For 10 years before I retired, I was chaplain to the dual diagnosis inpatient unit of the Palo Alto VA Medical Center, Palo Alto, CA. This VA is known as one of the 4 or 5 leading VA hospitals nationally. The 20-bed dual diagnosis, all-male, locked patient unit, was designed as a 14-30-day acute treatment program. Most of the patients were from the Vietnam War era, with an increasing representation from the recent Middle East wars. On discharge, patients would often transition to one of the VA’s long-term addiction treatment programs at Palo Alto’s second hospital campus nearby in Menlo Park, CA.
A great strength of the dual diagnosis unit was its experienced staff, from the psychiatrist, psychologist, and social worker to the excellent nurses – all experienced in both mental health and addiction treatment. The chaplain was an integral part of this strong, integrated team.
Dual diagnosis is identified as a mental illness co-occurring with addiction to alcohol and/or drugs. On this particular unit, the mental illness typically affected the patients so that they remained in touch with reality. Their mental illness diagnoses would usually be, for example, depression, panic attacks, PTSD, not schizophrenia.
The function of the medical staff was to address and treat the mental illness as well as the addiction issues. The chaplain’s job was to identify spiritual issues and support the medical staff’s treatment plan. Thus the chaplain conducted a broad-based course in spiritual beliefs and practices, including physical movements. One day I had all the patients line up for exercise at the grab bars in the main hallway. We were having so much fun that the nursing staff poured out of the office to join us.
In addition, I led an Alcoholics Anonymous-based discussion group. I was also available for personal discussion of spiritually-related issues.
A successful introduction to all my groups was a brief 10-minute breathing/meditation period, which settled the patients down and seemed to energize them. To remind the patients that our whole bodies, not just our minds, are spiritual temples and need healing, I would also lead a vigorous physical exercise period of 15-20 minutes several times a week.
Finally, I arranged for an Alcoholics Anonymous meeting to be provided weekly by AA’s Hospital and Institution Volunteers.
All in all, working at the VA was a wonderful growing experience for me – personally and professionally.
by Sally Brown