Le Devoir – « The salary of success »
29 March 2016
The owners of the intermediate resources in mental health see their remuneration lowered when their clients (users) make progress.
Le Devoir – March 29th, 2016 – Jessica Nadeau – Health
When Sarah (fictive name) arrived at Luc Desjardins’ home, she would self-harm herself and made multiple suicide attempts. She was so insecure she couldn’t even leave the house. And now, years later, she is radiant: she does volunteer work with the children, swims at the olympic municipal pool and runs her errands by herself. « I am here because I had difficulty living by my own in an apartment. Here, I feel secure. I have much support from the social workers and my medical team, it helps me move forward. » The home of Luc Desjardins is filled with troubled people. Some of them have mental health problems, behavior problems or consummation problems. People that need a little or a lot of help to resume their lives. « You can find people, talking to themselves, in the streets of Montreal. They are people that are not living in our resources », explains M. Desjardins. In his large home in Repentigny, that he had adapted, M. Desjardins cares for 8 people. He feeds them, listens to them, makes sure that they all brushed their teeth and makes their bed. He attempts preventing fights, to manage conflicts and get them to find solutions before an overflow of emotions explodes, sometimes at the expense of the furniture. He tries to make them aware of their responsibilities and brings them to be as independent as possible. All of this, with the help of the Health establishment from his region who give medical and professional services — psychiatrists, social workers, etc. — and who pays him for the services rendered to the needs of his « clients ». The more overwhelming the patient is the more substantial is the payment given to the resource. Health establishments have a clinical and budgetary classification scale that they apply to the letter. They proceed to a reclassification of the clients at least once à year. Perverted effect : This classification has a perverted effect, reports M. Desjardins. He gives the example of Sarah. He worked very hard to help her control her anxiety and to bring her to stop harming herself. But now that she is better, they say that the level of services is less. So the « classification quote » for Sarah is lowered. The payment for M. Desjardins is then also lowered consequently. « It makes no sense at all, we must continue to work hard to maintain the good results, exclaims M. Desjardins. Furthermore, I don’t know anyone who gets a cut in their paycheck if they did a good job. I can’t go to the bank or call Hydro-Québec to tell them : I have done such a good job that they cut my pay check, can you cut my electricity bill and my mortgage in half? It just doesn’t work that way. This brings a financial instability which is terribly hard to manage for the owners of resources. » Sitting at the end of the huge kitchen table, M. Desjardins laments all this bureaucracy that ignores the ground reality which demotivates the few 8000 owners of intermediate resources like his own in Québec. « The Ministerial interpretation always comes down to the basic service. We told the minister that it makes no sense, that it doesn’t encourage the resources to want to do more for their clients. But they said that the resources loved their clients and that they would care for them and give them all the services needed even if they were not adequately paid to do so. They play with our feelings. And it’s exactly what we do » Deactivate the anger: The smell of beef stew reaches the second floor, where Sarah and Robert (fictive names) are making a puzzle of Spiderman in the main room. « Can I show you my little home ? », says Robert proudly bringing us in his room. « This is my way of life. I have collections of different things, caps, and movies. I have many movies. You could say that I am a movie buff. I have a blu-ray machine and a nice tv. » But it’s not really about his room that Robert wants to talk about. « I would like to talk to you about mental health problems, people have a lot of prejudices, he says with poise. It’s difficult to make friends because people are afraid of this. The media talks about us in a bad way, they often associate crimes to people who have a mental illness. They shouldn’t do that. We are human beings too. We aren’t bad people. In fact, we are intelligent, because we know to get treatment. Schizophrenia is like diabetes, we must learn to live with it. » Pierre is cleaning his room. He comes out with a waste basket full of lottery tickets and goes to his favorite place in the house: the smoking room. « What I like best here is my freedom. We don’t have to go to bed at a specific hour. We don’t need to report ourselves if we want to go to the store or to the mall. And as for the food, it’s almost always good, even if I think it’s a bit too healthy for my taste. But we catch up with a good old hotdog every once and a while», he says, which makes everybody laugh out loud. From construction to mental health : The atmosphere is friendly for a morning in March. Everybody praises M. Desjardins’ merits and the ones of « the pretty Julie », social worker of the week. But this is not always the case, explains M. Desjardins, who has seen many different others. On most of the room doors, there are pictograms to help the clients (users) to identify their emotions and the solutions to avoid the downfall. It also allows the social workers to be aware of the potential risks. « Fits are part of our daily lives. » Over the years, M. Desjardins has developed a true expertise with his clientele of behavior problems. He loves the challenge. « In many cases, they are professional trouble makers, he says with a large smile. They will do everything to prove that they can be thrown out. They will try anything and they will test you in different ways. They are so predictable in their unpredictability, I love it ! » Yet, he had never thought of working with this type of clientele. « Before, I worked as a construction worker, I had four companies, it was really driving me crazy. My sister had an adult foster home and I felt at ease with her residents. So I went to get accredited. I first thought of working with children, but they told me that I would be better in the mental health division. I didn’t know anything about that, but they were right ! » M. Desjardin loves his lifestyle. However, he noticed that the sad thing about this job is that there aren’t many people that are going to take over. « The average age of the resource owners is about 60 years old », he says sadly. And with the problems with financial instability of the declassification of the users, those who might have been interested before are not sure of wanting to take part in the adventure anymore. « If you have an unstable budget, how can you try to get a mortgage on a new home ? How do you want to keep your employees ? That’s why the younger generation is not willing to take over. I get phone calls every now and then from young adults who ask me how to do this job. But the truth is that I really don’t know how they will make it. I find this sad, because being an intermediate resource is a great way of living. »
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