Social Work in the Public Eye (May 2012)

Natasha HoustonNatasha Houston, a social worker certified in military sexual trauma, was one of the first people former U.S. Marine Paul Schinker went to for treatment of MST, after three decades of suffering, according to an article in the Billings Gazette.

The article says Schinker came from an abusive and dysfunctional home and he saw the Marine Corps as a way to escape and create a new life that was as far away as possible from his Montana hometown. Once in the Marines, Schinker excelled in boot camp training and graduated in the top five of his group, after which he was deployed to Okinawa, Japan, on assignment.

It was during his deployment that Schinker became the target of a gang rape by his fellow Marines, and the experience left him traumatized and suicidal.

“Here I am, I’ve got the world by the tail,” Schinker says in the article. “I’m in the United States Marine Corps. I’m in a group of elite people. I’m in a brotherhood. This is a big family. We’re all there to protect and watch out for each other. This is what it’s about.”

Schinker underwent a brief round of treatment in the military psychiatric ward after the rape, and upon returning to his deployment he became the target of bullying and stigmatization by his fellow Marines. By choice, he left the Marine Corps on an honorable discharge, the article says.

After returning to the United States, Schinker lived with the memory of the rape for three decades before seeking help at the Veterans Center in Billings, Mont., where he met Houston.

“He was suicidal, frantic,” Houston says in the article, speaking with Schinker’s permission. “He was struggling with basic needs. … Schinker was trying to make himself into something new and different. I’ve seen his military records. He was a perfect soldier. I think his fellow Marines were jealous of him.”

The article says that after meeting with Houston, Schinker sought treatment in Bay Pines, Fla., at an acute psychiatric unit specializing in MST. Schinker acknowledges in the article that he still deals with symptoms of MST and post-traumatic stress every day. He now lives in Billings with his wife, Jennie.

Januari LeoThe Affordable Care Act could affect the way many Texans living with HIV and AIDS receive care, according to KUHF Houston. An article says that a provision of the Affordable Care Act could shift more low-income patients in Texas to Medicaid.

Januari Leo, an HIV health care advocate who works at Community Health Services in Houston, is concerned that the shift could prevent some patients from receiving the care they need. The two federally funded programs in Texas that serve low-income, uninsured Texans with HIV/AIDS are Medicaid and the Ryan White program, the article says, and more than twice the number of patients are on Ryan White due to the state’s strict Medicaid eligibility requirements.

In 2014, a provision in the ACA will require Ryan White patients to shift to Medicaid. This future change concerns Leo, according to the article, as tens of thousands of people will suddenly have to move from one program to another. New guidelines could make it difficult for some people to get the same care, she says.

“I want this transition to be smooth,” Leo says in the article. “I want people to remain in care. I want service organizations to understand the gravity of this situation, and that they have to begin acting now.”

Some clinics balk at the idea of accepting Medicaid clients, Leo says, because the reimbursement rates are lower.

“They’re not going to be able to keep up with the cost of seeing patients,” she says. “So patients are going to have to go elsewhere to get their services.”

Leo says she is working with other advocates to help patients prepare for the shift, before the changes of the ACA go into effect a few years from now. In addition, the article says the group is speaking to state agencies, including health and human services, to help facilitate the transition.

“We’re getting that they are working on it — internally, steps are being taken,” Leo says. “As with any government department, everything’s kind of hush-hush, and it’s very hard to get definite answers, but they are working on it.”

Mark GorkinNASW member Mark Gorkin says a stress-fueled burnout isn’t necessarily a factor of everyday life, but a health condition that affects job performance, quality of life and the human psyche.

“Today’s world is 24/7, wired and always on, and often cycling between upgrading and reorganizing - if not outsourcing and downsizing. And as company mantras become ‘do more with less,’ it’s no surprise that more and more people are struggling with job stress and burnout,” Gorkin says in an online interview on Blog Talk Radio.

Gorkin, LCSW, specializes in treating patients with chronic stress. He says in the interview that it’s important to recognize burnout when it happens and then take the steps to effectively treat and alter the condition.

“The classic setup for burnout is a professional or personal situation that places high ongoing demands and responsibilities upon you while restricting your sense of control, autonomy and/or authority,” Gorkin says.

Burnout is a gradual process by which a person detaches from work and other significant roles and relationships in response to excessive and prolonged stress and mental, physical and emotional strain, he says. Gorkin says there are four stages to look for to determine burnout: physical, mental and emotional exhaustion; shame and doubt; cynicism and callousness; and a sense of failure, helplessness and crisis.

Using a system Gorkin calls the 4 R’s can help in burnout recovery.

“Running, reading, retreating and writing are the principles that I applied to my own personal burnout,” he says. “Doing some brisk exercise for 30-40 minutes will provide a tangible sense of control and accomplishment; turning to humorous novels or cartoon books to add some absurdity to your perspective; taking time to reflect; and taking the time to express and analyze your emotions through writing provides a stress relieving anchor.”

Although Gorkin says burnout evokes an experience of loss - from the loss of control or abandoning a cherished goal - to a sense of helplessness and hopelessness, wrestling with that loss often yields renewed energy and transitional possibilities.

For more stress relief tips, visit Gorkin’s website at The Stress Doc.