PART II: He turned down treatment for years. But they never gave up

BEN TAPARRA WAS in a bad way.

He'd been living on the streets of Kapahulu for years, withering away from an untreated mental illness and an addiction to crystal methamphetamine.

And he'd refused help — again and again and again.

Vinnesha Bertola, an outreach worker at the Institute for Human Services, says Taparra was so unreachable even she struggled to connect.

But she and others never gave up.

And one day, he said yes. And a new, specialized psychiatric street medicine team from IHS was there to get immediate help.

'You have everything you need'

Dr. Chad Koyanagi, an IHS psychiatrist, had diagnosed the 62-year-old as schizophrenic and after more than 250 encounters, Taparra finally agreed to take anti-psychotic medication.

Outreach workers reassured him, he wouldn't have to take a daily pill. Instead, he'd get a monthly shot — Invega Sustenna, a controversial prescription that some argue should be reserved for only violent patients.

Koyanagi, though, believes it should be a first-line drug for chronically homeless people who are severely mentally ill.

"Someone who doesn't believe they are mentally ill is probably not going to take pills," Koyanagi said.

The drug's impact on Taparra was profound. Two and a half months after starting on the medication, he left Kapahulu Avenue for a bed at Tutu Bert's, the specialty shelter designed for those who are medically frail.

Moving into a shelter was a milestone — one that almost didn't happen.

Moments after grabbing his bag to move into the shelter, Taparra started having second thoughts.

Those jitters were evidenced in his questions to outreach workers:

"I need cash. You mean you're not giving me cash?" Taparra asked. "We're going to help you with the grocery part," Bertola responded. "Yeah, but what do I do? Do I go out in the road and start panhandling again?" "Love, you have everything you need here."

In those first days, Taparra's case managers had serious doubts he'd stay. But a month later, he had settled in.

"He's doing awesome. As he was medicated and we gained more encounters with him, it was obvious this was a man that just needed medication and help," Bertola said.

Falling down — and getting back up

Taparra began to put on some weight. His violent tendencies were gone, but in conversation he was still hard to follow.

"I used to work in the nightclub and we used to do cocaine. But you know I know world professional surfers," rambled Taparra, during one visit.

He also struggled with old habits.

"I did crystal meth last week -- $10 worth," Taparra admitted to his outreach worker one day, well into his stay at the shelter.

"So, let me get this straight," Bertola responded. "Last week you told us you did $5 worth of meth. This week you're telling us you did $10 worth of meth. Ben, I don't want you doing those drugs. If you're on your meds and you're here, there is no reason for it."

'A completely different person'

Despite the setbacks, Bertola and the IHS team knew they were making good progress.

They enrolled Taparra in drug treatment. They also helped him get his Social Security card, birth certificate and state ID.

Once he had all those documents he could begin the process of getting his own place.

Six months after his first dose of psychiatric medication, Taparra was almost unrecognizable. A new man.

"I've been hearing voices since 1989. They talked to me all day," Taparra said. "The shots have given me the motivation to ignore the voices I hear."His transformation amazed even his case workers.

Taparra kicked his meth habit. And these days, he's talking to a counselor several times a week to cope with his schizophrenia.

"They take this shot and it's like they're a completely different person," Bertola said. "They can talk to you. They're your friend."

But Taparra's success didn't come without its share of obstacles. He's lost the vision in his right eye. Doctors say it stemmed from a beating he endured while he was homeless.

And his wait to be placed in permanent housing also took longer than expected. He ended up leaving the shelter and went back to living on the streets in Kapahulu. After two days, though, he returned to Tutu Bert's.

Finally, on July 17, he moved into his own apartment. Since then, Tappara has been able to reconnect with his brother and his children.

"I want to thank the people for helping me," he said.

ON TO PART III: The IHS psychiatric street medicine team launched in January. It tackles some of Oahu's most "hopeless" cases.

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