I might be a little too optimistic. Yeah, that sounds like Schizophrenia to me. I've only been in mental hospitals, and there was usually a handful of those with Schizophrenia at any given time. Sad to hear about those living arrangements there (I'm not a fan of group homes). I've always had a home. Yes, nicotine helps and smoking is very common in those with such. Smoke permeates the halls of mental hospitals all the same. The staff of hospitals love to smoke too, usually in courtyards and the smoke rises to the patient windows.
I have Schizophrenia (never smoked, so I never made any connection for symptomatic improvement), and yeah, I've wanted the voices to stop (I don't yell, so I never yelled), as they're not nice, but I ended up getting used to them and they've only been there for a few months at a time during a couple of exacerbations. I mostly have visual hallucinations of somewhat disturbing things when it comes to hallucinations, but I learnt to ignore them; I always take a second look because that's natural. I was actually untreated for years because no one asked the right questions. Medication has helped a lot. Delusions, I'm not too bad, well, I don't think I am. I do have paranoia and think people are out to harm me, but it's hard to tell if it's from Schizophrenia or PTSD.
I couldn't really say if Autism or Schizophrenia is worse, and I don't think the combo will make it any harder than just having one of them, at least in my case.
I guess it's not too bad here for mental health stuff, at least private. Albeit, I think nurses and doctors should be a little better trained than what they are.