Inpatient Mental Health Counselor Career Guide and Mental Health Insights

Transcription

(Music)

Eric Fisher: I learn a lot from the people that I work with from their life experiences because of their personalities, the jobs that they're on, the choices that they've made for themselves to empower them…

Dan: Today on Time We Discuss, I want to welcome Eric Fisher and it's time to discuss what it's like working as an inpatient mental health counselor. Eric, thank you for joining me today.

Eric: You're very welcome Dan, happy to be here.

Dan: So this is cool. So I have spoken to a mental health professional very, very early in my podcasting days. So it's nice to bring someone back around as a little bit of a refresher. And you're not doing this currently, but you did do it in a past life, as I like to say. So let's talk about it. When you're working as an inpatient mental health counselor, let's start about this. What's the difference between inpatient and outpatient? Let's start there.

Eric: Inpatient, it's kind of like having kids with you, you know, because I'm with the person, you know, usually for eight, even more hours a day. It's not like I'm with them like every single hour, but they're in the vicinity for the duration of my time at work. Outpatient, you know, I might see someone for 60 minutes, 90 minutes, and then I might not see them for a week, two, three, four. And so that's, I would say that's the main difference.

Dan: When you're working with outpatient, with outpatients, from what I gathered, usually like 20 patients might be typical. Does that sound about right?

Eric: Yeah. So I've done inpatient on two different occasions. My first time was in Mississippi, and that was at least 20, if not more. And my second time here in lovely Calgary, Alberta, it was very boutique and it was, it could have been like eight to 14, 15, a lot smaller.

Dan: Okay. That was going to be my next question. How the outpatient number of patients differs versus an inpatient. Okay. So it can be, can be about the same or dramatically less.

Eric: As far as my caseload, I would say that, yeah, there can be a difference for sure. People come into treatment, they leave treatment. And then, you know, as people are staying in treatment with inpatient, there might be new people that come in if it's an open, which it usually is an open type of treatment plan.

Dan: So let's talk about a typical day for you. When you were doing inpatient counseling, what was a typical day like?

Eric: So a typical day would be doing some type of like skills group or process group where just open, anyone can share or psycho education group on something with mental wellness. And then there's individual counseling during that day with the folks that I'm working with an inpatient. I might have to do some phone calls or some paperwork. Oftentimes there is some meetings with the interdisciplinary team or amidst the counselors that are part of the team. And then there's some activities often that are available to that I would be part of when I was in Mississippi could have been like volleyball or kickball or something fun like that. And so they're very, very varied depending on the day.

Dan: OK, now we talk about an interdisciplinary team. I've heard of like crisis teams. I don't I don't really know much about that. Is that kind of a similar thing? Completely different.

Eric: A little bit different. An interdisciplinary team consisted for us of medical doctor, a psychiatrist, the counselors, even sometimes the chefs that were available if they were available because we had some chefs at the boutique place where I worked. And also we would have the nurses. Yeah, the counseling team. So it was medical, mental health wise. And then also the administrative staff as well would be present.

Dan: The particular place that you were working in, what kind of what kind of mental health, I'll say illness was treated there. I'm not even using the right terminology. Was it like a depression clinic or was it like a substance abuse? What kind of facility was it?

Eric: Yeah, the latter for sure, Dan. And so for the first one, substance use and then, yeah, I mean, they would come in with co-occurring concerns and then at the boutique treatment center in Calgary, substance use as well. And yes, sometimes there'd be trauma and other types of concerns like depression, like you mentioned, or anxiety or relationship issues. And so for both of them, it was substance use. They were coming there primarily for.

Dan: So this is a bit of an odd question for you. And I don't even know what you said that made me think of this, but I know some doctors, for lack of better words, might look at the patient on a more holistic level. Is there anything going on like that in the mental health where you might be like you talk about the chefs, maybe, maybe some kind of diet thing or acupuncture or something like that? Does any of that happen on a more holistic level or is it not so much?

