Mental Health in Maryland

1. Outpatient Mental Health Clinics (OMHC)

Outpatient mental health clinics provide therapy, counseling, medication management, social skills teaching, and case management services to individuals with severe and chronic mental health problems. Career prospects available in OMHC include:

Therapists and Counselors: New regulations require therapists and counselors in OMHC to have a minimum of a Masters degree and a license (such as LGSW, LCSW, LCSW-C, LGPC, LCPC, RNC, APRN/PMHN) in nursing, social work, psychology, counseling, or psychiatric rehabilitation. Also, an RN without a Masters degree but with an RNC from ANCC can be employed as a therapist. Salaries are very attractive.

2. Psychiatric Rehabilitation Programs (PRP)

PRP programs are an extension of the services provided to the patient in the OMHC. A PRP may stand alone or be an additional service to an OMHC. The purpose of PRP is to promote the rehabilitation, integration and improved quality of life for the patient at home, school, work and community. It aims at helping the patient to function at his or her optimum best in life. The counseling can be done at the Program office (onsite) or at the patient’s home (offsite). PRP counseling could be about a wide range of topics, including anger management skills, social skills, assertiveness skills, medication compliance, coping with symptoms, managing peer pressure, taking a bus, determining bus route, drug and alcohol, gang prevention, sex education, STD education, accessing community resources such as food stamps, affordable housing, bus pass, ID card, driver’s license, job search, preparing for job interview, keeping a job, improving attention in school, completing homework and school projects, respect of authority, etc.

Even though a mere one-year work experience in a mental health setting or having an AA degree qualifies one to be a PRP counselor, PRP programs prefer to employ persons with a BS degree in any health or mental health related field such as nursing, social work, counseling, psychology and rehabilitation. PRP counselors are usually paid $14 or more per counseling session. Each client receives 2 to 8 counseling sessions per month.

3. Expanded School-Based Mental Health (ESBMH)

In addition to the school clinic, some schools also have an ESBMH clinic. A therapist assigned from an OMHC manages each of such clinics. Apart from providing therapy to troubled kids sent to the therapist’s office from the class or principal’s office, the therapist also serve as a resource person to the school staff regarding particular children, issues or topics related to mental health.

4. Crisis Response Programs (BCRI, BCARS)

Mental health professionals are also needed in crisis centers where services are provided for anyone in mental health crisis. The two main centers in Baltimore are Baltimore Crisis Response, Inc. (BCRI) and Baltimore Child and Adolescent Response System (BCARS). For employment inquiries, please call 410-433-5255. There are positions that do not need a Masters degree.

Sociology of Mental Illness

The more one reads about mental illness, sees or interacts with some of the mentally challenged, or those whom society considers as mentally ill, the more the question about the reality of the problem comes to the mind. Also the more the question crops up the harder it is to arrive at a conclusion regarding what mental illness really is. An attempt to define mental illness helps to expose the ambiguity and the futility involved. This fact guided the thought of Mechanic (1980) in his book, “Mental Health and Social Policy.” For example, Webster’s Third New International dictionary defines insanity as, “such unsoundness of mind or lack of understanding as prevents one from having a mental capacity to enter into a particular relationship, status or transaction or as excuses one from criminal and civil responsibilities.” One can infer from this definition that the law has been assigned the role of determining what behaviours and who fits into this category. Of course, the law is manmade and influenced by the types of behaviours identified, compiled and classified as “unsoundness of mind or lack of understanding.” In short, the law can only ruminate on what is already in existence. Thus, the law in response to the evidence adduced before fits them into this predetermined categories. The point here is that the law, is culturally determined by the society or the social structure. That is, the social structure, in one way or the other determines who is mentally ill, cured, and who should continue to bear the label. Another question is how does the law conclude that one person is sane while the other is not? This point needs some clarification. That the social structure determines what falls into the category of mental illness is a source of concern because it introduces subjectivity into the meaning, definition and interpretation given to the “behaviours” in question. Let us assume that people within the social structure know what the normal behaviours that are expected of their members are. We can garner this from the fact that we all operate within the boundary of the “assumptive world.” The concept “assumptive world” relates to the fact that our behaviours are continuously being evaluated by others and by ourselves - relative to others. That means that the reactions (real or perceived) of the people to our behaviour(s) will determine/influence how we feel about ourselves, the nature of the world around us, our ability to predict what to expect from others and the resultant effect of our actions (Frank, 1974:27-29). The factor that should be noted is that the assumptive world varies and depends on the culture. For example, it is assumed that shoes are to be worn on the feet, not on the palms. Again, the type of shoes worn depends on the setting — bathroom slippers (depending on the social class) are not expected to be worn to formal functions. Eye contact should be made while discussing with somebody not for one to continue to stare at the other’s ears — the Yoruba culture makes a further restriction, it does not expect a child to maintain eye contact with an adult. This shows that even though these norms are not codified or written into law, they exist and people through socialization are expected to acquire/learn them in conjunction with the appropriate cues. In fact, most of the times we do not know that some of them exist until we have violated them - but we are always prepared to make appropriate amends. Despite this, we are subjected to and we subject ourselves to the reactions of others as to whether our behaviours are positively or negatively responded to. A positive reaction could mean that the behaviour is acceptable within the context in which it occurs and we can thus afford to repeat it. For instance, in some churches, a spiritualist who goes into trance while devouring the wrong doings of others, or while claiming to have seen God if praised for the revelations made is apt to repeat the behaviour following the prescribed cue. However with the interpretation of the Bible today, particularly by the Pentecostal Churches, such persons could be ostracized or marked out for deliverance — for according to this faith or new interpretation, no human being (because of sin) can ever see God but could see His son Jesus Christ. Also, going into trance is not the order of the day but speaking in tongue is the current norm. This being the case, it becomes risky or too expensive of behaviour for any member to repeat the unmerited. The above reinforces the view that a particular behavior in different setting will elicit different reactions and responses from people as dictated by cultural interpretations, definitions and understanding (Frank, 1974; Mechanic, 1980; Henslin, 2002). These definitions and responses are also influenced by factors such as the person involved his/her personality, and the where and when of the behaviour. A good example is an incident that occurred while a hungry Nigerian musician who was in a foreign country was “bowling” down some “akpu/fufu” (a Nigerian meal made from cassava) at a station. Somebody called the police claiming that a Blackman was trying to commit suicide. In summary, all of the above reactions exert influence on the actors and the observers and the decision as to whether to continue with the specified behaviour or not. The key factor is for the person to know the cues and to respond appropriately, else, it draws unwanted attention.