Overview

Jean has spent the majority of her life in long stay hospital settings, having been known to mental health services since the age of 20. She experiences delusions, auditory hallucinations and exhibits different personalities from day to day.

Prior to moving into her home with AFG, she was detained under the Mental Health Act and was receiving a depot injection on a fortnightly basis which she was extremely resistant to, requiring restraint from five members of staff.

This would cause her to become very aggressive and experience periods of severe mental ill health, displaying behaviours that challenge such as refusing food and fluids, disrupted sleep patterns, threats to self-harm and continuous shouting. She refused to go outside and engage with the community and would regularly isolate herself from others.

Our approach

Moving into a home of her own

After years in clinical environments and a stay in one of AFG’s independent mental health hospitals, Jean’s multi-disciplinary team decided she would benefit from a transition in to supported living and out of clinical services.

Jean’s support team at AFG worked closely with her social worker, the local authority and other health professionals to identify an appropriate home for her. A bungalow was identified with adaptations to suit her physical and mental health needs, which included windows with integral blinds to protect her dignity as she would walk around her home in states of undress, a bath and a ramp due to her mobility needs.

Her new support team visited her in hospital over the course of two months to understand how best to support her and develop a trusting relationship to help her transition into her new home.

Jean was supported to decorate her home to her personal preference, which involved wallpaper shopping for the first time in 30 years. She was supported to fill her home with important items such as her piano, pictures and the bible. Following the move, her periods of mental ill health decreased, and she began to further build on the trust with her support team.

Medication

Once in a bungalow with her own tenancy and the improvement in some of her symptoms, Jean’s support team along with her multidisciplinary team agreed to take a positive approach to risk with her medication.

Her team recorded her mood and behaviour whilst receiving no medication and instead gave lots of encouragement, distraction techniques and reassurance. This proved to be a huge success and Jean no longer requires any medication.

Developing coping strategies

Recognising that Jean does not accept she has a mental health condition, her support team would not highlight their own positions as support staff and ensured that any clinicians that needed to see her would not wear uniforms, as this was a trigger to poor mental health episodes.

They supported her to make her own decisions and be in control of her own environment. For example, rather than making food for her and telling her when her mealtime was, they would prepare meals and allow her to choose when she ate and to serve herself.

The team found Jean benefited from having space away from staff when she was feeling distressed, so took positive approaches to risk by withdrawing to her summer house in the garden, for example, to give her space and quiet time. This worked well and saw an immediate improvement in her behaviours of concern, resulting in a reduction of support from constant supervision to staff oversight.

Outcomes

Living in home with own tenancy

Jean is now successfully supported in her own home, which is decorated to her own taste, for the first time in her life.

Reduction of support

Jean initially required constant supervision from two staff members due to the significant risks she posed to herself and others. She now enjoys going about her day with staff oversight, meaning she is not constantly watched but staff are on hand to support her, giving her a greater level of independence and improved quality of life.

Medication no longer required

Jean no longer requires depot medication, which had previously been used to ease her symptoms but would cause her extreme distress.

Activities and hobbies

She now enjoys going out regularly in the community for trips into town and afternoon tea, as well as playing music and drawing with staff at home.

Testimonial

“After the challenges that Jean has faced in her life, it was very emotional seeing her move into her new home for the first time – myself and her mental health nurse were in tears watching her look around in disbelief, asking if this really her new home. She has absolutely thrived in supported living and has a new lease of life.”

Michelle Dooley, Team Leader

“Jean has been empowered to take control of her own life and make her own choices. To see where she is today is a true testament of what positive person-centred support can achieve for an individual.

Cally Dee, Support Worker