Image by Gerd Altmann from Pixabay
DSP stands for Direct Support Professional. Most people with this job title help care for and support individuals who have been diagnosed with intellectual and/or mental health disorders who could also have a physical disability as well. Most individuals who receive this level of care reside in residential group homes that have been purchased by an agency who is in charge of providing care to the individual in question.
There could be anywhere from one, two, to even four or more individuals residing within one group home, and the number of DSPs assigned to that house depends on the level of care that the individuals need. Sometimes the clients are 1:1 which means one staff per one client. Sometimes an individual could also have a 2:1 ratio meaning two staff are needed for one individual.
A goal to being a DSP is to try to help the individual(s) under your care try to lead and live as normal a life as possible while trying to maximize the individual’s independence in hopes that they could live outside of a residential group home facility one day in the future. It’s about helping others live the way you would want to live and about treating those you care for with respect just as you would like to be respected. It’s about helping someone else get the most out of their life when they might not be able to do it for themselves.
I have worked as a DSP for several agencies and facilities and I was even a Senior DSP once and pretty much ran a group home on my own with minimal help from the lazy program director I had to report to. Before you are allowed to work as a DSP, you have to take and pass several trainings such as CPR, First Aid, and Medication Administration just to name a few. These trainings really can teach you a lot, but the one subject that should be touched on a lot more thoroughly is mental health related topics that can help DSPs better understand the individuals they’ll be serving.
These companies should teach more than blocking attacks and hits from an angry and upset client, such as teaching DSPs anxiety and stress reduction methods and skills that they could help teach to the people they care for during those mentally challenging times or to use before a crisis is in full blown effect. Anything that could help the client regain their composure before things get out of hand would be helpful to teach to DSPs. It’s like taking preventative measures instead of waiting for things to get out of control first.
For most agencies that hire DSPs, they do give new hires their clients ISP (Individual Support Plan) which has background information on the individual, it talks about their medical history, known behaviors, the clients likes and dislikes, as well as other useful information. They fill you in on the clients’ primary diagnoses too and the meds they are on for it but they do not give the DSP any additional information about their clients diagnoses and how it affects the person they’ll care for. Not everyone who has the same diagnosis will feel things the same exact way as everyone else and this is because everyone is born unique and deals in their own way that is special to them.
It’s easier to understand and care for someone when you are able to understand them better. And learning more about the client’s diagnoses could help with some of that understanding which could lead to overall better and more effective care. Most of these trainings that DSPs have to go through might brush on mental health topics but they don’t usually really get into a full-blown mental health discussion that could offer insight into what it’s like living with a mental illness or ways to help those we care for when it comes to their mental wellbeing.
I have seen far too many people start working as a DSP in group homes who knew next to nothing about mental health disorders or how to even interact with someone who has a mental health disorder without making the person in question feel outcasted or like they are different from everyone else because of their mental illness.
These same people tend to lack the knowledge needed to fully be able to help a client who is headed toward a mental crisis since they were never really taught how to deal with mental health emergencies in the first place. These same people tend to look at every outburst the client has as the client just acting badly without trying to figure out the root cause of the behavior in order to actually be able to help the individual instead of just trying to tell the individual to calm down over and over again until things either blow up worse or eventually calm down again.
But if each new DSP would be offered additional training regarding their individuals full diagnosis list and received trainings for those specific diagnosis’s including signs and symptoms to look out for, red flags to look out for, ways to help the individual cope with specific symptoms as they arise including what coping skills have helped them in the past and which ones didn’t work so great so that everyone is on the same page. They should also offer trainings on how to talk with the individuals about their mental health concerns so the clients feel more comfortable telling staff when they aren’t feeling like themselves if they are able to vocalize their feelings, wants, and needs because not all clients have the ability to talk to be able to communicate what’s bothering them.
These mental health trainings should also need to be taken by administrative staff and all management team members as well. While I was working as a Senior DSP back in 2017, I was appalled by my immediate supervisor and the program director’s reaction to a panic attack I had while on shift. They are the higher ups and they both have been in the field for much longer than I have. But their reaction proved to me how little both of them understand what it’s like living with mental illnesses and, in turn, how little they understand they people they are supposed to be supporting and caring for as well. They shunned me for having a panic attack, told me it was unprofessional, and then they gave me a pamphlet about a counseling service that was offered through the company.
