Gary Bloom

March 29, 2021

Systems Theory

(This is an excerpt from a book I wrote on how to have career in the mental health field. I unpublished it because it would need to be revised to stay current.)

Maybe in grad school, you decided to be a systems-oriented counselor, specifically a family systems-oriented counselor. Soon you’ll learn that the mental health system is full of systems.

Adult Protective Services:
A vulnerable adult may be financially exploited, or abused by a relative, friend, or caregiver. These situations may be complicated by the exploiter being the only one giving much attention to the elder. Unless you live in a very rural area, there’s probably an Adult Protective Services agency that would deal with this. However, mental health professionals are mandatory reporters when they suspect such abuse or exploitation, so you may need to make a referral. 

Child Protective Services:
Even rural areas usually have their own CPS agencies. You may have to provide court-ordered clinical services to a family. You are a mandatory reporter if you suspect abuse of a minor. 

Public School System:
There’s a drug epidemic in public school systems, and for inexplicable reasons, law officials can’t track down the drug peddlers. Let me give them a hand.

Young children are being given drugs for behavioral issues in the classroom: amphetamines, anti-psychotics, anti-anxiety, and anti-depression pills. Long-term effects, be damned. Ah, well, children make good guinea pigs. 

Health insurance system:
But only if you want to get paid.

Legal System:
Large cities have their own public health employees, but if you live in a rural area, you might provide services to the local jail. More likely, you may see someone who has been court-ordered for anger-management treatment because of domestic or other violent acts. 

Involuntary Treatment System:
Individual counties or large cities have their own resources to deal with (usually) state laws regarding involuntary treatment. Typically, an individual may be detained if an evaluation by a designated mental health professional finds the individual is one of the following: as a result of a mental illness that is acute or chronic, (and found in the DSM), is a danger to self, or a danger to others, or gravely disabled. Danger to self or others needs to be imminent, likely to occur within a day or two. Gravely disabled means that an individual can’t care for his or her basic health and safety. Involuntary detainment is usually in increments of 72 hours, 14 days, 90 days, and 180 days. Each detainment period is a legal proceeding. Usually, the first 72-hour hold takes place within a local psychiatric ward. The longer holds typically take place in a state hospital. This can vary in accordance with available mental health resources.

Healthcare system:
It should go without saying that the mental health system operates within the larger healthcare system.