The biggest problem my punters have got is you lot. "My kids don't want to know me. This place is all I've got." This place is a miserable suburban day centre for people with chronic mental health problems where I see one person a week. At least I think it is. It's so smoky I can hardly see my feet. "Philip?" When Philip smokes, the cigarette never moves more than a fingerprint away from his lips. It doesn't seem to involve any movement in the upper limb. I've been watching them all closely over the past few weeks and I think it's the cigarettes that move by themselves.

Philip is a financier's dream: he can turn a new washing machine and a few pairs of trousers into a £15,000 debt in five years flat. If you're looking for new markets, these are the boys you should be targeting. He's suggestible and desperately aspirant, but more than that, he still has a trail of smoke wisping out of his yellow moustache. Either that or his face is on fire. I decide to give it a minute and see what happens.

"I'm so embarrassed." He is, and it's painful. One of you out there has made this man feel very stupid. "It's just really depressing. I only wanted to be... normal, you know. It's pathetic, isn't it?" He's so resigned and natural with this insight that it almost feels like the most natural response would be to nod and agree. "I didn't even need the washing machine. It was huge. Anyway, it's broken now. I have to go to the laundrette. Which I don't like because it makes me paranoid. I don't like people looking at my clothes."

I'm looking at his clothes. He would be pretty cool if he was 17. And maybe black. "Nothing looks normal on me." Enormous denim skater pants and "phat" white trainers certainly don't. He's 40. "I bought these trousers last week when I went out shopping with the carer who comes to the house. She told me they looked good. Why can't people just be straight with me? God, I get so depressed."

I prepare to pounce. Depressed. Suicide. The most definitive negative outcome in any psychiatric patient. The one thing I have been told, even if I manage nothing else, to document every time I see someone. "How low do you get, at your lowest?" I throw out as an opener. "You lot are obsessed." He looks at the ceiling. "I'm not going to kill myself. All right? I suppose that means I don't get a community nurse." Jesus. These guys know more about the psychiatric system than I do.

"Of course not." I smile. But you're not answering my question, I think, and I need to write down the answer. Because for some reason, somebody, possibly a lawyer, has decreed that me writing it down now will make a difference if you decide to kill yourself later.

"Well, I'm not going to say it. Anyway. They've cut my electricity off. So I can't electrocute myself." Small mercies. I don't think he's going to kill himself. I call the social workers. Well, that's not quite true. Prepare yourself for exactly how boring my job is. I call the social workers on the number he has been trying, but all I get is some kind of voicemail. I call the number on the voicemail, and get some kind of fax machine. "Yup. That's right. That's the one." He looks out of the window. I call the other number for the social work team. Vivaldi.

'And the kids on the estate keep throwing things at me. They spat on my trousers this morning." I smile understandingly. We both look at the large greasy mucous stain on the front of his trousers. This man needs a new wardrobe and a house with electricity on an estate full of Guardian readers.

Finally we get through to Marjorie. I try not to be shirty about the fact that it took 20 minutes. "Oh, yeah. Artramont Estate, I suppose?" I look up. "Artramont Estate?" He nods.

"Jesus. There's some kid working for one of those new electricity companies who went round door-to-door signing up all the clients whose finances we have to manage. Now we don't know where any of the bills are going. He's a pushy little fucker by the sound of it." Sounds about right. "Has he got anywhere else to go? We might have to take him into hospital." Surely this isn't cost effective. Surely this isn't psychiatry. I look up wearily and catch myself dead. He's crying.