Eric: I try to look at, you know, holistically for the person, what's going to be in their best interest. And yes, we'll look at how they are doing with their eating because sometimes they're not eating too much for what we like to see, or they're eating, they're overeating, maybe emotional eating because of stress, or maybe they're eating because sometimes snacks were supplied. They're, you know, like maybe they're eating too much snacks that are not in their best interest. When I was in Mississippi, they used to make their own tea, but we would let them make their own tea and sometimes the exorbitant amount of sugar, we're like, okay, like we have to, you know, and then there'd be a, I would do a concession stand in Mississippi looking back. I'm like, wow, this is so bad. But you know, it'd be like, yeah, candy bars and sodas and stuff. And it's like, okay, you might be getting a little bit too much here. We have to look at that. So absolutely looking at sleep, looking at diet, you know, how are they working with the other people in the facility? So lots of things to consider.

Dan: When it comes to specialties, how do you decide what you want? How did you decide what you wanted to go into? If it's you wanted to work with people with substance abuse or depression or something like that, are there courses that you took at college or is it more, once you graduate you take continuing ed. How do you decide which route you're going to go with? How easy is it to change different roads that you're going down?

Eric: For me, not easy. I didn't take a single course for addiction in my bachelor's or my master's. And before my first stint in inpatient in Mississippi, I sat down with the director of the treatment center and she asked, you know, how much training do you have or experience? I was like, uh, none. And this is, this was like a few, maybe about, I can't remember how long it was, but it was definitely like six months before I started. And the way that I got started was, well, to make a long story short, I was potentially going to lose my position, like my job and my supervisor vouched for me to go to inpatient. I won't get into the logistics. It wasn't a treatment reason. There was some political and financial reasons as to why I was going to be not in my position. And so she advocated for me and that's why I ended up doing inpatient and really sink or swim.

Dan: So one of the things I'd like to talk about is if people are changing careers midlife, and this is kind of similar but different, what kind of skills, aside from the obvious, what kind of skills we're able to take with you that really paid back dividends when you switched into this role?

Eric: Tolerance for myself as much as possible. Yeah. Patience boundaries as well, because like when it comes to being around folks and me being very introverted, I mean, it just, it's, it's kind of, I don't want to say it's gotten, the word worst comes to mind. I mean, it's all like, I've just become more introverted as my ages went along. And so when it comes to being inpatient boundaries or the utmost where I needed to maybe get away for a few minutes and take a walk or whatever I needed to do just to take a breath. And so limits boundaries, preferences, whatever word I want to use for that. That was very important. And yeah, eating well for sure. Getting proper sleep because inpatient is a beast. It can be very challenging emotionally, mentally, spiritually.

Dan: Now working inpatient are your hours pretty much set. Do you get calls after hours? What is that like?

Eric: They're pretty much set when I was working. However, I had to do, yeah, I did have to do on call every so often in my first position, I may have had to do it a little bit in my second. I'm trying to remember, but definitely in my first and I'd be like maybe mowing the lawn and then I get a phone call in Mississippi and then, okay, now I got to take care of some type of situation. Maybe I have to drive back to the facility, which it was a small area. So it wasn't like a major drive yet. It's like a Saturday. I don't want to have to deal with it, but I got to.

Dan: Now, is that very common to get calls like that after hours?

Eric: It wasn't that common. It wasn't like it was every time that I was on call. It wasn't like it was every week.

Dan: Going back to COVID, I feel like there was a big push towards positive image towards mental health and taking care of yourself mentally and all that. But generally speaking, I know there are also a lot of misconceptions or there's stigma surrounding it. So talk to me about that a little bit. What are some of some of those things that people should be aware of that, you know, it's okay to treat your mental health properly and that sort of thing.

Eric: Self-care is the utmost. I think with COVID, Dan, we definitely figured out how important self-care holistically is for us and just making sure that we get the proper nutrients and sleep and exercise and especially social connections above all.

Dan: Talk to me about education. Okay. So if someone wants to work in an inpatient facility, I'm assuming they'll probably need a master's degree. Talk to me about a typical path that someone can take to go down that road.

Eric: A person can have a bachelor's and they can have like a support role. We did have in my second stint, we had these support staff that would, I wouldn't really call them case managers, but they would help out the patient, like the client population. Yes. For a master's, my master's is in clinical mental health counseling from the states. It's a master of science. A person could do like a master of arts in counseling psychology, yet something with either counseling or psychology in the mix up here in Calgary, it's usually the root of becoming a psychologist, which they can actually become with a master's degree, not just a PhD like the state's, a master of counseling psychology.

