Pubdate: Mon, 29 Dec 2014
Source: Globe and Mail (Canada)
Copyright: 2014 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Adriana Barton
Page: L1

WORKING IN THE DOWNTOWN EASTSIDE

Being first on the scene of a drug overdose was 'the most stressful 
situation' 28-year-old Ryan Semiao ever experienced

When a person suffering from a schizophrenic episode starts trashing 
his room and screaming in rage, one of the best things you can do is 
knock softly on the door and ask if he would like a glass of water.

That's one of the ways 28-year-old Ryan Semiao has learned to calm 
troubled residents since he began working full time in March at a 
rough-and-tumble housing facility in Vancouver's Downtown Eastside. 
Semiao's new job combines janitorial duties - such as cleaning up 
drug paraphernalia - with front-line support that may include helping 
someone find an alternative to drinking Listerine.

With no previous experience in the mental health field, Semiao has 
made the usual rookie mistakes since he started working at the 
Stanley Hotel in the dimly lit Blood Alley, a residential hotel run 
by PHS Community Services Society, the same organization that 
co-manages Vancouver's supervised injection site. Early on, he buzzed 
in at least one volatile individual after forgetting to check the 
building's "barred persons" list.

In the past nine months, Semiao has been first on the scene of 
numerous drug overdoses, which involves grabbing a "crash kit" to 
administer Narcan, a medication used to counteract the effects of 
opioid drugs and restore breathing while paramedics are on the way. 
Semiao described drug overdose as "the most stressful situation that 
I've been part of." Nevertheless, he said, "this is where I want to be."

Last year, Semiao left a senior position in the Western Canada office 
of an international non-profit organization because he was looking 
for something that was "a bit more hands-on." He heard about a job 
opening at PHS through his volunteer work with the Vancouver Street 
Soccer League, which provides camaraderie for people affected by homelessness.

His new job couldn't be more hands-on. The overwhelming majority of 
the hotel's 70-plus residents suffer from drug or alcohol addiction 
in addition to mental illness such as schizophrenia and bipolar 
disorder. The Stanley is either a last resort before homelessness or 
a first shot at housing after many rough nights on the street. The 
hotel's harm-reduction policy allows residents to shoot up in their 
rooms and find refuge during psychiatric crises that might otherwise 
land them in police custody. Semiao's job is to offer practical 
support, such as connecting residents with medical services, or 
filling out application forms for picture ID - and helping them stay alive.

So far, no one has died from an overdose on his watch. Semiao took a 
range of first aid classes during job training . However, in 
emergency situations, he said, "you just hope that the reflexes kick in."

Semiao was raised by a single mother of two, a nurse who worked night 
shifts throughout his childhood. Visiting his mom at work, he 
witnessed the feedback loop of his mom's attentive care and patients' 
appreciative responses. "That definitely had an impact on me," he said.

He added that dealing with the systemic barriers in the Downtown 
Eastside that reduce residents' chances of recovery can be extremely 
frustrating: "If I were to focus on these issues seven days a week, I 
don't know that I would last too long."

Semiao said it took him a while to figure out how to unplug from the 
job. From March until a few weeks ago, he was on the graveyard shift, 
working three 12-hour nights in a row. The constant threat of 
emergency left him on hyper-alert, wreaking havoc with his sleep.

He took up hot yoga and plays competitive soccer, a physical outlet 
that allows him to "run around not thinking." But Semiao said his 
sleep didn't really improve until he discovered a labyrinth in a park 
near his home. After a three-night shift ending at 8 a.m., he would 
follow the loops of the labyrinth very slowly, focusing only on what 
was directly in front him. Walking at a snail's pace for more than 
half an hour relieved his tension, calming him enough to sleep after 
a long night.
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MAP posted-by: Jay Bergstrom