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On August 29, 2016, Assistant Professor Michelle Lilly from NIU’s Department of Psychology gave a presentation to our HAC class on “Working with Clients Suffering from PTSD and Mental Illness.” She offered a lot of valuable information concerning this topic and shared some of her experiences throughout her career. In addition to her presentation, our class also read two articles concerning PTSD [post-traumatic stress disorder] and mental illness. Both the presentation and the readings were enlightening and opened my eyes to my own misconceptions concerning the topic.
Going into the presentation, I was somewhat prepared because the readings had broken down the basics of what qualifies as PTSD. However before reading the articles, I was under the impression that PTSD was mainly used to refer to symptoms experienced by war veterans or people in similar situations. During Professor Lilly’s presentation, she gave a little more insight on the qualifications for PTSD. One of the things she spoke about that surprised me, but also made a lot of sense, was that the rate of PTSD is high among women.
She further explained that a lot of the high rates of PTSD in women are due to them being sexually abused at some point in their lives. Hearing this really made me sad because I began to think of a woman whom I personally know that has experienced sexual abuse. I began to realize that she fit all of the symptoms of PTSD. She was sexually abused as a child, and she always seemed to end up with guys that were either abusive or had a traumatic background as well. In addition, I realized that her PTSD had been triggered after she had her daughter. Recalling all of this information during the presentation made me sad because I realized that this entire time, I never realized she was suffering from PTSD. I always wondered why all of a sudden she was having all of these feelings of depression when in the past, she had always been good. I also knew that the birth of her daughter had triggered thoughts from her childhood, but I never really quite looked at it as PTSD.
I believe that my experience of being misinformed about PTSD is what caused me to feel sad. In addition, I come from a background where mental illness is not looked into. A lot of times mental illness is looked at as weakness unless you reach the point where you need to be assisted. For example, a person diagnosed as bipolar would be looked at as not having self-control or someone making excuses. In fact, that person would likely be labeled as moody and not able to handle adversity. As a result, we are taught to be strong and learn how to accept adversity because it is a part of life.
Although, I was always supportive of this woman, I never quite understood why she would react like she would. Professor Lilly’s presentation explained it all. It explained that some people with PTSD sometimes snap at small things because they don’t comprehend that they are small. This was my experience with this woman. I never understood why she would overreact to almost everything I considered to be small. However, I was surprised that I had already used some of the methods utilized to help communicate with people suffering from PTSD.
I can apply what I learned by taking into considerations some of the ways to recognize PTSD and use the methods taught during the presentation to deal with clients who may have PTSD. In addition, the presentation was useful in my personal life. For example, I called the woman who suffered from PTSD and spoke with her about the information I had learned and asked her if she knew anything about it. She informed me that she had in fact been diagnosed with PTSD but was not able to continue to attend counseling due to financial reasons. However, I spoke with her a month ago and she is now seeing her counselor again. I am happy that I learned this information because I was able to understand a friend on a much deeper level.
Today I visited my client with my supervisor and a Spanish interpreter so I could meet him and update him on the progress of his case. I introduced myself to my client and shook his hand. Via the interpreter, I explained that I was the new student attorney assigned to his case and how I was in the process of collecting his updated medical information to send to Social Security. I told him that part of how I planned to accomplish this was to schedule a meeting with his social worker. I explained that once I received all of the needed information, I would send a memorandum about his case to Social Security with the goal of having his case reviewed and approved without needing to wait for a hearing. Acknowledging his frustration with the rotation of student attorneys on his case each semester, I told him that I hoped that I would be the last student attorney he would have to see. I asked him if he had any questions. He did not but stated that he wanted to be present at the meeting with his social worker and that he wanted to be kept updated about the progress of his case. I assured him that both of these things would happen. He thanked us for meeting with him, and I thanked him for speaking with us. I shook his hand one more time and told him that it was nice to meet him.