Dan: And I assume once you have that degree, you're free to work at a facility or do outpatient or even start your own business, right? You could do any of those things.

Eric: Absolutely. Yeah. I'm not considered a psychologist. I'm a clinical counselor, counseling psychologist, and yeah, a person can put up a shingle right now and they can do private practice or work for a clinic team or yeah, even an organization.

Dan: Eric, I understand you're also an author, so we have to talk a little bit about that. Talk to me about your writing. What do you got?

Eric: What do I have? I have a book out called the martial art of recovery. And so it's about the intersection of martial arts with addiction and mental health treatment. And then this last year, I can't believe I'm saying that already. The time's just flying by, but my second book is called buried alive. And it's, it's about a true story that happened and also some self-help concepts that are interwoven and true, the true story of this very near fatal incident happened with the family member of mine and just bringing those concepts to life with how that almost tragedy played out with someone I know being buried alive. Thankfully the person not, they survived. I did a documentary on it a long time ago, like with all three perspectives of the men that were involved. And then I transcribed pretty much word for word, the portion of the book that deals with that story.

Dan: Going back, you talked about martial arts and mental health and where they intersect. Talk to me about that. Is martial arts ever used in conjunction with mental health?

Eric: I know that for ADHD, martial arts, because it involves movement and balance and postures, those types of things, very important. It can be very beneficial for adults and children with that diagnosis. And just when it comes to sense of community, yeah, it can be really beneficial for someone with the martial arts and really just teaching someone the sense of self-control as well, which could be beneficial when it comes to mental health. And really just being able to cultivate more self-discipline and cultivate more self-confidence and hey, I can actually do this. I can show up for me, show up with other people that are, enjoy being with me. And like, we can have a fun time. It doesn't have to be a competition all the time.

Dan: So in working with a patient, how do you, how do you get to that point where you can say, I don't even know if you would, but like, Hey, let's consider martial arts. Let's consider, I don't know, gymnastics, fencing. I don't know. How do you, how do you get to that point where you have an activity, for lack of better words that can help them out? How does that, how do you get there?

Eric: Good question, Dan. People don't really care what I know until they know me and until I get to know them a lot more fully. And so, you know, it'll be quite traditional starting out. And I will mention even in a consult, hey, sometimes I use martial arts for working with people with substance use. I do have a book, not going to make you read it. It's out there, you know, not going to try to solicit it from you. I'm not going to ask you if you've read the book yet it's out there and I'll give them the name of it. And sometimes I'll just kind of bring in certain concepts from the book and from my personal experience, such as when it comes to surgiveness, when I was sparring at a really difficult time. And this is mentioned in the book. I had a difficult time between being really passive with sparring and becoming like full on aggressive. Like if I got pushed too much, I could be quite aggressive. So I had to find that balance, you know? And so I thought I can bring those type of experiences in and speak about that with people.

Dan: Okay. And that makes sense what you're saying. I, it's funny how the brain works. So I interviewed John Swift, he's a mental health counselor, like two years, I mean, at the very, very beginning of the show, pretty much. And then I interviewed him again as a dream therapist, because he uses dream therapy along with mental health counseling.

Eric: Cool.

Dan: It wasn't until you mentioned the martial arts, how you just kind of, well, this is something that I do. That's kind of what he said. It was like, well, I also offer mental or I also offer dream therapy. If you ever want to talk about your dreams, we can do that. And if not, that's cool too.

Eric: Yeah. Yeah. Total volition of the person. Now you're like, you're not on the ball and chain, you know, it's all good. That's cool.

Dan: You talk about being introverted and I can relate to that to a T because I, I probably come across being very, very extroverted, but I am not. I like to be by myself. And I was talking to Liz Teresa. She was a webpage designer. Her episode dropped just a few weeks ago at the time of recording this. And she said the same thing. Like when she's done, she's like, what's it be by herself? And I was like, I totally get that. So what's that like being an introvert when you're working as a mental health counselor therapist at the end of the day, do you just feel like completely spent? How does that affect you?

