A look behind the scenes

The Story of Karien: A Crisis Intervention for Peace, Safety and Hope

On a weekday morning, I am just stepping into the building. The smell of coffee can be smelled as I walk past the coffee machine. I set my stuff down by the computer where I think I’ll take a seat that day. I still had plenty of administrative things to do for my side duties that I am responsible for within CIT. My colleague introduces someone from “Safe Home” Rotterdam who is working a day shift. After we have had the handover from the night shift, a phone call comes in. This changes the morning and we can get right to work.

Case study
A social work supervisor calls the CIT. The case is recited. This is a 46-year-old Karien with mild intellectual disabilities and autistic traits. Also, Karien is wandering and has no fixed abode at the moment, but comes to work every day neatly. His counselor advised him to go to the homeless shelter. However, Karien herself does not manage to call the night shelter at 9 p.m., and so she sleeps on the street. Her supervisor calls because Karien is currently making suicidal statements and they are closed for 5 days after today, so she would be on the street for 5 days. Her supervisor worries and fears things will not work out. Karien is known to have diabetes; she worries about this too.

Because the case revolves around suicide, we went to the scene to check on Karien. We are going to see what Karien needs and make an assessment of her suicidality. Here we walk through the suicide protocol for this. When we have a better understanding of this, we can contact the mental health department. Do you have suicidal thoughts? Call 113 or go to the website www.113.nl

We engage in conversation with Karien. The conversation reveals that Karien misses her mother terribly. Her mother arranged everything for Karien, he says. Karien tells us that her mother passed away several months ago. Last week Karien got into an argument with her father and Karien herself decided to leave the house where she lived with his parents.

Karien points out that he doesn’t necessarily want to kill himself, but that it’s all pointless this way either. Karien indicates that it is all a bit much for him. His would like peace and help to get everything on track.

As I ask Karien questions about her diabetes, we gradually find out that Karien has been pricking with the same needle for 5 days and also does not have a measuring device to measure her blood sugar levels. Karien is good at telling me how things are supposed to be in a normal situation, but doesn’t seem to be able to make the translation to practice. Karien doesn’t oversee it all and doesn’t know how to get it resolved. But one thing was certain, going back to her father was not an option, Karien indicated.

As the conversation progresses, Karien tells us that she has not been able to shower herself since Sunday and indicates that she has run out of clean clothes. Karien still had a little money, she indicated, and from this she ate sausage rolls and drank Coke. In this way, she kept her blood sugar levels right by feel.

Coordinate crisis spot
After talking with my colleague Amber in the office by phone and considering the above situation, together we came to the conclusion to facilitate a crisis spot for her on Karien’s approval. From this point on, Amber goes into action by phone in the background and climbs into the phone with one of our chain partners, “Amarant”(www.amarant.nl).

Karien has diabetes. Since Karien has not measured his blood sugar for days, it is important to check it. Perhaps certain behavior stems from Karien’s blood sugar levels, or Karien is in mortal danger. We checked this in advance with a doctor who knew the colleague at VT (thanks for the help/thinking). With Karien’s permission, her family doctor was called and I explained the situation. Karien was able to go directly half an hour later. We immediately drove Karien to the family doctor. Blood sugar monitoring showed that it was very high. Together with the family doctor, we then looked at what was needed to get it back down.

Crisis spot
In the background, my colleague has been in contact with the Amarant Foundation. They had a suitable place for karien where she could stay for the next 2 weeks. At this location, the staff is trained for diabetes and can be well attuned to the needs of karien. When karien heard this, a burden visibly fell from his shoulders. karien was very happy and emotional.

After the doctor’s visit, we went to pick up Karien’s things at work. We then drove on to the housing group where Karien is being temporarily taken care of for the “crisis.”

Amarant helps people like you, with an intellectual disability, autism or brain injury, take advantage of your abilities. Your well-being and happiness are central to this.

Because the CIT is an integral team within Hart van Brabant, this sometimes makes switching gears in situations like the above easier. I myself have been seconded from “Amarant” to the CIT. As I have been working within this organization for a long time, I therefore knew that Amarant would be the most suitable organization for Kees.

The Crisis Intervention Team consists of professionals from Jeugdbescherming Brabant, Veilig Thuis, GGZ Breburg, Amarant Groep and Sterk Huis. Together they have the knowledge to properly assess the situation. The goal is to provide peace and safety as soon as possible, and if necessary, shelter or other support is considered. The Crisis Intervention Team operates in the Heart of Brabant region and can be reached 24/7 at 0800-8013.

Because Karien was no longer overseeing it all, she left the direction completely to us that day. Karien trusted that she was in good hands and expressed her delight that a solution could be provided. When we took Karien to her temporary sleeping place and made the transfer to Amarant, we noticed that Karien became emotional. Karien thanked us again for the good care and burst into tears. Fortunately, Karien is in good hands. As we closed the door, I too blinked away a tear. After all, we all remain human beings with feelings.

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