I was not sure what to expect as I was aware that sometimes my client was very lucid and cooperative while at other times, he could be irritable and confused. Colleen told me that the last time she had seen him, he did not know who she was. Also, the way that the clinic is structured, student attorneys are assigned to a case for timeframes ranging anywhere from a summer to a whole school year. The amount of time that a student attorney is assigned to a case depends on how long they choose to stay enrolled in the clinic. Given that the clinic has been working on my client’s case for about a year, he has had three student attorneys before me, which I knew frustrated him. Because of these frustrations and his fluctuating memory and mood, I was concerned about how he would respond to me. I was relieved that he responded to me favorably for his peace of mind and for mine as well. I was proud that I still knew how to apply the people skills I had acquired from past work experience to put him at ease. It was rewarding to establish some trust with him and to give him a status report on his case that he appeared to be satisfied with.
Based on this meeting, I will strive to be diligent in keeping my client informed of the status of his case as it progresses. His frustration with having more than one student attorney gives me extra incentive to not only complete my memorandum in a timely manner but also to make sure that it provides enough strong details to encourage Social Security to review and approve his case before a hearing date.
During both semesters of my 3L year, I was a student attorney at the Health Advocacy Clinic in Aurora and I have to say that being at the HAC was one of the best parts of law school because I could finally put into practice everything I had learned. I had my own clients and everything! My guided tour of Hesed House, the second largest homeless shelter in Illinois, was also the first time I had ever stepped foot inside a homeless shelter. Parts of my experience at the HAC were heart-wrenching, but upon later reflection (which is critical to the clinical experience), I found that each day was satisfying in its own right.
So when I learned that an AmeriCorps VISTA position opened up at the HAC, I leapt at the chance. The period between finishing studying for the bar exam and landing your first job is beyond stressful even though you suddenly have tons of time on your hands. The fact that I knew I’d be returning to the HAC to work in a community I had become familiar with helped the transition quite a bit.
Being a VISTA here will certainly pose some interesting challenges because I am no longer working directly with clients, but have a more behind-the-scenes role. Also, a VISTA’s pay is purposely limited to be at or near the poverty line. This will allow me to better understand and appreciate the work that the HAC does for its homeless clients. How better to understand your client’s financial instability than to be in a similar position? Granted, I still have my own apartment to come home to every night, which is a stark difference between me and the clients the HAC serves, but the financial limitations of being a VISTA will undoubtedly further teach me humility, a value that is key to a legal career in public service.
I am one week into my year of service and am already impressed by how much work needs to be done so the law students can have a beneficial clinic experience and to increase the capacity of the clinic, which is one of my main focuses. I continue to learn something new every day and the environment here provides tons of opportunity to further hone my community outreach, interviewing, and public relations skills.
I am beyond thrilled to be back at the HAC where, just like when I was a student attorney here, I can leave here knowing that the work being done by not just the HAC, but the Hesed House and Aunt Martha’s Health Care staff, is invaluable and extremely important to the low-income and homeless residents of Kane County.
Class of 2016
The spring semester 2016 is coming to a close for the student attorneys at Northern Illinois University College of Law’s Health Advocacy Clinic (“HAC”). As this semester quickly comes to an end, I spent some time reflecting on my time at HAC.
During the semester, we are required to complete Critical Experience Assessments (“CEAs”) that act as an outlet for us, as students, to process the situations, people, and/or experiences we come across. Recently, I looked back at the first CEA I wrote, after my first week working with Hesed House, Aunt Martha’s and HAC and I wanted to share a portion of it with you.
“This CEA, I want to talk about my first week at the HAC. Specifically, my second day there – which included a tour of Hesed House. The tour started with a meeting in the Hesed House library, and then we went on a guided tour. During the tour we saw the PADS sleeping area, the locker section, the cafeteria, kitchen, and the Transitional Living Community (TLC) where many children stay at Hesed House. As we walked through, we passed by many of the guests – female and male.
