Mick and Bianca
Mick and Bianca have been married for two years. Both have histories which include psychiatric illness and previous hospitalizations at local facilities as well as at the state psychiatric hospital. Mick, 49 y.o., has been diagnosed in the past with schizoaffective disorder, obsessive compulsive disorder, and major depression. His current diagnoses are major depression and generalized anxiety disorder. He takes Welbutrin 300 mg once daily and Xanax 0.5 mg as needed up to four times daily. Bianca, 37 y.o., has also been given numerous diagnoses in the past, including schizoaffective disorder. Her current diagnosis is bipolar disorder with psychotic features. She takes lithium, seroquil, and ambien (for sleep). Both Mick and Bianca receive some entitlements. Mick gets SSDI based on a minimal work history as a laborer with a construction firm. Bianca also once worked, sporadically for several years in retail, and currently receives SSDI, but she has not worked in 10 years. At one point in the past, she received SSI in addition to her SSDI
Currently, Mick and Bianca reside in a small one-bedroom apartment. They receive Section 8 rental assistance. The landlord, however, is unhappy with them and has been threatening eviction due to several complaints from neighbors. During a recent incident, Bianca was experiencing symptoms and was screaming inside as well as outside the building. She spent three evenings sleeping on the fire escape because she was afraid to go into the apartment. It took Mick and a friend two days to convince her to seek help from treatment providers (she sees a psychiatrist and a therapist at the local behavioral health program), and very late one evening, she finally consented to go to the emergency room for a psychiatric screening. During more lucid moments, she had been quietly expressing dissatisfaction with her life and feelings of hopelessness, wondering if she would ever be well enough to experience an absence of relapses altogether. She was admitted 7 days ago and is currently awaiting a decision about her discharge and aftercare plan.
Mick, who had been stable for a number of years, is currently experiencing increased symptoms of his depression. He is extremely saddened and worried about Bianca and his ability to take care of her. He is confused about her psychiatric status and their future, and he feels he cannot even provide the basics for her.
For example, at times nearing the end of the month, they have such little money that they are only able to eat one meal every other day. They are barely “getting by” in his eyes. With only a 10th grade education and no high school diploma, Mick was able to secure a part-time position delivering groceries in the neighborhood for a small grocery store. In fact, at one time, the employees at the store occasionally provided Mick and Bianca groceries free of charge, mostly bread or other staples which had not been sold prior to the expiration date. However, recently, the workers have stopped doing so because the owner discovered their actions and forbid them from continuing to hand out free items.
In addition, Mick is also anxious, as he was recently in a minor car accident with the company vehicle; he had backed into the poles surrounding the small parking lot, which are meant to prevent customers from removing the shopping carts. Although there was no impact to the front of the vehicle, the air bag in the van inflated and possibly jarred his upper body. The collision caused him great pain in his knees and shins, possibly from slamming on the brakes. No other serious injuries were sustained. However, he has been to doctors repeatedly, as he cannot determine what to do for the pain. Mick is not clear whether the owner of the grocery store filed an accident report with the insurance company, and the employers refuse to help pay for the medical bills, particularly because doctors have been informing Mick that his pain may be due to chronic arthritis as a result of his age and weight.