If they knew anything about mental health, they should at least know that panic attacks can come out of nowhere suddenly leaving the sufferer with the inability to control the attacks, when they happen, or even how long they last. They really made me feel like shit and made me feel incredibly self-conscious and paranoid as all hell to have another one while at work. They made me feel like I did something wrong by having a panic attack or like I did it intentionally. I went right back to work as soon as the attack ended too, so it’s not like I left and abandoned my shift because the way they walked down to me for having a panic attack you’d think I just up and abandoned my shift and put the individuals I cared for at risk.
As soon as I felt the panic start to rise inside me, I told my clients that I just needed to step outside a moment and closed the door and had the panic attack behind the company vehicle so my clients wouldn’t see me having the attack. I thought I did the best I could, but I was told my best wasn’t enough.
I just couldn’t wrap my head around how some people can make a career out of caring for, advocating for, and supporting those with special needs while yet not knowing or understanding the first thing about mental illness and lacking sympathy for those who struggle with it every day. I think the reason I always got along with almost all the individuals I cared for throughout the years was because of my sympathy and empathy for them and because I was usually able to understand what they were going through or if I didn’t fully understand their unique situation, I would try my hardest to see things from their point of view so I could try to help them reach solutions for their problems instead of acting like their problems weren’t important and would go away on their own.
I would let my clients know that I was listening to their problems by occasionally reiterating what they already told me instead of just nodding my head up and down. I was able to allow my clients to feel comfortable with me and like they could trust me. I was able to tell them and have them see that I knew where they were coming from with certain things without letting them know that I struggled with my mental health just like they did since company policy prohibited me from sharing that I was also bipolar or that I also deal with anxiety with the clients.
The company would rather have a DSP act like they don’t have mental health problems then allow the clients to have someone they know they can relate to. With my last two clients I had back in 2017, there were so many times I wanted to share the fact that I was also bipolar just like them so many times with them but I never did out of fear that my bosses would find out (since clients do like to talk a lot about what people tell them and about what staff are doing and so on) so I kept it to myself.
I know it’s technically unprofessional to tell a client about shared struggles that you two have in common, but if some of the individuals had at least one person they could relate to that wasn’t also a client at the agency they reside within, more clients would start to feel less isolated and lonely. Most clients only have their housemates and paid friendships with professionals such as the DSP or group home supervisor and lack any real support from their family or if they have would happen to have a friend or two outside of the program. DSPs are like paid friends for most of the clients. It could be beneficial for some clients to be aware of the fact that even the people who care for them can have problems with their mental health too because it could potentially help motivate them to want to do more in their life since they are now able to see that it’s possible to lead a more normal life while still having mental and/or intellectual disorders.
Most of the clients I have cared for and supported throughout the years couldn’t see their full potential and weren’t always given the opportunity to show their potential either. They get thrown into this listless lifestyle of routine and order and repetitiveness and always being told by their caregivers what they can or cannot do at any given time. They have limited freedom compared to say like me or you. They just fall into this groove of staff taking care of their every need that they sometimes forget that they are able to do certain things for themselves.
A majority of DSPs only work in this field because they think it’s easy money. Many people do the bare minimum when it comes to interacting with their individuals and just follow the routine and do things for the client that they could do for themselves with some direction and patience but instead of waiting for the individual to get it right, some DSPs cut in and finish the task at hand just to say that it’s done but doing that also takes away what little independence our clients do have.
It’s hard to believe that these agencies haven’t started training more on mental health than they do. How are you supposed to provide care to someone if you aren’t fully aware of what is actually going on with them? Isn’t it better and more effective to get the full picture than just a corner of it?
I really do believe that training DSPs in mental health related material would be much more beneficial for everyone involved and would lead to better care for the individuals we serve. I am not saying that all DSPs need to take college level psych classes, but just talking about and learning about different mental health matters that can be done and completed in your typical 8-hour training session or one full day of training. The more you know, the more you can grow.
Plus, if they would train on coping techniques to help deal with stress and anxiety it could also benefit the staff when they are having a hard time dealing with life. It’s not just beneficial to the clients if they would teach a little more about mental health to the DSPs. Learning coping techniques can help lower and reduce work place stress levels. If the staff know how to handle their own stress more effectively, they’ll be able to also help their clients more effectively as well.
When staff are more equipped and packed with additional knowledge and tools that can help them better care for their individuals, everyone wins. There is no harm in having staff learn about mental health disorders when they are expected to care for individuals with intellectual and/or mental disorders. Additional trainings would just make DSPs even better at their job and can help prepare them for possible issues that could arise when they better understand and know the people they are serving.
Samantha is the author of "My Bipolar Mind: You're not alone," she is also a freelance writer, blogger, and mental health advocate who runs and manages her own mental health blog MyBipolarMind.com.