July 31st

Morning palm

There is a convenience store within walking distance of my new office. I can’t quite see it from my desk because of a large, thorny mesquite and clump of date palms. If I could, I’m sure that even in the middle of the afternoon, when temperatures in Phoenix made the distant sidewalk wavy with heat and ozone, there would be a group of folks huddled together in the shade of the store’s red awning.

Most would have $.89 Styrofoam cups full of soda and crushed ice. Some you can smell before you see them, as it goes with living on the streets in Phoenix in the summer. Others have loud, angry conversations with the spirits the rest of us cannot see. Many are missing teeth. A few wear clothing revealing tattoos that have become blobs of ink after years of weight fluctuation, and lots of hard living.

These folks are there in the morning when I stop for coffee on my way in to work. And they are there when I drive past, as the orange sky fades into another pink desert sunset.

In downtown Phoenix, there is a large homeless outreach where many of the city’s nomadic homeless sleep at night. In the morning, they are awoken early, given a basic breakfast and shuffled back outside. Some panhandle. Some find shade in a park to take refuge until they are allowed back inside the shelter. The Big Gulp Group hangs out at the local Circle K.

They watch as the cars come and go first thing in the morning. Folks in khakis and polos and A-line dresses file out of their compact cars inside for a morning hit of caffeine. Their shiny state badges reflect the morning sun. Their cars drip steadily from over-worked air conditioning, leaving tiny pools of iridescent coolant on the pavement.

Rarely do the Big Gulp Group and the employee cohort converse. Those who are filling up before filing up the stairs of the nearby health department keep their heads down, down. The homeless talk to each other but usually do not ask those coming and going for a thing. Both groups seem to pretend the other doesn’t exist.

There is little I know for certain about working in behavioral health yet; however, I do know it is often a matter of genetics for those who end up under the awning sipping a Big Gulp vs. those in corner offices sipping lattes. All of this is determined by some great wheel of DNA luck, spinning some of us to early death and others to high-end long term care facilities as centenarians.

Folks who suffer from severe mental illness die on average 25-30 years earlier, of preventable diseases, than their non-mentally ill counterparts in the community. That means most of these folks are dying in their 30s and 40s of preventable illness.

I’ve been rolling this statistic around for a couple weeks, trying to understand how it can be truth.

I am but one cog in this huge programmatic wheel. One more that punches in, and punches out, and could become an apathetic, ineffective drone – meeting the government employee stereotype. Thankfully, I work with a team of people who are passionate and love their work. They inspire. It feels like we are working on something that could make the state’s health better, especially for those like the Big Gulp Group.




Posted in
Arizona, Public Health
Follow the comments.

7 Responses

  1. There are a lot of folks whose brain and heart are disconnected…I am happy that you are not one of them. That is how you will make a difference in the world…by just being you! 🙂

  2. Also glad they habe you for help. Proud of you and lobe you Kell. sorry about the lisp, my keyboard has mental issues. (i think they are enbiromental though, ie bodka+redbull?)

  3. Shannon August 1, 2013

    Here is the public health initiative in Minnesota, Increase the life expectancy of people with serious and persistent mental illness by 10 years in 10 years

  4. Good writing here, Kelli.

  5. What you described here is such a rough day-to-day realization for me, too. Another difficult thing for me to balance is my fairly libertarian point of view on freedom (ruin your life if you so please, drink a tallboy at 11 am if you want!) with my somewhat idealistic view on mental health (anyone can heal from anything if you work at it hard enough!).

    Being A Person Who Truly Cares certainly comes with its own burdens, that’s for sure.

  6. I know that Circle K, the stairs leading up to your office, and the mentality that some State employees can have after many years of doing their job…you continue to inspire me, and I am so glad you are back, especially since many of our patients receive their services due to funding that comes through the OBHL. I thank you, I am proud of you, and am so glad that you realize that everyone has a story, Big Gulp or not.

  7. On the long “street” where I work there are tons of homeless “meth heads”. I don’t know if what lead them to being there is a mental illness or what but sitting at a stop light watching them “spin” is enough to keep me off drugs.