Eric: Oh yes. Emotionally mentally spent effects, you know, certain sessions will affect me in different ways. If I'm working with someone with trauma, there has been times where, you know, there's certain images, maybe what's been spoken about and you know, that'll. That'll just kind of, that'll keep with me and I have to take care of myself. If I've spoken with like five or six people, like five to six face hours. Yes, it just, it can be quite, yeah, it can be really demanding and it can, I can be very drained and I feel like I do need to have that certain amount of time to do some self care, even if that's just vegging for 30 minutes, watching a TV show, taking a bath, taking a walk, exercising, whatever I need to do to take care of me. And you know, I do apply the extroverted therapist out there that get a lot of their energy from being able to have those experiences in those sessions and nothing wrong with that. On my end of the stick, I have to definitely be wary of even the space between sessions as well. If I have too many back to back, that can be quite daunting.

Dan: Again, when I was talking to John, he talked about this idea of like, not only does the patient get stuff from him, but he also, it's, it's almost reciprocated kind of, they also learn things that, you know, how do I want to phrase this, but there's stuff that you as a therapist can take away as well. Talk to me about that. Like what's, what's been your experience with that?

Eric: Definitely reciprocal. Yeah. He's definitely on to something. I learned a lot from the people that I work with from their life experiences, because of their personalities, just the jobs that they're on, the choices that they've made for themselves to empower them. So when it comes to empowerment, when it comes to even those little victories, you know, that they're able to overcome and the teachings there that they can give me when it comes to being able to make those strides and they might say something in a certain way that I haven't thought of before. And I'm like, yeah, that's right. Yeah, I can take that. And it even comes from emails that are sent to me. Sometimes folks will send me, you can, you can maybe call like a, maybe like a personal, like, like a, it would be, it would be seen like a journal article, you know, that they would do for themselves. And they might be typing to me something that I've never considered before electronically.

Dan: Talk to me about PTO. I know different times, you know, different companies, different occupations lend themselves very well to like, you know, you get X amount of vacation, sick, whatever other times you don't, you might be like a 1099 employee or something like that, which I don't think is the case where you were working in a facility like that. Do you, does a person typically get like standard paid time off? What is that like?

Eric: When I was in Mississippi, the PTO was like garnering, I believe it was a day, a month, and so I would have to like wait until later in the year where I could take off a week. Up here, you know, I work for myself now. I'm pretty much self-employed and in a lot of contract positions. So if I want to take off, I take off. However, it's not paid time off. I just don't get paid.

Dan: A minor drawback. Minor.

Eric: Yes. Minor. Yes. When I was working inpatient up here, it was similar. It was either a day or a day and a half every month when I finished.

Dan: One thing I want to do before I hand the floor over to you, I want to take a second and thank Mickey Mikkelson for introducing us. Mickey was in episode 51 as a publicist. So everyone, please go check out that video. The link will be in the description. I'll put up a little card up at the top. Now this is the part of the show where I'd like to offer my guests the opportunity to talk about a project they're working on, a cause they believe in, more about your books, for instance. I'd like to leave it open. My way of saying thank you. So if there's something specific you'd like to discuss, the floor is yours.

Eric: Thank you, Dan. And it's awesome that you had Mickey on. Yeah, he's a great guy. Yeah. Some other books, the martial art recovery, self mastery practices to subdue addiction and achievement to wellness and buried alive four a ways to free yourself from the dirt. It's the name of those books and a cause that I would like to advocate for is actually a nonprofit in Erdri, Alberta called the Thumbs up Foundation. It was started by two people. Actually both had the same name, husband and wife, Kim and Kim Titus, both named Kim and they started the foundation. They're one of their sons, unfortunately died by suicide and didn't get the treatment that he required. And they've just been go getters when it comes to opening up a system for mental like holistic brain health, cutting through the red tape, getting the treatment on a medical mental health and supplemental level with other practitioners that a person needs. And so the thumbs up foundation is, I think it's The Thumbs Up Foundation.com

Dan: I'll make sure I get those links. I'll put them in the description. They'll be on the website. They'll be all over the place when people are trying to find that and you, they'll be able to find that. Eric, It's been absolutely awesome having you on Time We Discuss and we learned all about inpatient mental health counseling.

Eric: Hey, it's been a pleasure Dan. Thank you for having me on.