I’m going to compare services to a domestic violence situation. How does it work?
Some of this done by individual employees who are:
- Toxic, with a savior complex (they “resign” and job hop to different organizations and are never held accountable. Legally there's not much that can be done)
- Bitter from burnout and can't take a break.
- Bitter from wanting to help but finding out they don’t like the work/aren’t good at it.
- Some of it is done by other clients. Classic bullying, targeting someone who stands out or has low self esteem.
- Sometimes, the abuse happens to everyone equally. They all have to interact with one bad employee. Or the abuse is systemic- a bad practice applies to the entire program, county, or even federal law.
This list is a combination of the cycle of domestic violence and the cycle of narcissistic abuse. The dynamics are slightly different. I have combined both because in cases where it is not possible for a person to leave a narcissistic relationship, it becomes just as deadly as domestic violence. All of these thing can happen in abusive interpersonal relationships. I’m going to highlight things that don’t happen in social services, and provide explanations for how it happens in services. Hoovering
Street outreach. Because a lot of abuse is systemic, this is not intentional.
Love bombing
Future faking
Happens at intakes. About half the services they say they provide, they don’t provide. The reasons vary. No one is holding them accountable, contracted partners backed out, legal issues, staff is overwhelmed, lack of success or interest, etc. A toxic staff member will do this intentionally.
Physical abuse
Bullying from other clients. In hospitals, restraining someone after doing nothing to prevent a crisis or de-escalate a crisis.
Physical neglect
Happens a lot at assisted living facilities.
Medical abuse
Medical malpractice in hospitals. Medicating someone after doing nothing to prevent a crisis or de-escalate a crisis. Because hospitals hire anyone, zero mental health training. Hospital psychiatrists prescribing intense medications or providing intense treatment without enough consideration due to case loads being too high. Federal law requires some mental health services to force people to take psychiatric medication to get therapy even if they don’t need medication.
Medical neglect
In the psychiatric hospital, not treating physical health problems. Going off medication because of poor management in hospitals and services. Caused by bad practices and policies.
Financial abuse
Surprise billing for homeless services funded by medi-cal. It’s a state issue.
Economic abuse
Services demand so much time and fighting bureaucracy that it prevents people from working, holding a job, or going to school. Federally, there are income caps to use services that prevent people from getting promotions and high-earning jobs.
Sexual abuse or harrassment
All services are a workplace, what makes it different than others is that people live at this workplace. This is equally as common as sexual abuse and harrassment in workplaces. Unless something has changed recently- in San Diego, nothing happens without evidence, including working on preventative measures. Both a program issue and county issue.
Violation of spiritual boundaries
Forcing clients to attend church services or bible study groups. Program-level issue.
Violation of emotional boundaries
Programs and the county require staff to ask clients about traumatic experiences to collect data. On occasion, there is a toxic staff member that maliciously asks for extremely detailed information and draws the process out as long as possible. Many staff don’t do this. (Unrelated note: the county decided not do an initiative to get a large number of homeless people housed because they would have the data to prove people were housed)
Gaslighting
The US has a lot of capitalist, pull-yourself-by-the-bootstrap propaganda. In addition to being brainwashed, some people have a hard time doing emotional labor. Therefore, many staff members are psychologically incapable of understanding disability issues, how a service has failed a client because of systemic issues, and legitimately difficult or hopeless situations. A common way people are pushed out of services they are entitled to is because staff gaslight them. Toxic positivity later turns into victim blaming.
Justifying excuses
Gift giving
Isolation
People are not allowed to get housing services with their partner or pet. People might have street siblings or a street family, and they can’t get services without being separated. Sometimes emotional support animals are allowed.
Minimizing
Denial
Blame-shifting
Not allowing disability accommodations
Control with arbitrary rules.
Sometimes staff invent arbitrary rules that the organization does not actually have in order to use entertainment the program provides for themselves instead of the client, punish a client or even kick them out of a program. Happens in both social services and hospitals.
Intimidation
The occasion toxic staff member does this.
Coercion/ threats
The occasional toxic staff member does this.
Explosion
Apologies
Honeymoon
The domestic violence cycle of abuse.
I’ll start off by saying in social services this is a problem with the structure of the program, not the staff. The services never provided the support the person needed, which means as time goes on the person in an increasingly bad situation. Despite this, any program that can be aged out of or has a time limit usually weans people off of services. This creates a situation that resembles domestic violence where the more time that passes, the more the person is harmed, and the less benefit they get from the relationship. This specifically happens with clients who are seeking services because they don’t have support, which is a common demographic.
In the healthcare system it is often the staff unfortunately. Not necessarily the same ones. Western medicine is incredibly violent. The more medical trauma you have, whether that trauma be physical or mental, the sicker you get. The sicker you get, the less doctors want to help you. They get frustrated you won’t fully recover, but getting no help drastically reduces quality of life.
Forced codependence
This is helping someone but not wanting them to get better; preventing them from being independent. Services do not provide enough support in order to successfully leave. This is because of outdated federal laws, and the attitudes that influence federal laws and funding such as the two false beliefs that there are a large number of people who take advantage of services & if services are difficult to access it will motivate them to work. This often means that once someone gets on services, they are either so broken physically/medically that they can not be independent, or if they try to be independent they don’t have the baby steps to each it and instead are cut off cold-turkey, leading to failure.
Discarding-
If they feel they can’t help you, they ignore you. It’s normal for people to be in situations where they can not be helped, medically or environmentally. They still deserve services that can improve their quality of life even if they won’t recover.
Strings-Attached
Most of the strings I’ve listed. Healthy help is unconditional with healthy boundaries.
Preventing you from leaving
Federal law requires some programs to force clients to not leave the program, and if they leave they are not allowed to come back for months. This is a serious problem for programs that do not provide beds, such as safe parking lots and camp sites, where a person may want or need to temporarily couch surf or stay somewhere indoors with an actual bed.
On occasion, a person will be hospitalized and placed on a hold in a way that is malicious and has nothing to do with safety. It happens less than in domestic violence situations, but still happens.
Obsession with doing things in a technically legal way, expect in private the law doesn’t apply
I won’t go into detail. It was just funny there was an obsession with covid masks when they were doing things that were way more harmful and less legal than covid precautions.
Filming without consent while preventing collection of evidence.
Psychiatric hospitals have security cameras in the hospital wings. They use HIPAA as an excuse to not turn over footage of medical malpractice.
Using mental health treatment to cover up abuse.
Mental healthcare
Phrases:
“Beggars can’t be choosers!”
“This is free. You should be grateful.”
“If you don’t like it you can leave.”
“You don’t have options.”
“You can trust me. I promise” (Some staff who have good intentions say this. But some of the staff that say it have bad intentions.)
“I’ll make sure I do that.” *Never happens*
“I promise it won’t happen again” *Happens*
“This is just how it is." (They think that you being treated right or acting legally is too high of an expectation.)
Comments