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Had a hard time deciding whether this should go here or in mental health. Mods please move if you think it's necessary.
I'm a librarian. I have a regular patron who waits at the door for us to open and stays until we close, every day. Some of my coworkers are afraid of her, because she seemingly randomly gets into arguments with people we can't see. Sometimes she gets a bit loud, but she'll quiet down if someone says something to her about it. Sometimes when she's really upset, she'll leave the building and rant in the courtyard until she's ready to come back in. I think she has a fair amount of control if she can do that. Sometimes I can convince her to come to my adult programs, though she doesn't interact with the other adults. Sometimes she seems to be directing her anger at me; as in, she will pass by me and glare at me while appearing to berate me about something, but I have no idea what she's talking about. I don't think any of it is genuinely directed at me. I always greet her in the morning and tell her to have a good night when I see her leaving, but I'm the only person on the staff who talks to her. She makes everyone else uncomfortable. But it's clear that she needs a place to be; her ID indicates that her home is a shelter. I'm not even sure that she stays in it, though, because some nights I'll see her wandering the streets after the library's closed.
I guess what I'm wanting to ask is if anyone has any insight into what's going on with her, either because you've had the same experiences, or you know someone who has. To some degree, I'm sure it's different for everyone, but I figure there must be some similarities. How can I be more helpful to her?
While I sympathize with your situation and can relate (having been a volunteer librarian in small towns for decades and had my share of unusual patrons) I think you need to be careful about inserting yourself farther into her life. You mean well but could end up alienating her from a place where she feels she can spend time and where she is somewhat safe. If you mishandle a situation someone could end up being hurt. She needs careful handling by an experienced trained professional and this is beyond the scope of your position. Is there a private reading room you could steer her to when she seems agitated or disruptive? Have you discussed her with your head librarian/manager? They may know more about her situation and could provide guidance for you. Maybe have someone contact the shelter her ID shows so they are aware of how she spends her time. They might be able to help as well.
Unfortunately we don't have a private room to offer, but she seems to voluntarily get up and either go outside or to the restroom when she gets too upset. But there have been a couple of times that she was just too loud and the deputy stepped in to calm her down, which worked out.
I think the manager is aware of her, but I might bring her up again just to keep her (the manager) abreast of the situation. I hadn't considered contacting the shelter. I don't know why not, really. So that might be an option.
I can see how doing anything more might just make matters worse when I mean well. You're right--I don't know how to handle this sort of thing beyond the obvious.
Unfortunately we don't have a private room to offer, but she seems to voluntarily get up and either go outside or to the restroom when she gets too upset. But there have been a couple of times that she was just too loud and the deputy stepped in to calm her down, which worked out.
I think the manager is aware of her, but I might bring her up again just to keep her (the manager) abreast of the situation. I hadn't considered contacting the shelter. I don't know why not, really. So that might be an option.
I can see how doing anything more might just make matters worse when I mean well. You're right--I don't know how to handle this sort of thing beyond the obvious.
Maybe it's time for the library staff that tends to be on duty when she's there to sit down together and compare notes or possibly get some advice from a therapist (again maybe a resource from the shelter?). What can help and what not to do. It may make everyone more comfortable with the situation and you will all feel you are working together as a united front.
Maybe it's time for the library staff that tends to be on duty when she's there to sit down together and compare notes or possibly get some advice from a therapist (again maybe a resource from the shelter?). What can help and what not to do. It may make everyone more comfortable with the situation and you will all feel you are working together as a united front.
Your library should have policies that address this. Having people loiter in the library all day is not a new thing, but disturbing other patrons really is not something that can be tolerated. The library isn't a care facility.
I would think that some kind of meeting with the staff at the shelter would be beneficial to both facilities, but I agree that it's not something that you should take on personally.
Your library should have policies that address this. Having people loiter in the library all day is not a new thing, but disturbing other patrons really is not something that can be tolerated. The library isn't a care facility.
Yes, and it's a fine line. No one has complained about her yet, but some will look at her with puzzled expressions. If someone had a legitimate complaint and/or she acted out against another patron or staff member, we'd have grounds to suspend or ban her. (I really hope it doesn't ever come to that...I'm biased because I like her, of course). We have a lot of regular patrons who deal with all sorts of mental illnesses, but she stands out because 1) she stays all day every day and 2) her problems appear to be more severe. Thanks for your take on it.
You can't be helpful to her.This person needs to be on medication right away.Maybe if you can find some way to contact someone from the shelter...???She needs to be on medication.
If someone claims or acts as if she is hearing voices (and we are excluding the possibility that this is self-talk, which normal people engage in), then that person needs to be evaluated by a psychiatrist for psychosis. (Yes, I work in psychiatry.)
I have had patients who were in most respects fairly normal who report hearing voices. From the perspective of psychiatry, the most important concern is that the voices may end up "telling" (= commanding) the patient at some point. Sometimes that happens, and sometimes it doesn't. Psychosis is characteristic of schizophrenia, but it is also found in other disorders as well.
Of course, be careful, but psychosis is not exclusive provenance of violent individuals. In fact, the rate of violence among the mentally ill is no higher than the rate of violence among the non-mentally population.
The usual treatment is a psychotropic class of medications known as anti-psychotics. The second generation of these medications are called "atypicals" (atypical in the sense that they are not like the first generation medications -- the atypicals have fewer side effects). Contrary to popular distortion, an antipsychotic does not turn a patient into a zombie. This same class of medications is often used to treat bipolar illness, and it is even used to augment treatment of MDD (= major depressive disorder.)
The right atypical at the right dosage will improve her life. She won't have to experience constant "crosstalk." But the first step is psychiatric evaluation. She may not know that her experience is atypical (pardon the pun). It's a sad state of affairs that some poor(er?) people have mental illnesses; in fact, these conditions can contribute to their homelessness (difficulty holding down a job.) Some homeless shelters have a primary care doctor who may come by and treat some common conditions. However that may be, this woman doesn't know that she needs to see a psychiatrist.
I think you have been exceeding kind to her, and I admire you for that. (Mental illness already has enough social stigma attached to it.) If you can find out the name of the shelter where she stays, I would advise you contact those who run the shelter. They might be able to get her to a public hospital for an evaluation. Best wishes.
Agree that she is psychotic and may or may not have schizophrenia. Yes, the antipsychotics help a lot of people, but they don't always make the voices stop. Depends on the severity of her illness.
OP, I appreciate your treating this person with dignity. As long as she is not disturbing other patrons and her behaviors don't escalate, I would let her stay. It seems like she benefits from the daily routine. You probably don't want to get more involved, though, especially if she has long-standing mental health issues.
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