That morning, getting ready for my second day at the clinic, I was mentally preparing myself to be very aware and conscious of what the tour might bring. I had expected that I would not be too surprised by what I saw – thinking that because of past experiences (such as volunteering at soup kitchens, working with homeless students at a prior internship, etc.) I would have been desensitized to the “shock” effect that a homeless shelter often has on people. During the tour, I found myself not desensitized as I had anticipated. Rather, I found myself very emotional. At one point I actually had to tell myself to hold back tears. That point came when we were in the “bright room” in TLC.
The “bright room” is a room intended for children to essentially gain a sense of what we consider “normalcy.” Our guide told us stories of some guests she had interactions with. After hearing her stories, I felt a sense of being overwhelmed combined with humbleness. My heart was broken for the children of Hesed House that were growing up calling the “bright room,” one small room, their place to grasp a sense of normalcy. I was overwhelmed by the sad truth that there is so much that needs to be done for the homeless community, and that people are often afraid of the culture or just repelled by it.
At the same time, I was humbled. I saw the mats that are the “beds” for the guests to sleep on. I saw the small lockers – where the guests are able to keep all their worldly possessions, if any. I saw the laundry room and the kitchen. During that tour, I was able to see what it might be like to be homeless, in very small sense. After hearing the story from our guide about a male guest – who after receiving a new pair of shoes, cleaned his old ones to give to someone else who could use them – I was so humbled. Humbled, but also ashamed of all the petty and selfish things I have complained about. I thought to myself – how fortunate am I to have more than one pair of shoes, to have clean clothes and a whole closet, a bed that I call my own, a kitchen for my family to use, and a warm house to live in and call mine.”
After writing this CEA, I really started to focus on why I had such an emotional response and where it had come from. My conclusion, after now taking part in the HAC for a full semester, was selfishness. Before I had started working at the HAC, I was focused on what I needed to do to get through law school. My plans revolved around me, my schedule revolved around me, my choices revolved around me. I had been so caught up in pursuing my career plans, that essentially I lost sight of the fact that the world does not revolve around me, and that there are so many out there who need help.
The HAC has constantly reminded me this semester to not lose sight of why I started law school. I came into law school passionate, wanting to make a difference in our world, but then lost sight of it as I became bogged down with school work, deadlines, a busy schedule, and grades. Being able to have the opportunity to work with the HAC, has not only pushed me to keep pursuing my dreams of becoming a lawyer but has also renewed my vision. The work we have done this semester with the guests of Hesed House and the patients from Aunt Martha’s has reset my focus. There is still so much that needs to be done in our communities, but it can be done when we partner together and strive to make this world a better place for one another.
Perspective changes everything. A statement that I think most people are aware of but can never fully appreciate without really seeing things from a different perspective. One of the biggest lessons that I have learned since working at the Health Advocacy Clinic is what a “break” in life can really mean. For me, from my perspective, it is going on vacation or having a week off of school. For many of the residents here at Hesed House, a break in life seems to take on a different form or a different meaning, or perhaps more accurately, a different perspective. From the perspective of residents here, I think they see breaks often as things that I take for granted. They are happy to have food, water and shelter. So from their perspectives, I think something like hanging out with friends or watching a movie can constitute a break for them. I see these things as common-day occurrences, which looking at it from their perspectives, gives me a new-found appreciation. I really have got to see this through one of the gentlemen that I have had the honor to work with; his name is “Jim.”
