The writer is a clinical social worker at the Substance Abuse Treatment Unit of Connecticut Mental Health Center (CMHC). She wrote this article as part of the Storytelling Challenge at CMHC in celebration of National Social Work Month.
Years ago, I was working at a residential facility for individuals struggling with addiction. The majority of these clients were mandated by the Department of Corrections or Court Support Services Division. Only a handful had enrolled voluntarily. At the time, I had just started working as a clinical case manager. I had a caseload of about 40 clients.
Because all of my clients were living at the program, I had the opportunity to get to know them pretty well. There were those who were labeled “problematic,” one being a young man in his early 20’s who had been sent to the program by the court.
During his time in treatment, this young man had made a point of sharing that he was only in the program because he didn’t want to go to jail. He would fall asleep in groups and typically was placed on restrictions because he'd been caught smoking in his room. He would get into fights with peers and at times be confrontational with staff. At one point, he was accused of bringing drugs into the facility and selling these drugs to other clients.
Eventually, this young man was discharged from the program.
Although I was aware of his behaviors and the accusations against him—and he was, I will admit, a difficult individual to work with—there was something about him that made me advocate for him to stay.
It’s hard to explain what it was exactly. He was young and full of potential. When we met individually and he didn’t have to put up his “tough guy” act, he was down to earth and funny and even allowed himself to be vulnerable. He shared his story with me, explaining how he had a decent upbringing but had always been considered the black sheep of the family.
He’d been a problem at school. When he started using drugs and getting into legal trouble, his family eventually turned their backs on him. He was a young adult still finding his way in life—like many young adults we know who have made mistakes. This young man was being discharged from the program for doing the only thing he knew how to do. He was getting the same reaction from the program that he had received in the past, from his teachers and from his family. He was being discharged for the very reason he'd been placed in treatment in the first place.
I understood the program was looking out for the safety and well-being of the clients he had placed at risk. However, he was at risk too. Were we really making the best decision by letting him go?
Months later I was surprised when I received a call from him. He was crying on the phone. He literally begged me to help him get back into the program because, as he explained to me, “Maggie, if I stay out here I’m going to die. I know I’m going to die out here…”
I reassured him I would try my best but told him I couldn’t guarantee anything. After hanging up with him I went to one of the administrators and informed her of the call I had received. She told me no. I continued to plead with her to take him back. After all, this time he was the one asking for help. She remained firm in her decision and therefore I had to tell him we weren’t going to accept him back into the program.
Months later, I was making my way into the building when news reached me that this young man had died. Apparently he had been in the middle of committing a bank robbery when the police had arrived on the scene. He’d been shot and killed before making his escape.
I’m still affected by this memory. I can’t blame anyone, really. He made his choices and unfortunately suffered the consequences. However, I do wonder, “What if?”
What if he had been readmitted to our program? What if this moment had led him to a life of recovery? Perhaps he wouldn’t have committed the bank robbery. Perhaps he wouldn’t have been shot and killed. I’ll never know the answer to these questions but the question I pose to us now is, “When exactly do we close the door on a client? When do we stop holding hope for these individuals who have lost hope, if they ever had it in the first place?”
I believe people need second chances. People sometimes need third, fourth and fifth chances. I would never want anyone to lose hope in me if I were to be in a place as hopeless as it must feel to any person struggling with addiction or chronic mental illness. Sure, people make their choices, but who are we to determine when there’s no more hope for change? We can’t make miracles happen but I believe we can hold hope for our clients.
In some cases, hope is the best medicine we can give.