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GREENSBORO — Teresa Grant takes her medication and looks at the sleeping guy in her tiny apartment. Her young children live somewhere else.

Claudia Tanseer is deep in debt, but she somehow got signed up for three Internet service providers. Blame attention deficit and bipolar disorders.

Joe Herbin is thinking about taking a job at a bar. Not a good idea for a guy with a long history of substance-abuse problems.

Tara Hodge knows them all. She leads an Assertive Community Treatment Team, or ACT Team, that cares for people with some of the most severe mental health problems in Guilford County.

How severe? These people talk about suicide. Some can be violent. Many don't have much money, as if having a brain disorder wasn't hard enough.

Yet, "most of the clients we have don't want to be in treatment," Hodge says. They don't take their medications sometimes, and they don't like being bounced around a topsy-turvy mental health system that has shuffled clients from public agencies to private ones.

"Change is hard for this population," she says.

***

This is not one of those 9-to-5 jobs.

Hodge's day sometimes begins before 7 a.m., when one of the team's 45 or so clients calls her. By the time team members arrive at the west Greensboro office of Psychotherapeutic Services, one of many private companies now handling mental illness as part of the state's mental health reform, they've already spoken to some of their clients.

Hodge, a 34-year-old from Rockingham County who smiles a lot, never planned on this type of work. She saw how hard it was for an aunt whose step-grandson was an antisocial drug user. He stole for drug money and wound up in and out of jail.

"I swore I would never work in mental health because I did not want to work with kids like him," she says.

She sought a health job out of college, and when the general rehabilitation job she wanted unexpectedly changed to a behavioral health position, she took it.

She's loved it ever since.

On one late summer morning, Hodge sits with the team and runs down a list of each client. Team members say lots of alarming things.

"She's starting to switch personalities again."

"He can get really dangerous when he starts using, and gets psychotic."

"The burns on her arms are healing."

The team has seven members. They include a psychiatrist, a nurse and a substance-abuse counselor. There's also a "peer specialist" who has wrestled with obsessive-compulsive disorder and alcoholism; he shares his experience with clients.

The team members try to visit each client at least three times a week; some visits are more difficult than others. Employment specialist Mareida Grossman-Orr relayed a recent conversation with a patient who wielded a tennis racket as he spoke with her.

"He was holding a racket up in the air like he was saying, 'I'd like to whack you with it,' " she tells the group.

"I put my finger on it to say, 'What's this do?' He started explaining the functions of the racket, then I got the hell out of there."

***

The meeting ends, and after some paperwork Hodge makes a late-morning visit to Teresa Grant, a 29-year-old who suffers from bipolar disorder.

A guy is asleep when Hodge arrives at her apartment; Grant says it's her cousin. Hodge asks about Grant's pills, which she goes into the bathroom to take.

"I gotta watch you take 'em," Hodge says, peering through the crack in the door.

"How long has it been since you ate?" Hodge says later.

"I haven't," Grant says.

They decide to make a run to the Church's Chicken drive-through down the street. Grant steps outside and closes the door.

"I know it's not your cousin," Hodge says about the guy.

"That's my second cousin on my great-granddad's side," Grant says.

Hodge has a $5 limit for meals for clients; the bill for Grant's three-piece chicken with okra is $5.81. Hodge buys, but she makes Grant give her a dollar because the bill is over the limit.

The $5 limit teaches clients financial responsibility, but it's not part of the job description. Hodge says she doesn't get reimbursed for the meals; she just doesn't like seeing people going hungry. She also pays an extra $10 at her gym so clients can work out with her.

Grant wants to own a home some day but needs to learn to live independently. She had lived in hotels and eventually wound up with the ACT Team run by the Guilford Center, the county's mental health agency. When the agency cut services as part of mental health reform, she ended up on Hodge's team.

Hodge visits Grant again a couple of days later. Two guys are asleep there this time.

"Who was that in your room?" Hodge asks when they leave.

"That was my uncle and cousin," Grant replies.

Hodge drives her to Potter's House, a Greensboro soup kitchen. Several people are milling around outside.

"Look, don't be hanging out with any of these people out here," Hodge says as she drops Grant off. "If you go anywhere, go to the library."

Grant is a friendly, social person, Hodge says as she drives away, and "I'm sure people take advantage of that."

***

The next stop is a downtown apartment complex that is home to the smart and fast-talking Joan Morgan. She has been seeing the team for only a short time, but she's not happy with the service and she's not afraid to tell Hodge so.

"As of this point, you haven't given me any help at all," she says.

Morgan is schizophrenic. She's been feeling nauseous, and she wants Hodge to do something about it. Hodge sits with her for an hour, but Morgan, 56, does most of the talking.

"I'm not crazy," she says. "I'm desperate."

She tells a story about a man who "verbally abused" her outside her apartment. She makes several swipes in front of her face and says she knows karate.

"I'm small," she says, "but I'm very fast."

Hodge looks at her impassively. They eventually agree that Morgan should make a shopping list so a team member can take her to the grocery store the next day.

"I don't trust anybody, anytime," Morgan says, "and that's my problem."

***

A couple of days later, Hodge arrives at a west Greensboro apartment complex. She approaches a floor mat that reads, "A wild wacky wonderful woman lives here."

"I don't function well," Claudia Tanseer says as Hodge drives her to a therapist's appointment. "I'm very bright, and if you give me something I'm very good at, that's fine. But the practical world, I don't deal well with."

Tanseer, 60, had spent much of the week at Wesley Long Hospital. Hodge took her there after finding her "disoriented and confused."

She tells therapist Steve Terranova that the hospital staff said Tanseer had taken too much medication.

"People always think they know what's wrong with you," says Tanseer, who suffers from bipolar and attention deficit disorders.

She has always had difficulty with money and debt.

On her bills, which Hodge now handles, Tanseer tells Terranova, "It makes me very anxious, confused."

After a conversation about riding the bus, now that she's not driving: "There are just too many things that are confusing."

Tanseer rides with Hodge back to the office, where they start paying bills. Tanseer owes Time Warner Cable $500; AT&T, more than $1,000.

"That's not correct," Tanseer says.

Tanseer is an artist, and she brings out several collages and puts them on the floor when she gets back to her apartment. She still needs to stick some of the materials to the backboards.

"The trouble with ADD is that you're always doing so many things at one time," she says. "Nothing ever gets finished."

***

Later that afternoon, Joe Herbin whips out two identification cards. In one, he's strung out and wild-eyed. In the other, he looks like a businessman.

"Me on drugs ... me off drugs," the 52-year-old says. He struggled with addictions to alcohol and crack cocaine. He later adds: "It made a Jekyll-and-Hyde out of me."

Hodge speaks with him on his front porch, just off U.S. 29. Trucks whiz by as the conversation turns to employment. As a Vietnam veteran, Herbin is entitled to veteran's benefits, but he'd like other income, too.

At one point, Herbin says a guy approached him about a job serving drinks in a bar. Herbin says he isn't drinking anymore.

"You don't need to work in no bar," Hodge says.

"Cuz that's a trigger?" he says.

Right.

Hodge says Herbin should talk with Grossman-Orr, the employment specialist. Herbin's OK with that.

Later, Hodge remembers her own family. Both of her grandfathers were alcoholics. It was a "hidden secret," she says.

Secret or not, lots of people know someone who's struggled with drugs or brain disorders.

"Substance abuse and mental illness run in the majority of families," she says. "Somewhere."

Contact Nate DeGraff at 373-7024 or ndegraff@news-record.com