On any given night, as many as 800,000 people in America are homeless. The government estimates that about a quarter of them suffer from profound mental illness, including bipolar depression and schizophrenia, and in most cases, they are left untreated. But they can be helped, and one proven way to do that is through direct street outreach by social workers.
Richard Hendrick is what they call a front-line provider. He's a psychiatric social worker in Springfield, Massachusetts who specializes in helping homeless people with schizophrenia. That means he's almost never at his office. This is what you hear on his office voice mail. "Hi, this is the voice of Richard. Please leave a message and I will get back to you soon, I hope. And if you are on the street and you want me to find you, let me know where you are"
So it was almost inevitable that he would meet Amir Robinson, a 41-year homeless man diagnosed with schizophrenia-paranoia. Mr. Robinson was born in Springfield; he lived in San Antonio for several years before returning to his hometown a year ago. He remembers arriving in Springfield feeling scared and vulnerable. "For some reason, when I first got off the bus, there was a yellow kind of taste in the mall, a filthy taste," he says. "Like there was drug fiends all over the place."
Amir Robinson made his way through the city until he found a bed at a homeless shelter. He noticed Richard Hendrick about the same time the social worker noticed him.
Hendrick: "I think the first place we met was at the Worthington Street shelter, you came in from Texas and landed at the shelter, which is one of the places I do my work. I kind of knew at the beginning that you were struggling with some mental health things and I probably went over and introduced myself and we started to talk."
Robinson: "I asked him about medication issues, that I needed his help because I was homeless. I wasn't even stressed really, it's just that there was an overwhelming feeling that I needed his guidance."
And so began what Mr. Hendrick calls "the journey". Depending on how well a client keeps in touch, the trip can last for weeks, months, or even years. He seeks out people with profound mental illness, including schizophrenia and manic depression, whom he visits on the street or finds in shelters. His therapy methods are low-key. "Typically, I'll know a person. I'll know his or her name, and often the journey begins for me just using that name," he says. "Like, 'Hi Mr. Robinson,' or 'Hi Janet.' I might sit near a person at lunch and a conversation may or may not develop. It often starts with two people getting to feel one another, almost literally, sensing each other."
With Amir Robinson, the relationship clicked. Mr. Robinson had been in and out of psychiatric hospitals since he was in his early twenties. He describes his youth as occasionally violent, with a few run-ins with police. These days, he says he doesn't seek out company, so just having a friend in Richard Hendrick is meaningful. "I'll just sit there and talk to him, makes me feel better. Sometimes when I go to see him, we'll go to have coffee and donuts," says Mr. Robinson. "Sometimes he takes me to get my blood drawn at Baystate Medical."
As Mr. Hendrick develops each relationship, he also makes judgements about clinical treatment. He usually recommends medication to help schizophrenics cope with everyday life, although he does work with people who refuse medication, because some of the drugs can have unpleasant side effects. Amir Robinson was on little or no medication when his journey began, but Mr. Hendrick helped him find a doctor who put him on a regimen of anti-psychotic drugs.
Robinson: "It helps in many ways, not only do I concentrate a little more better and show productivity in my speech, but it's not like I can't understand myself without it."
Hendrick: "My sense is that you struggle with this whole mental illness thing, but you know you seem to be better when you take medications than when you don't take them."
In this journey, goals are modest. Richard Hendrick keeps track of his clients' successful forays into "normal" life. He points to one time when Mr. Robinson went to court to try to get back pay from Social Security.
Hendrick: "He did all the research, went to the law library at Federal Court, and ended up on his own before judge magistrate, presenting his case. I was there just as a support person, but was just totally impressed at how he handled it, presented his case. He didn't necessarily prevail on that level, but he was fine with that."
Robinson: "Well, actually it was held in the wrong court. That was a federal court. If I want to appeal it, that would be District Court."
The two men don't see each other as much as they used to, because, they agree, Mr. Robinson is doing better. Mr. Hendrick helped him find the boarding house where he lives on state assistance; he also put him in touch with a community employment service. But even as Richard Hendrick roots for his clients' progress, he's hoping his own job won't become an oddity. He's worried about state budget cuts targeting social workers and street outreach programs. "Amir and others really are well served by having someone to go to, someone who can be non-judgmental and be with them in the moment, and in the course of doing that, [good] things happen," he says.
The next leg of Mr. Robinson's journey? He's looking to renew some family connections, with his friend's help.
Robinson: "My mom and dad don't live here, neither do my brother and three sisters, and I miss them quite a bit. Reporter: Do you want to visit them?"
Hendrick: "Maybe a trip?"
In the meantime, Amir Robinson is just grateful he can call home from Richard Hendrick's office for free.