Aiding the mentally ill a source of joy for CHCS caseworker

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Editor’s note: During her field placement for the University of Maine technical writing program, Sarah Dean was given the opportunity to interview and job shadow Beth Kingsbury, an intensive case manager at Community Health and Counseling Services. Clients’ names have been changed to preserve anonymity.

It is not unusual for Beth Kingsbury’s day to begin between 4:30 and 5 a.m. As an intensive case manager for Community Health and Counseling Services in Bangor, she often uses the early morning to catch up on paperwork or prepare for the day ahead.

Kingsbury sees 10 clients each week, but some cases require meetings at least twice per week. Her workday often begins before 8 a.m. – a time of day often foreign to college students like myself.

On meeting Kingsbury for the first time – an appointment she graciously scheduled for midmorning – I discovered that in addition to seeing clients, she helps facilitate “dialectical behavioral therapy,” which is intended, she explained, to teach people to help themselves.

Her role as a social worker at CHCS is a very busy one. Nevertheless, Kingsbury said she always knew that this was what she wanted to be when she grew up. For as long as she can remember, her goal in life was to help people in the community who could not live productive lives on their own. She did not plan to become an intensive case manager, but is overjoyed that she found the job eight years ago; she has loved it ever since.

Like most people, I didn’t have a good idea what an intensive case manager does. I asked Kingsbury to describe some typical services. She explained that she meets one-on-one with clients, usually in the their homes, to discuss a variety of issues and needs in their lives.

“Clients don’t cancel; they like meetings,” she said. “There is a need.” Kingsbury’s emphasis on the necessity of the services she provides reflects the beliefs of many in the health care field.

Most of the clients she sees have personality disorders; however, some have mood disorders, such as manic depression or problems with alcoholism.

While some of her clients are highly functional, others need her assistance with many of the routines people without mental illness take for granted, such as paying bills, shopping and regulating spending money.

After hearing Kingsbury explain her responsibilities, I thought, “A day spent talking with people, writing checks to pay their bills and shopping? Where do I sign up?”

However, observing her in the field, I began to realize her job was not all fun and games. Kingsbury is most concerned with getting her clients what they need, even though dealing with the details of client services can be a hassle. She said some of the most pressing unmet needs are obtaining eyeglasses, hearing aids and dentures.

Some resources in the community are picking up where state or federal services leave off, such as a vision care program offered by Pearle Vision. Many other related services are needed.

One client, we’ll call her Crystal, is a person with manic depression who lives in Bangor. In the past, Crystal had assistance paying her rent, and Medicare covered medical expenses during hospital stays.

Crystal also received Social Security benefits. However, since she married about a year ago, Social Security payments have slowed even though Crystal and her new husband still need the aid. Crystal fights for what she needs and files every 60 days for continued coverage.

As Kingsbury commented, it seems odd for the Social Security system to almost condemn marriage, which often serves as useful support in living and dealing successfully with mental illness.

This is where Kingsbury’s role as a case manager comes in. She helps her clients work within the system to get what they need.

I had the opportunity to observe these and a number of other factors in Crystal’s life that require a lot of her time and emotional energy. Even so, Crystal seems to maintain a positive outlook.

Aside from the financial aspects, Kingsbury has the opportunity to work with Crystal on tactics to help her overcome other problem areas in her life. For example, Kingsbury and Crystal have developed ways to help Crystal cope with stress, and to use interpersonal skills to help improve her relationship with her husband.

Crystal is making progress with getting her life in order. While the majority of her improvement may be attributed to Crystal herself, her close professional relationship with Kingsbury is an invaluable resource.

After leaving Crystal’s apartment, Kingsbury called her next client, we’ll call her Jackie, to let her know we were coming to visit.

Jackie lives in a supported living environment – a group of private apartments rented to members of the community with mental illness or who have related needs. The building is staffed 24 hours a day in case of emergency, conflict or other needs of the residents.

Kingsbury seems more involved in Jackie’s life. As Jackie’s payee, she not only controls payment of bills, but also regulates Jackie’s spending money.

Kingsbury takes Jackie wherever she needs to go to run errands and, because Jackie is diabetic, they work together to find healthy food for Jackie’s diet.

During my visit, Jackie also showed me some of her “homework.” As part of her treatment, Jackie works on skills to help her deal more effectively with life’s problems.

Kingsbury asked Jackie specific questions about treatment and other personal issues. Though I was an outsider witnessing the interaction, the strength of the relationship was evident. Kingsbury genuinely cares about how Jackie is getting along with her neighbors, and what steps Jackie has taken to strengthen her interpersonal skills.

Kingsbury’s professional relationships stay professional, but she obviously cares about the well-being of her clients.

After a full day of clients, Kingsbury said there were some stereotypes surrounding her clients and her career that need to be corrected.

First, she asked, “How are people in the community supposed to overcome challenges in their lives if people are unwilling to help? People shouldn’t be afraid of them [the people using community health services]. They’re bright enough to say, ‘I need help.'”

Help is precisely what Beth Kingsbury provides. She serves as a positive role model to people who may never have had one and teaches them to use – not abuse – the services available to them through the state and the federal governments.

Kingsbury educates her clients, not only on how to receive services, but how to live independently. Though her days are long and her patience is occasionally tried, she is a constant source of guidance and strength.

In turn, seeing clients is a rewarding experience for her. As she said during one of our meetings, “You know – I really like what I do.”

Sarah Dean was a senior at the University of Maine at Orono this year. She graduated Saturday with a bachelor of arts degree in psychology and a minor in rhetoric and writing.