After Steven refused to take the drug prescribed by his psychiatrist, he was discharged from Springfield Hospital Center. Continued hospitalization, his doctor decided, was pointless because he was a voluntary patient and he was not dangerous to himself or anyone else.
Nine days later, on April 22, 1983, Steven, who requested that his last name not be published, went to White Flint Mall and bought a knife. Convinced he was a member of the Palestine Liberation Organization ordered to commit a cold-blooded murder, Steven went to his parents' apartment. He forced his way in, cut the telephone wires, locked the front door and threatened to stab his father. He was disarmed by a security guard summoned after his mother managed to run out the front door and seek help.
Steven's father, who was unhurt, had his son arrested on a charge of assault. Several days later Steven was committed to Springfield, where he spent the next 13 months.
When he was discharged last May, Steven had nowhere else to go, so he moved in with his parents. For him and his family, as for many former state hospital patients and their relatives, coming home is far from an ideal arrangement.
Because there are so few alternatives, 65 percent of Springfield's Montgomery County patients go back to their families. Like Steven, many are the adult children of middle-class families struggling to be independent of aging parents exhausted by the demands of chronic mental illness.
"We just can't let him down," said his mother. "He's been on the street and in a lot of awful places." But having him home, she said, is "a constant struggle."
Steven finds it equally difficult. At 35, an age when many of his peers are established in careers and raising families, he must rely on his parents to drive him everywhere. His dependence is a painful contrast to the seven years he spent after dropping out of college. He worked as a stagehand in New York and in a 'head' shop in Cambridge, Mass., hitchhiked across country, and lived in Israel.
Since then his life has been a nightmare of more than 15 hospitalizations in at least five hospitals on two continents.
In 1974 he was first hospitalized in Israel for an illness variously diagnosed as paranoid schizophrenia and manic depression. Several years later Steven, convinced he could solve the crisis in the Mideast, flew to Cairo. He was arrested after he destroyed property in his hotel, and he spent a harrowing three weeks in an Egyptian jail before being deported.
Many of Steven's hospitalizations occurred after he stopped taking medication and quickly deteriorated. "My parents have had to bear the brunt of my hostility," he said, although he finds their repeated questions about whether he has taken medication annoying.
Steven considers antipsychotic drugs, which he says he now takes "reluctantly but dutifully," a "crutch." Drugs, he says, have very unpleasant side-effects and make him feel dull. He also dislikes the way they blunt his conviction that he is a prophet.
Those delusions do not render him incapable of living in the community, but his penchant for violent threats or acts, usually directed at his parents, does.
Dr. Samathanam N. Abraham said he discharged Steven from Springfield in April 1983 after advising Steven's parents to press criminal charges if he threatened violence.
"He becomes very threatening but he has never really hurt anyone," said Abraham, who added that he did not consider Steven truly dangerous. "He was plainly refusing the recommended form of treatment. We're an admissions unit and we have to keep patients moving."
After a year at Springfield where he was elected president of the cottage where he lived, Steven was accepted by St. Luke's halfway house. He was kicked out two months later when he attempted suicide by drinking toilet bowl cleaner. He did that, he said, because he was afraid he would be forced to return to a job he hated. Last fall Steven entered a schizophrenia research project at the District's St. Elizabeths Hospital. While there he again attempted suicide by smashing a glass jar and slashing two tendons in his hand, which required reconstructive surgery.
Until last week Steven had been living at home, seeing a psychiatrist weekly and waiting for a vacancy in a halfway house. Last week he moved into a supervised apartment with two other ex-patients. He has a volunteer job and will soon begin two college courses. He says he feels more optimistic about his life.
"I think this time things will be different," he said.