Can Connecticut afford to lose more homecare mental health nurses?

Homecare mental health nursing clients do not live in a bubble. They are your neighbors and members of your community — served, medicated, and stabilized by homecare behavioral health nurses.

Psychiatric patients live in families and communities. They are your neighbors. Their children go to school with your children.

Home care nurses serve more than just their patients, since their patients’ health and well-being impact society as a whole. Nurses can bring stability to a mental health client who in turn can bring stability to the home and community.

Ask yourself how you are affected in your own personal life when a family member is ill, be it mentally, physically or both. The stress of illness has an emotional negative impact on the lives of many family members. Homecare nurses interact not only with their client, but on many occasions with all the other family members in the home. They sometimes  find themselves in the thick of family discord, needing to respond as a sort of proxy referee.

Homecare nurses all have horrific stories — especially in psychiatry  — of patients becoming knife wielding maniacs, for example. You’ve heard those stories, perhaps, but there is a more subtle side to what we do.

Children and young adult family members in a mentally ill patient’s home often bear witness too much dysfunction and family discord. These children also see we nurses as representatives of the health care system; and often they state they, too, aspire to become nurses when they grow up.

Circumstances vary widely regarding the nature of our being in someone’s home, whether it is a referral from a parole officer, the courts, Department of Children and Families, outpatient treatment facilities or psychiatric hospitals. A nurse’s caring and professional interaction with a mentally ill family member sets the example of normality, teaching that hope and recovery is attainable and dysfunction is not the norm.

Psychiatric homecare nurses skills are used by many and have far-reaching consequences beyond simple medication administration.

The science of disease and its relation to mental health exists and is not theoretical, but practical. Who has not heard of or is not familiar with the terms genetics, epigenetically pre-disposed, or PTSD? Genetically pre-disposed as in family members, children, blood relatives and their likelihood of inheriting a disease or disease trait? Epigenetic as in environmental factors that affect those genes, such as stress, abuse, PTSD — events that can be traumatic and may manifest themselves in future dysfunctional psychological behavior.

As homecare nurses we can’t influence genetic endowment, but epigenetic factors, PTSD, stress, family discord, exposure to substance abuse — we can and do influence these factors and by doing so attempt to prevent the ultimate assault to anyone’s psyche, especially those of impressionable children and young family members.

Our patients and their families sometimes live in a hellish bubble of sorts, full of family discord and overall dysfunction in great part due to the ravages mental illness on a family member. But as homecare nurses we are allowed to enter their world, sometimes willingly by clients, sometimes through bureaucratic or societal forces such as the Department of Children and Families or parole officers.

A dear friend of mine who grew up in a severely dysfunctional home once said to me, “You never know what goes on in someone’s home.” I think of that often because, as visiting nurses, we do know what goes on. We bear witness to it, into that intimate bubble of a patient’s home and that of their family, a place where we can interject hope, recovery and a better life.

It is often said, “you learn what you live.” We accept this to be true and what is learned should be good and helpful. And, yes, there are many horrific stories, but many more of progress and recovery — recovery assisted by psychiatric homecare nurses. Homecare nurses teach constantly, and people do learn and they do get better and much of the horrific stuff stops.

I have been a nurse for 21 years, mostly spent in behavioral health: seven years in the West Haven Veterans hospital emergency psychiatric unit, 14 years full time home care.

Home care works by serving patients, family members, our communities and society as a whole. Talk about bang for your buck! It’s a pretty good investment in public health and society as a whole, in this nurse, husband, father, grandfather and, yes, citizen’s opinion.

Can society afford to lose such a valuable resource? Recent and historical events perpetrated by under-served mentally ill individuals would say no. Are our collective memories that short? I think not.

Please oppose the governors’ cuts to home health care nursing for the mentally ill.

James Shokite is a registered nurse for New England Home Care and is a 2015 recipient of a Florence Nightingale Award for Excellence in Nursing in the Greater New Haven Region.