Thank you for Everything

Photo by Meghan Forsyth

Lord, I can be such a shit-heel.

Michael  came to HAP in January 2010, referred by his therapist at South of Market Mental Health.  I did his Intake, and immediately recognized him as one of our clients.  Very paranoid, schizophrenic and druggy.  Long history of suicide attempts. “I don’t abuse substances, I experiment.” Big anger and violence issues—“My friend wouldn't let me borrow his gun.  I would have done it right, with a silencer.” He said he had an active SSI case at Recon, and we decided to help him.

The next week, after inquiring at SSA, we learned that his Recon had been denied the previous month.  His next step in the process would be to appeal that decision before an Administrative Law Judge at the San Francisco Office of Disability Adjudication and Review.  As our office normally only handles initial applications and first appeals (Reconsiderations), I referred him to a private attorney who does that kind of work, made sure that he knew how to get to her office, and wished him well.  I was kind of sorry to see him go.  I liked the little dude.  I would miss him.

Seven months later, Michael showed up at our office. I tried to put him off until the next day, as it was Tuesday afternoon.  We do intakes on Tuesdays, and it had been hellish.  He was insistent though, so we went to my desk.  He told me that his attorney had fired him, and his hearing was coming up the following Wednesday.  He said that he had gotten upset in his lawyer's office, he might have pounded on a desk with his fist. She told him that she couldn't work with him any more.  Since then, he'd been 5150'd, and he brought the hospital record to show me.

I called his attorney.  Her story was a little different.  She said that Michael hadn't been compliant with treatment, his doctor was unsupportive of his claim, she just didn't have anything to build a case on, and felt that she had to withdraw.  I asked her if she'd mind if I went to the hearing with Michael. I hate to send him in there all alone, and what could it hurt? She had no problem with that. She'd be interested to hear how it worked out.

The following Wednesday, we met at the Office of Adjudication and Review.  I had about ten minutes to go over Michael's case.  I submitted the evidence of the 5150.  The hearing started.  The judge took his time, elicited Michael's story from him.  Grew up in Nevada with his uncle's family, was sent to the Philippines for a while when he got too hard to handle, lived with another uncle there.  Never worked. Judge Riety had spent some time in the Philippines himself, and could relate with Michael on that level, was able to verify his story against his experience there.  He could see how disabled Michael was, wanted to grant his claim, but was bound by Social Security's rules about documenting disability. Michael didn't have any evidence that his insanity wasn't purely drug fueled.  Social Security demands that a claimant's conditions be disabling regardless of substance abuse.   I asked the judge to keep the record open for six weeks so that Michael could get into a treatment program where he'd have no access to street drugs, get some clean drug tests under his belt, and still come up (I was confident) stone crazy I mean psychologically disabled.

For the next few weeks, his caseworker at The Treatment Access Program (TAP) Mental Health Central Access, his therapist at South of Market Mental Health, a social worker at Asian American Recovery Services -- Project Adapt and I worked together to get Michael into residential treatment.  Given the limited capacity of public health resources and Michael’s reluctance to give up the freedom he had on the street, it was slow going.  Before anybody would talk to him, he had to get out to SF General for a TB test, wait three days, and go back to have it read. We’d get him an intake interview somewhere, and he’d balk at not being able to smoke.  “I don't wanna go to that place.  They didn't like my attitude.  Then I ran out onto the freeway, but the cars stopped and wouldn't hit me, ha-ha-ha-ha?”. Eventually we got him a slot at Robertson Place, a residential drug treatment program across the street from Golden Gate Park.  

[Image by Jamie Hewlett]

Michael liked it there, mostly. When I spoke to him on the phone, he told me enthusiastically about the “flummingbirds” in the garden outside his room. I was working with his counselors there, making sure that they understood what kind if evidence we needed to show the judge. I went to visit him one rainy Friday in November, but he had been taken to the hospital that morning because of an overdose of psych meds that he’d somehow gotten his hands on. I’m sure it isn’t the case that they have a big bowl full of risperdal tablets in the day room with a sign that says “Be Nice.. Just Take ONE!”  He was eventually 86’d from the program for an incident involving a cheese knife and a hole punched in a wall.

Back on the street, Michael struggled to comply with his sobriety.  He got a psych eval in December at South of Market Mental Health which I forwarded to the judge. He kept going in to get his urine tested and coming up clean.  In January, out of the blue, I got a call from ODAR.  Michael received a fully favorable decision, and should start receiving checks next month.  He was overjoyed when I told him.  I sat him down, and we called his old lawyer to thank her for the help he received from her on his case.  

Michael is trying to find housing.  I haven’t actually told him that he can stop getting tested for drugs.  He seems to be doing so much better sticking to that regimen. He’s still in treatment, and Medi-Cal is now picking up the tab.