Counselor Advocacy: What They Did Not Teach in Grad School

I was always told that it is absolutely impossible to learn everything you need to learn to be able to effectively help other’s in the two years (sometimes three years) of graduate school. I understood this. There is much talk on continuing education and how not only are you required to have this to renew your counseling license, but it is necessary to continually educate yourself to help your clients. I understood this and embraced it. However, some things I learn continue to surprise me.

Advocacy was talked about some. There was not a specific course on it or even much experiential activities. In short, we talked about it as it came up in classes. Typically advocacy came up in my ethics classes–because being an advocate is part of being an ethical counselor. It was also talked about in my multicultural counseling class because recognizing that some groups of people are marginalized is part of our necessary knowledge/intervention with some. There was some talk about “advocacy days” which is where professional counselors go to the state capital and discuss with legislators about the struggles we see with our clients and advocating for changes to remove, or lessen, these struggles. Outside of these, advocacy was not talked about much.

It’s safe to say that I left grad school with the impression that advocacy was an action on a larger scale. Attending the advocacy days, getting involved in legislation decisions, etc. I did not know that advocacy can also be engaged in on a one-on-one basis, or even right here in my own city.

For those who may be reading my blog for the first time, I will briefly explain what I do for my jobs. First, I am a licensed counselor working part-time as a university counselor. My full-time job is being a crisis specialist at my local mental health authority. For my university counselor job, I see students for counseling to help them through personal and mental health issues so that they may succeed in their personal and academic endeavors. For my crisis specialist job, I respond to crisis calls and intervene with individuals who may be experiencing suicidal thoughts, homicidal thoughts, and psychosis, alongside other issues such as drug addiction, incarceration, relationship issues, etc. Little did I know that I would need to advocate for the people I help in these jobs.

Being a crisis specialist allows me to be exposed to a wide variety of situations. I go to many locations including my local hospitals, jails, inside client’s homes, and sometimes in the middle of the street. I meet the client’s wherever they are at. This means that I have to collaborate with law enforcement, medical professionals, and other first responders such as paramedics/EMT’s.

Working as a crisis specialist has given me a first hand look at the amount of misunderstanding there is about mental illness and behavioral issues in the world. Let me tell you, it is impossible to describe how much judgment there is. What I clearly see as a mental health issue, others see as a moral failure. Allow me to give some examples.

First, let me say that I respect all other professionals I come into contact with when on crisis calls. I thank them for their service to human beings and to my city. Law enforcement, medical professionals (especially ER staff), and first responders are not given enough credit for the situations they deal with on a daily basis. So, I thank them for their selfless sacrifice. And I also feel the need to speak up about issues that involve them.

An example that clearly sticks out in my mind is with medical professionals. I work alongside medical doctor’s, physician assistant’s, nurse practitioner’s, nurse’s, social worker’s in the medical setting. This typically takes place in the ER. You see, what typically happens is that someone goes to the ER with suicide thoughts, unsure of where else to get help, or they go to the ER after they have attempted suicide. The medical professionals medically clear them and then I am called to evaluate the mental health side and help the individuals get connected with the appropriate treatment. This should be a smooth process, but too often, it is not.

Too often, medical professionals do not respect that we are the mental health authority. They do not respect and yield to our decision making. I understand, they are trying to do what is best for their patients and also protect their license. However, they do not have the education we do about mental health. I have education, training, and experience in identifying specific mental health disorders and what level of treatment this requires. I have worked in inpatient psychiatric facilities–I know what kind of issues this will and will not help. Yet, too often, medical professionals push for hospitalization when I feel that no longer is it necessary, it could be further detrimental to the already existing issues. This requires that I stand up to the medical professionals–which does not always go over very well.

Another example is with law enforcement. I collaborate with law enforcement at my local jail’s, the police department, and often times at individual’s homes and community settings. For those that are unaware, police officers have a legal right to detain someone if they are deemed to be an imminent harm to themselves or others. This can include imminent suicidal, homicidal, or psychosis risk. However, in order for someone to be involuntarily admitted to an inpatient psychiatric facility, we have to evaluate the person. This is where things get muddy.

Majority of the time, the police officers I work with do a substantial job with upholding the laws and rights of each person we see. The ones I typically work with are very specific on the criteria that they will follow through on an emergency detention order. They understand that there are laws against unlawful search and seizure, and they do not want to violate these individual’s rights. Nor do they want to have to explain in court why they violated those rights if there was not a cause. But there have been times when I do not see evidence of a mental illness, or there is not an imminent risk, and the officers are still wanting to involuntarily admit the person. As a counselor, it is my duty to make sure that if I am involuntarily admitting someone, it is to protect them from hurting themselves or someone else. It goes against my ethics and, quite honestly, my personal morals to involuntarily admit someone without evidence of mental illness and without imminent risk.

Another situation I have encountered is with law enforcement. Again, I will say that the law enforcement I have interacted with does a wonderful job with doing what is right in situations. But there have been times where they fear for the safety of the person or others and consider charging them with something to keep them safe. I see way too often how mental health and the jail system collide, and it is often not a pretty sight. There have been times where I have to stand up for the person and say that jail is not going to help them.

This are just a couple of situations I have encountered where I have to advocate for a client. I was not expecting to have to advocate for clients in these situations. Sometimes, it can be uncomfortable to have to stand up to medical professionals and law enforcement, but I became a counselor to help. I became a counselor to advocate for those who may not have a voice. I became a counselor to pave the way for humans to receive the help and resources they need. And I vow to do every thing I can to help.

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