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Philip Cooke @philipcooke.bsky.social

I was once offered a VA outpatient mental health job w/ the explicit non-negotiable expectation I would maintain a caseload of 150-200 patients. That means seeing most patients once/month. Actively suicidal patients would get weekly sessions, no one else. This isn’t new, but it will get worse.

aug 27, 2025, 1:01 pm • 4 1

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Alejandra Hope @alejandrahope.bsky.social

Are you... not in the UK?!

aug 27, 2025, 7:18 pm • 1 0 • view
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Philip Cooke @philipcooke.bsky.social

lol no! Chicago. But I did visit the UK in June 😆

aug 27, 2025, 7:49 pm • 2 0 • view
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Alejandra Hope @alejandrahope.bsky.social

Chicago! Omg. (side note, IFPE will be in Chicago next year!) I remember your visit to the Freud museum back in June... yet for some reason I have always thought you were somewhere in the UK! Lmao, no idea why 🤣

aug 27, 2025, 7:53 pm • 1 0 • view
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Jo Ní Ghiolla Shúiligh @jogil.bsky.social

This is madness. You would have about 50 patients per week even if you saw them once per month? Like, how? I don’t think I could even remember the names of 200 patients btw.

aug 27, 2025, 9:14 pm • 1 0 • view
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Philip Cooke @philipcooke.bsky.social

Yeah exactly! It’s not actually any care or treatment, just a way for the government to say (somewhat falsely) that veterans have “access” to mental health care. The potential moral injury of working under those conditions was too much to take.

aug 27, 2025, 10:17 pm • 2 0 • view
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Jo Ní Ghiolla Shúiligh @jogil.bsky.social

Moral injury was exactly what came to mind.

aug 27, 2025, 10:42 pm • 1 0 • view
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Jo Ní Ghiolla Shúiligh @jogil.bsky.social

I also thought you were in the U.K. and this has thrown me for a loop😂

aug 27, 2025, 9:15 pm • 1 0 • view
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Philip Cooke @philipcooke.bsky.social

I kinda like the idea of not being presumed American!

aug 27, 2025, 10:18 pm • 2 0 • view
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Jo Ní Ghiolla Shúiligh @jogil.bsky.social

😅

aug 27, 2025, 10:43 pm • 1 0 • view
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🤐 Zeeroh Bovine 🤐 @zeerohbovine.bsky.social

And likely crammed into a room with other clinicians and no privacy. 😡

aug 27, 2025, 9:20 pm • 2 0 • view
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Philip Cooke @philipcooke.bsky.social

And with the most drab furniture and fluorescent lighting.

aug 27, 2025, 10:19 pm • 2 0 • view