I didn’t really have any expectations going into my first interview with Jim and the subsequent interviews really weren’t any different. I came to expect Jim to be the same as he was in the initial interview and outside of that, I expected little different as we had more and more meetings. I tried to keep an open mind about the interviews as best as possible and in doing so, it got me thinking about these experiences and this new-found perspective. What I was thinking during these interviews was how tough Jim’s life has been. He doesn’t seem to have, from my perspective, a break in the foreseeable future. But what he does have is a break, from his perspective, in the foreseeable future. I always want to work as hard as I can for clients, but I have gotten to know Jim and have an attachment to the outcome of his case. This is because getting him benefits will, at the very least, produce some positivity in his life like having more money to be able to move out of his current living situation. By getting this for Jim, I aid in finding him a break which will hopefully lead to more breaks. Jim has lived a life recently that, after all of the hard work he has done, has ended up with him searching to find a home and trying to work to feed himself. Things that I take for granted. The struggle that Jim is having has provided a new perspective to me in regards to what a break in life is considered. Breaks from Jim’s perspective seem like everyday occurrences to me that help me get recharged for the next couple days, but nothing that provides a long- term recharge like a longer vacation. From Jim’s perspective though, getting benefits and getting housed would be a life-changing break that would lead to future breaks. Hopefully he gets one break and is able to turn that break into bigger and better breaks. Maybe one day we can share a perspective on the meaning of the term “break.”
One can’t help but to see how unfair life can be after working with the residents at Hesed House. Jim is such a nice gentleman and so strong willed that hopefully life will make its mission to give him some more breaks and allow for his perspective to change. I hope that Jim will always be able to fight and keep going because he really deserves a bigger break than what he has received recently. It is great that there is a break coming soon since he is getting housing help and is seeing people about his challenges in life. As much as I have helped Jim, he has also provided me with a new perspective on breaks and a new appreciation for what life has given me. It is amazing how different the perspectives make the meaning of break change.
I think these experiences have taught me to work that much harder for our clients. I will likely get a break according to my perspective at some point. These clients will hopefully get a break, as I see it, and I can continue to be aware of what a break is from their perspective so that I don’t take it for granted. Further, I think that my experiences with Jim and with the clinic in general have taught me that this is good work to do. These people have lived tough lives and they deserve breaks just like everyone else in life.
It was Friday morning and I was waiting for a client to come fill out her Power of Attorney (POA) for Health Care. I was really excited for this because I had not had the opportunity to do an initial client interview yet, and this would be my first time assisting a client with completing a POA. I was also grateful I was able to have the experience of doing one, since POA Day was Wednesday, and I am scheduled Fridays at the clinic.
Going into the situation I was very nervous. I had never done a POA before and I reviewed the POA documents, but actually doing interviews is always different than preparing for them. I definitely have seen that play out a lot this semester. You can prepare all you want for client interactions, but often they go nothing like you planned. Going into this experience I expected the client to have a lot of questions. This document is for long- term planning, and the population we work with at the Health Advocacy Clinic often does not have a lot of long-term plans or knowledge about what POAs entail. I was thinking the POA meetings and paperwork would take more time than they actually did. Because if the client potentially did not know or understand the forms, filling out and explaining them would take some time. I also believed some of the POA would be left incomplete, due to clients not having contact information for their agents. I also went into the situation feeling unsure of how the client would react to me. We would have little opportunity to build rapport, and I would be delving into very personal information with them. It definitely left me with feeling awkward and unsure before the interview.
My client came for the POA appointment and things went smoothly. The client had all of her wishes pretty thought out, and she had all the contact information necessary for the appointment. This really surprised me and made the interview go very quickly and efficiently. I was also relieved and happy to see the interview go so well. When the final completed copy was given to her, I was very excited. Overall the experience went well.
I think the experience was good for me because my client was very pleasant and friendly. She communicated well and knew exactly what she wanted out of the POA and who she wanted as her agent. I think we are just taught to prepare for the worst, so I had prepared many situations in my mind prior to the appointment. I ended up being pleasantly surprised that it went smoothly.
I think it is very important to be prepared. And this is a skill I will continue to use and develop in practice. Since I was over-thinking the situation, it ended up being better than I had imagined. However, I do think expecting the unexpected or having no set expectations is more realistic. I think planning ahead to be prepared and equip yourself with resources to help our clients is all we can do. There will always be difficult meetings we cannot always be prepared for, or possibly easier meetings because we were prepared. It’s so dependent on our client base. And working with so many different types of people is something I have really enjoyed during my clinic experience so far. It makes us all constantly adaptable but appreciative of those meetings that go smoothly. I especially found this POA meeting insightful because I learned how to complete one. I was also able to help a client accomplish her goals of having a POA done for her family’s sake and making her medical wishes known to them. Completing POAs is a great feeling because you feel like you are contributing to the client’s life directly by making it better long term, and that is exactly why I want to be a lawyer.
