A series of profiles on persons who make Cambridge a better place in which to live and work
By Lawrence Prift
The city in Winter makes unusual demands on the human condition...the holiday season, so busy and bright, has suddenly ended...family problems, re-awakened during the long holiday season, continue to bother...we bid goodbye to yet another year...days are short and Spring seems a long time away...cold weather reduces our outdoor activities...with more time spent indoors, increased personal contact may create frictions that trigger underlying problems...people living alone feel an acute sense of loss...
Jennifer Piemme has one of the more demanding and difficult jobs around. She and her colleagues work in the Outreach Unit of the Psychiatric Emergency Services (PES) division at the Cambridge Health Alliance (formerly the Cambridge Hospital). Theirs is the Unit usually called to the scene when an individual in the Cambridge community is deemed to be at risk. Referrals come from hospital emergency rooms, Cambridge Police Department, Cambridge Fire Department, schools, community agencies (such as Cambridge Somerville Community Action Program), and social service agencies (such as Massachusetts Department of Social Services). Presenting problems include: child abuse, elder abuse, disabled abuse, the aftermath of a homicide or suicide, and the consequences of a natural disaster such as a blizzard or area flooding.
The Psychaitric Emergency Service is the unit usually called to the scene when a person is "at risk" in the Cambridge community. (Photo by Lawrence Prift)
Criteria for involvement by the PES Outreach Unit: the person is at risk to themselves and/or others
the person exhibits disorganized behavior
the person is clearly incapable of caring for themselves
Some examples of persons recently referred to the PES Outreach Unit: an elderly woman had been living in the home of her middle-aged niece. The younger woman had been verbally abusive to the older woman. The older woman did not, at first, seek help because of the interdependent relationship she had with her niece. Finally, the elderly woman sought help when her niece became accusatory and physically intimidating.
a high school student, in the middle of a schoolyard play period, threatened to kill someone.
a middle aged woman was admitted to an area hospital with an initial diagnosis of recurrent substance abuse...she had abstained from drug use for 4 years. Yet, during a night of impulsive bar hopping with her friends, she took in a number of prescription medicines that belonged to other persons. PES was called in. They found that, rather than being a substance user, the woman was only "temporarily disinhibited" because of poor personal judgment.
The Outreach Unit performs triage on all cases by inquiring about the present problem and treating the most acute cases first. The Unit performs an emergency evaluation, issues a treatment recommendation, and makes a referral to an appropriate provider.
Jennifer Piemme is representative of her profession. She has a Master's in Social Work (MSW) degree along with 10 years of mental health care experience, including 7 in acute care services. She brings to her duties an informed sensitivity, a working knowledge of community resources, an ability to think on her feet, and flexible responses to a given situation.
Often, the Outreach Unit is a person's introduction to the mental health care system as the PES is itself an extension of the Emergency Room into the community. PES consists of two outreach clinicians and a supervising clinician. Each clinician, in addition to a full work week, is on call two evenings a week. PES, in addition to the Outreach Unit, consists of an Acute Central Intake Unit and a Child and Adolescent Psychiatry Unit.
Translators for virtually any language can be found by the PES. Languages routinely spoken at the PES, though not necessarily in the Outreach Unit, include Spanish, Portuguese and Haitian Kreyol.
The Psychiatric Emergency Service, is open for service 24 hours a day, 7 days a week, and is located at the Cambridge Health Alliance (formerly the Cambridge Hospital), 1493 Cambridge Street, Cambridge, MA 02139. Phone: 617-498-1560.
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