autonomous cogs in the machine. They are millions and they are unmentioned and they are intriguing and they keep it all going. I appreciate the beauty in their anonymity and collective power.
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