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The help that John does not want

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In this fictional scenario, could anything have been done to prevent John’s distress? Who should be involved?

John’s parents, Sue and Neville, thought he’d been doing well for a year or so. His schizophrenia had been under control.

He lives in a “granny flat” under their house; really more of a room with a bathroom and a sliding door to the back yard. They all prefer that he has a separate entrance. Nobody has to see the marijuana he smokes, and there is privacy when his case worker comes to visit.

But now, Sue and Neville are worried. Since an old friend of John’s died, they hardly ever see John outside. All they see is white smoke from his flat. And the television is on loud until very late. Plus, they suspect he has stopped taking his medications.

On Monday morning, Neville phones Kate, John’s caseworker. “I could see him this afternoon. Will he be in?”

“He’s always in. We’ll be here too.”

Kate knocks, slides open the door, and sees John in a T-shirt and tracksuit pants, joint in hand, staring at the television. He doesn’t turn or acknowledge her. Kate moves around him to be in his field of view. “Do you mind if I turn the TV off?” she asks.

“Just turn it down.”