What I am saying that both visible and invisible disabilities can both be a hardship and at times even devastating to individual.

Just because a disability can not be seen doesn't mean it's any less disabling than one that can be seen by most people.

This doesn't doesn't necessarily mean more so. It means that a visability of disability should not be sole criteria of who is considered disabled.

To me there is one very important exception to above. The person with an invisible disability has to deal with not only their disability but public's attitude toward it. For it's easy to realize some one who is physically challenged as being impaired. It's harder to realize that a person who may look normal may also have an impairment.

7. Integrate your behavioral & psychiatric information Once you've collected objective data on individuals' mental health patterns, it is essential to share this information with your team's psychiatrist. Sending data (& someone who can explain it in a knowledgeable & straightforward manner) along to individual's psychiatric consultation will improve accuracy of their treatment & allow individual to reach stabilization as quickly as possible, with a minimum of medication(s) and side effects.

8. Develop a network of support around individual Along with well-trained staff mentioned above, it is advisable to help individual develop trusted relationships with a number of other people in their lives. This gives them a variety of options when they are feeling insecure or emotionally charged. It allows them to seek out whoever they feel would best understand their current concern & confide in them, possible avoiding or minimizing a mental health crisis.

9. Always have a back up plan! That being said, in best-laid support plans, there will be moments of crisis. That, unfortunately, is simply nature of mental illness. So it is critical to think through as much as possible how crises will be managed before they happen. For instance:

** When this set of circumstances occur -- we will seek inpatient psychiatric care at hospital X.

** If there are legal allegations -- we will follow individual justice plan developed in cooperation with local law enforcement officials.

** If these symptoms reach this level -- we will increase individual's access to mental health counseling to this number of visits per week.

** If these symptoms occur -- we will implement individual's suicide prevention plan.

** If individual cycles in & out of competency to make life decisions -- we will work with local court & family members to establish a plan for conservatorship or guardianship with criteria for when and how long it would be necessary.

10. Know when you need help As with any challenging field, there will be moments when you and your team will simply be out of ideas & unsure what to do next. When that moment occurs, don't be afraid to ask for help. Go to other professionals who are experienced with this population & seek out feedback. Frequently a fresh perspective will get your team back on track or at least offer a direction to head while you re-group.

One final note: This is a highly complex population & this article is by no means exhaustive. Please use information provided here as a place to start & learn all that you can about successful treatment methods from our resources & those of others if you are supporting individuals within this population. We would also like to express our thanks to Robert Simmons, one of our consulting psychologists, who provided tips contained in today's column.

© 2001 Lisa Simmons