On February 19th, 2016, a fellow student and I gave a presentation to Aunt Martha’s about an expansion of the NIU Health Advocacy Clinic into an area of the law we have never ventured before: criminal expungements and sealings. It appeared everyone who was working that day at Aunt Martha’s HOC or NIU Health Advocacy Clinic was in attendance, including Professor Boraca and Dr. Sun.
Because Professor Boraca, my fellow student partner, and I had all talked about how to best format the PowerPoint presentation, we began with a case example of “Rob,” a person whose life is difficult because he has a 2010 criminal conviction of destruction of property on his record. Rob is a 26 year-old man living at Hesed House’s Transitional Living Community who has saved up enough money for a down payment on an apartment. Because of his criminal record, no one wants to rent to him. Likewise, Rob has also been looking for work but because of his criminal record, no one wants to hire him. Because of all these hardships, Rob has become depressed, developed hypertension (high blood pressure), and is pre-diabetic. Because he does not have a reliable source of income, Rob struggles to pay for all the medications for his conditions.
My partner and I explained that there are two possible ways that we can help a person like Rob. The first is to expunge his criminal record, which removes arrests, court supervisions, and certain probations from a criminal record. While the preferred method in the case of Rob, his record cannot be expunged. Rob has a conviction on his record for destruction of property, a conviction being a final judgment of guilt by a court. Convictions cannot be expunged.
The second option to help Rob is to seal his criminal record, which hides a criminal record from the general public. The record still exists and the police and employers required by law to look at the record could still see the record. When a general member of the public would look up the record, the general member of the public would not see the parts of the record that were sealed. While expunging a record can only occur if there is no conviction, there is no such requirement for sealing a record.
After analyzing the facts of Rob’s case, we told the staff of Aunt Martha’s that it would be possible to seal his record, though various parties, such as the Illinois State Police, have a right to object to sealing of his record. The ultimate decision is in the hands of a judge. We then talked about how Rob’s life has improved since his record was successfully sealed—both potential rentors and employers cannot see his criminal record. Rob has rented an apartment and is working full-time as a sales receptionist. Rob is much happier and is no longer depressed. He also can afford his hypertension and pre-diabetes medications.
We also talked about several common misconceptions that exist, including the misconceptions that “anything can be taken off of a record,” “I’ve been arrested multiple times so I can’t get my past expunged,” and “it’s a waste of money and time to try to expunge anything.” We then discussed the exact process for sealing or expunging a criminal record, which we predict will take roughly 6 months to complete. Finally, we reiterated that not every record can be expunged or sealed and thus, we will not be able to represent every person in every situation. Hopefully with Aunt Martha’s assistance we can help Hesed House guests similar to Rob in our example.
While initially nervous whether Aunt Martha’s staff would agree that we should engage in helping people expunge or seal their criminal records as it was outside of the traditional subject matters handled by medical-legal partnerships, I was quite pleased how the presentation went and the reception that we received from Aunt Martha’s. It seemed the Aunt Martha’s staff was excited that NIU Health Advocacy Clinic has decided to help people expunge and seal their criminal records. The staff members were active participants in the presentation, asking questions and answering whether they thought we could help Rob. One staff member, in particular, was quite happy that we were going to help people destroy or hide parts of their criminal records and noted that it is something that is frequently asked about by their patients.
With Aunt Martha’s support, we will begin selecting a client or two for a test-run of expunging or sealing their record. If all goes according to plan, NIU Health Advocacy Clinic will eventually open its expunging and sealing services to patients of Aunt Martha’s HOC.