Even when ‘disturbing voices’ were threatening to turn Vivek’s life topsy turvy, it was a perceptive friend who had the good sense and heart to bring him to SCARF, an organisation that managed to ultimately streamline his life.
When Vivek* first came to SCARF, he had been ill for over 22 years and had not worked for at least the last three. Separated from his wife and children for over a decade, Vivek was living in a garage owned by a family friend, and working, at least on paper, for a quasi government establishment. It was this friend, Dhanya*, who brought Vivek to SCARF. At this point, Vivek had been wandering around aimlessly, shabby, unkempt, talking to himself, and occasionally making threatening gestures at passersby.
Vivek described his life at length – the ‘disturbing thoughts’, ‘those people who kept telling him what to do’, the ‘voices’, he said, who constantly troubled him. He felt others were ‘controlling his life’ and people on the road were ‘threatening him’. He reported that there were many people, both within the family and outside, including strangers, who’ would destroy me, if I let them’. He mentioned his habit of borrowing large sums of money for no particular reason, and the subsequent cycle of debt he was trapped in. He also added that he’d never felt the need to visit a doctor nor had he felt that there was anything wrong with his behaviour. It was ‘all those persons around me who are the problem, they need to be told to keep away from me’.
Family Unit Breakdown
It had been over a decade since his wife had given up on him, moving back to her parental home with her two daughters. Vivek’s inability to go to work regularly and therefore, the lack of money to run a basic household, was the last straw for his wife, who disabled by osteoarthritis needed a lot to help move around. After her departure, Vivek sold household articles whenever he needed the money. He visited his family infrequently, and often only when he needed money. It took us over seven months to convince Vivek to share his wife address.
Employment Track Record
Vivek had a troubled employment history. He rarely completed assignments on time; he quarreled incessantly with colleagues and often roamed restlessly around the office, unable to sit in his chair for long. He frequently took leave from work, often without pay. At the time we first met Vivek, his employers had transferred him to rural office, probably hoping he would resign. However Dhanya- who was also an acquaintance of his employer- stepped in and got the transfer rescinded. She also persuaded him to visit SCARF; Vivek however remained annoyed with her for ‘interfering with his life’. Despite this Dhanya was persistent, allowing him to live in her garage, ensuring he took his medication and helping him with both food and clothing whenever he ran out of money, which was often enough.
Interventions after Schizophrenia Diagnosis
After a detailed examination that indicated a diagnosis of schizophrenia, we identified three main areas of intervention for Vivek-
- ensuring he complied with his medication routine
- improving his performance at work,
- inculcating some basic money management skills.
Adherence to Medication Routine
We gave him free medicines but were never sure whether he was actually taking them, especially after he reported being convinced they would harm him. After much persuasion, Vivek agreed to take long-acting depot injections every fortnight. But this was no easy task either and took the combined persistence of our social worker and Dhanya to ensure he came to SCARF every two weeks. At times, we sent someone to Dhanya’s home to bring him to the centre and this tug-of-war continued for three months until Vivek finally agreed to come on his own.
Performance at Work
All this while, Vivek’s employers had no idea he’d been ill and were keen to somehow get him to quit voluntarily. We visited the office regularly, explaining his case, and emphasizing the importance of regular treatment. Over time, as they witnessed the gradual improvement in Vivek’s performance at work, they overcame their initial resistance and today, often remind him to visit us for follow-up sessions.
Money Management Skills
Teaching Vivek money management skills was a formidable challenge. We began six months after he first visited SCARF and persuaded him to show us his salary certificate. A large part of the salary went towards repayment of various loans. Over the course of several weekly discussions, Vivek learnt basic budgeting and accounting for his expenses. We also convinced him to send his wife a small but invaluable sum of money every month, which is today used to support their daughter’s education. On this front, our work is far from complete and we remain vigilant for lapses, for any sign that Vivek is returning to his previous, somewhat reckless ways.
There is no doubt that Vivek has come a long way from the unkempt, restless wanderer he was. For us, his story illustrates the very tangible correlation between mental illness and homelessness, particularly when no family support is available. Most of all however, Vivek’s story reminds us of the crucial long-term role played by social workers and friends, like Dhanya, who stepped in to help when she needn’t have. It was really her tenacity and determination that led Vivek to SCARF, and to recovery.
* Names changed on request
