Jane was diagnosed with Schizoaffective Disorder - Bipolar Type and has a history of cocaine use. Ten years ago she was employed full-time as an administrative assistant and enjoyed her life with a husband and three kids. But after a series of involuntary psychiatric hospitalizations, she lost her job, her husband left, her children were removed from her home and she became homeless. For the next seven years Jane cycled in and out of homelessness, abusive relationships and involuntary hospitalizations. Immediately upon discharge from the hospital she would drop out of treatment, stop taking her medication and the cycle would begin again. Because mental health providers were unable to make a lasting connection with Jane, this pattern was destined to continue. Finally in February of this year, Jane was accepted into CUCS’ 350 Lafayette Transitional Living Community (350 TLC) - a program for homeless women living with a mental illness where PPOH psychiatrist Linda Bellama provides psychiatric services.
When Jane entered the program, she had very poor hygiene, a very flat, blunted affect, spoke and moved very slowly and was very withdrawn. Thanks to the freedom 350 TLC provides, Linda is able to determine how long she spends with each client (rather than the strict 15 minute assessment and follow-up standard for traditional psychiatry in these settings). This has allowed Linda to take the time needed to form a strong doctor-patient alliance with Jane. By their third meeting Jane disclosed an issue that had been making her extremely anxious. She had lost all forms of identification, believed that she needed at least one ID to get the IDs necessary to receive benefits, that without the needed identification she would never get her benefits reinstated, and was therefore doomed. Linda informed Jane that our staff were extremely skilled in working through this exact issue and then let Jane’s social worker know of Jane’s problem. Jane’s social worker was able to obtain identification for her and this solidified Jane’s engagement with Linda and the 350 TLC staff. With Jane firmly engaged, Linda then worked on adjusting each of her medications to their optimal levels.
Jane now practices excellent hygiene, smiles often, talks at length with Linda and other staff, socializes with residents, has re-established contact with her children, and is actively working toward obtaining permanent housing within the next four months.
