George is a 48 year old, African American male. He lives alone in a one-bedroom apartment in a bad part of town. He identifies as bisexual, and is diagnosed with schizophrenia. He first began working with the agency back in 2000 (32 y/o at that time, entered hospital when he was 29), as he was discharged from a state psychiatric hospital following a 3-year stay there. Prior to this hospitalization, he had been living with his parents, mostly in isolation, as his family was ashamed of his mental illness and attempted to hide it from the public eye by keeping him at home most of the time. He grew up with few friends and had little contact with people outside of his family. He has no reported history of drug or alcohol abuse.
George worked a few odd jobs and did some under-the-table construction work in his 20’s, but his work history is largely inconsistent. He has been a cigarette smoker since he was 16, and currently smokes a pack of cigarettes a day.
Living with a supported housing agency, his first few years adjusting in the community were marred with repeated relapses that required him to be hospitalized every few months. Despite the numerous inpatient stays early in his recovery, George was usually able to stabilize fairly quickly, and never required that he be transferred back to the state psychiatric hospital, instead leaning on short-term care facilities to help him.
For a period of about fifteen years George led a fairly quiet and stable life. He remained in his apartment, attended a self help center, and had two close friends in the apartment building that he spent time with frequently. It wasn’t what he had envisioned growing up with aspirations to be own his own construction business, but George made due with what he had and was fairly happy.
Tragedy struck George last year. When he first was released from the hospital in 2000, he ended up fathering a child with a woman he barely knew. He spent time with his baby daughter in the first few months of her life before the mother took the child and moved out of state, cutting George out of his daughter’s life completely. He attempted to reach out a few times in the first few years following their move, but eventually gave up as his psychiatric symptoms got the better of him.
He found out from an estranged family member about nine months ago that his daughter, whom he had no contact with since she was a baby, had recently been killed in a car accident. She had been 15 years old. Finding out this news sent George into a tailspin that was exacerbated by him completely stopping his medication. It culminated with him him losing his apartment and ending up back in the state psychiatric hospital. He spent 7 months there, and then was discharged back to the same supportive housing agency he spent the previous 15 years with, though in a new apartment as well as in a different town about 5 miles from where he used to live.
George was also assigned a case manager (Derek) upon discharge, who has been working with for the past two months. Derek is replacing a case manager that had worked with George for many years prior to his most recent hospitalization, but had recently retired. They have only been working together the past two months, despite many others in the agency knowing him well.
George had SSI and Medicaid prior to the hospitalization but has been having problems getting his benefits reinstated. He is prescribed an anti-psychotic medication (Risperdal) that he gets in the form of a biweekly injection at his local outpatient clinic. While George has recently began to understand the importance of medication to his recovery, he still does not like getting the injection and wishes he was not on medication. He took Risperdal in pill form previously for an extended period of time prior to getting hospitalized, but his doctor is fearful he will stop taking it again so they are advising injectables.
Presently, George is trying to adjust to a new apartment, new case manager, new form of medication, new town away from his friends, and the news that his 15 year old daughter has recently died. He would like to re establish a connection with his old friends, but it’s been months since they spoke so it feels awkward to reach out, and he has no car, so visiting them would be a challenge. He can afford his apartment because he has a rental subsidy, but is forever running out of money due to his cigarette habit, and would like to find a way address his budget.