The school year is about to start again and it might be useful to study some particular cases that manifest themselves in all their complexity. The head teacher, among the many medical-legal duties that fall to him, also finds himself having to face particularly difficult situations even though he has never received institutional training in this regard, not even in competition. In the case of an Office Medical Assessment (AMU), the situation is particularly delicate, above all because the teacher may not agree with the measure set by the principal and suffer it, obtorto collo, even trying to escape from it.
I will therefore present, in three subsequent articles, ten cases of teachers suffering from a major psychiatric disorder. Episodes reconstructed thanks to the analysis of the documentation prepared by school managers and ministerial technical inspectors (extracts of their documents in italics).
At the end of each case we will ask ourselves a question to which we will give a reasoned answer. The objective we propose therefore does not consist in fully analyzing the story of the teacher but in establishing which is the appropriate behavior to be assumed by the head teacher in the specific circumstance reported in the question.
A teacher who exhibits unusual behavior during the service is sent to the AMU by the head teacher. Below is an excerpt from the report pursuant to art. 15 Presidential Decree 461/01 of the school manager.
…From day one the AA teacher exhibited a variety of attitudes which, depending on the circumstances, amused, annoyed or frightened colleagues.
It is a serious disturbance to the work:
- since the beginning of the year, despite constant reminders, he comes to school at the times he chooses;
- for completely mysterious reasons, it has long refused to indicate the times of entry and exit;
- to any reproach, or does not respond, or gratifies the interlocutor with the license of an imbecile;
- when the service order does not agree, it refuses to sign and, of course, refuses to execute it;
- in the presence of written disputes, he refuses to collect them: the registered letters sent to him are returned to the school for complete storage;
Given that the undersigned is certainly not able to formulate medical diagnoses, two types of intervention are requested:
- that a medical examination is arranged, with particular reference to the aspect of mental health, which ascertains the suitability of the aforementioned teacher for the service and, in any case, the degree of danger of his presence in a community of adolescents;
- that a disciplinary measure appropriate to the gravity of the negligence committed is imposed.
Final diagnosis of the Medical College of the CMV: paranoid psychosis.
Request: What does not convince in the interventions requested by the headmaster?
Reply: While the request for an Office Medical Assessment (AMU) in CMV has its own obvious logic, by the headmaster it makes no sense to propose the contextual application of a disciplinary measure. The latter could possibly have meaning only after the teacher’s “suitability for the job” has been pronounced by the Medical Board. There is in fact the risk – as in the case in question – of sanctioning a worker suffering from a disease that should be treated and certainly not “punished”. The manager, as equated to an employer, is still responsible for the health of the teachers and before sanctioning it is necessary to first ascertain whether the cause of the problem is not a question of compromised health.
The ministerial technical inspector, called by a school manager to resolve a thorny situation with a teacher, comes to the conclusion that “… the compromise of the professional profile of the AMF teacher is to be found in problems likely to be placed on the side of psychophysical balance …”, therefore requesting the sending of a medical-collegiate visit to assess the health conditions of AMF. Following the inspection, the provisional suspension of MFA from teaching is ordered as a precaution but, without waiting for the outcome of the medical examination, charges are also moved by the Superintendent of the charges also to the head teacher as he is held responsible “… Of inexperience in dealing with the case, which would have largely determined the degree of tension and concern encountered in the school. It is enough to read the heartfelt requests addressed to the manager of the competent office of the Superintendency to understand the total inadequacy to manage such a case: “… This is a problem of phobias and relationships. AMF has some obsessions and obsessions so even if you try to explain some things to her, she doesn’t understand. Parents and teachers expect answers from me: what to do? How to get around? How to try not to lose other users? I therefore ask for your support, through suggestions and procedures, in order to better manage the situation. Finally, I ask, if possible, to request whoever is competent to define the case “.
Medical College Final Diagnosis: Paranoid Personality Disorder
Request: Is the “inexperience” remark raised by the inspector to the headmaster agreeable?
Reply: It is also true – as reported above – that no training is given to school managers regarding their medical-legal duties; however, the use ofOffice Medical Assessment (AMU) is the responsibility of the school head who also has the right to resort to the precautionary suspension of the worker (DPR 171/11). The inspector’s finding of inexperience therefore has an indisputable foundation. The manager’s inexperience also manifested itself in having resorted to an inspection visit instead of the AMU.
Case III
The head teacher requests theOffice Medical Assessment (AMU) for the CM teacher and writes the ritual report for the CMV (ex art. 15 DPR 461/01): “It is a person with a clear obsessive-paranoid attitude that causes serious communication problems. She is so involved in her obsessive depressive problem that she refuses contact with everyone, not holding out her hand to anyone who offers it to her to greet her. My precise didactic and behavioral indications were useless to facilitate the meeting with the schoolchildren, because her attention is always self-centered, aimed only at her personal problems. She explicitly stated that she was afraid to enter the classroom and her trembling appearance was so neglected and unpleasant that I very reluctantly accompanied her in front of the pupils.
The person in question is always in a confused state, he is never able to focus attention on a real data even of little importance “.
Final diagnosis of the Medical College: Obsessive Compulsive Disorder
Request: What obvious mistake did the manager make in drafting the report?
Reply: The very serious mistake committed by the manager consists in having formulated, in the report for the CMV, a diagnostic hypothesis that does not belong to him. The aforementioned error exposed the principal to a complaint with the repercussions of the case. A school manager can never make diagnoses, diagnostic hypotheses or clinical evaluations, prognostics or therapeutic considerations in relation to one of his employees, as he does not have the skills, abilities and faculties.
I hope that this way of writing this column (Problem Based Learning) is useful for teaching school readers to learn good practices in exercising their profession.
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See also
The unsuitability of school staff in the DPR of 2011 n ° 171. Who does what and how
Unsuitability for school, the procedure for teachers and ATA. What the integrative CCNL of 2008 says
