community mental health

It is both less hectic but has much more responsibility than hospital based mental health. Not sure what Canada is like but here it involved having a "case load" of mental health clients. Up to about 20. Your job is to try and keep them well in the community. It is very holistic; you help with every area of their lives - jobs, living skills, medication, counselling, housing, financial planning, coping with their children, relationships etc.

You go out in the car and visit them, or they come into the office for sessions with you. How often depends on you and what you think. You need to make sure they are travelling ok, taking medication, monitoring drug and alcohol issues, working out if they need intervention or support. You teach skills for living with mental illness or other issues, set goals, monitor progress, work out plans.

I find it very challenging but incredibly rewarding. You work with ppl over years sometimes. Those with psychotic illness, drug and alcohol problems, anxiety disorders, depression, borderlines. Each have their own challenges. The borderlines who call you suicidal every friday night when they know you are going home for the weekend; the schizophrenic who goes missing and only you have any clue about where to find him as you know him so well; the depressed mother who is not getting out of bed and not handling her children well...and you need to make the decision about whether she needs more support or if her children need to be removed from her care for a time.

It can be dangerous at times. You don't have duress alarms and you are generally in someone's home where there are weapons and unpredictability. You often have "his word against mine" type scenarios. You have to document so carefully.

On the plus side, you get to know your patients really well...and most of the healing that is done happens in the community. But the responsibility is huge. I'm not sure I would recommend it to a new grad, but not sure if it works the same way over there.