So a lot has happened in the last six months.
The babysitting job didn't work out. It turned out the mom didn't need someone full time, just when she got called in to work, which obviously wasn't going to be enough. My sister (M) ended up finding a live-in nanny job in a suburb that's about half an hour away from me. The mom (K) was a single mom going to online school while she worked a retail job and her parents picked up the tab for the vast majority of her living expenses. That turned into a nightmare very fast. K was very lonely and pretty much wanted to use M as her sidekick/pet. She was extremely emotionally abusive and would have screaming fits and hurl personal insults at M, as well as going into her room while she wasn't there and "cleaning" or leaving "gifts" in the closet. She was only paying M $100, and they lived in a gated community which K would not give M the code or a key to. There are also no busses in that town, so after 3 months of that, and a big scene where K would not write M a check when the last one went missing, I went and picked her up and brought her back to live with me. The job was definitely a learning experience for M, as K was very particular about the house being absolutely spotless, so M learned to clean, do dishes, cook food for the little girl she was watching, and shower every day.
During this time I also did seek out sliding-scale mental health services. There is only one place in my town that offers that. I took M there and after 2 months of waiting for a 20 minute appointment she was diagnosed with bipolar and given Depakote and Hydroxazine (an antihistamine for anxiety). She is not bipolar at all. She took one of the anxiety pills and ended up having a panic attack. She told me she told the psychiatrist about her depersonalization episodes and the psychiatrist told her that she had never heard anything like that before. (After she told me this, I looked up depersonalization on Wikipedia and she has every single symptom.) We threw the meds away.
Anyway, M landed back in my house and I've rearranged my living room so that she has a little space to sleep in behind my couch. She applied for food stamps, however when she called to set up her phone interview the automated system told her that her SSN and Case Number did not exist in the system. She could not get through to a person on the phone so I had her walk to the local office and she told me they told her to just wait for them to send her a second packet of information. The second packet arrived, she called the number, and again it told her that her SSN and Case Number did not exist. Every time we call them we get a message saying all lines are busy and to call back later.
I had her spend all of her free time applying online to restaurants, and she did finally get an interview at a McDonald's in a bad part of town. She went there and it turned out to be a cattle call and everyone who showed up was hired. The first few days of her working were really hard. She had to wake up early and ride the first bus there, and for the first week she missed most of the busses and would call me sobbing and I would have to wake up and drive her to work. She has been working there, taking the bus an hour each way every day. She was able to use some of her nannying money to buy herself a smartphone and she uses the GPS capabilities on that to get herself to work and back each day. I have no idea what we would do if she didn't have that phone.
I took her to a psychiatrist that was recommended by my counselor and she told me he listened to her and gave her a prescription for Straterra which has helped tremendously. She's now able to remember what it is that she needs to do (like eating, setting dr appt.'s, etc.) and her ability to retain information is improving. She is actually able to plan out her day instead of focusing on one task at a time. We just need to work on actualizing those plans more often. Since she started taking Strattera, her hours at McDonald's have gone up and she's making about $200/week. She's started hanging out with people her own age that she meets on a dating website and has even gone on a few dates.
Now we're working on getting her a place to live. This is really difficult because she is really resistant to calling people. I spent a couple hours compiling a list of roommate ads on craigslist and she did not call or contact any of them, which was really upsetting to me. It's been really hard for me at times, I feel like a social worker, a therapist, a hotel, and a chauffeur. I had a period of a week where I just fell into absolute and total dark depression and I cried everyday. I think it was a culmination of all this effort, my lack of privacy, and a bout of PMDD (it runs in my family).
She still needs to work on a lot of things: getting a place to live, learning to ride a bike so she can get around better, learning to drive a car. But she has come a really long way with a lot of pushing and a lot of pretending not to care what happens to her so she will do things on her own.