E's Story - Mental Health Needs
E lived with his parents/siblings whilst completing his A levels, then went to university where he had his first psychotic episode. E did not complete his course and was detained under Section 3 Mental Health Act. Following discharge E was homeless and was placed in local authority accommodation. E had a diagnosis of Paranoid Schizophrenia and had become well known to the CMHT/Recovery team and substance abuse teams. E had substance misuse issues resulting in extreme paranoia and extreme eczema. He was not engaging with substance abuse services.
Following many assessments with professionals involved with E, it was recommended supported living as a suitable type of service and Outlook care was identified as being a provider who could support E.
E needed to regain skills/confidence for independent living.
Transition Plan
E supported by his care coordinator, shared goals and how he wanted to be supported in his new home. E wanted to remain stable mentally/physically, move to his own flat, live independently and return to his studies. A transition plan was agreed with E after he visited an Outlook Care supported living service and met the other people who lived there, E felt happy. The transition plan included :
- Some short stays to ensure E was comfortable with the placement.
- E was supported by staff to get everything he needed to enable him to meet his basic needs as he had been homeless, and it was so important that he felt ready to start this positive move to his new service.
- E was also supported to apply for benefits in relation to his tenancy.
E expressed how positive he felt and how well supported he had been by Outlook Care staff.
Support Delivery
A detailed risk assessment and support plan was developed with E and he gave feedback on changes he wanted to make before implementation:
E felt in control of his placement although he was also glad that he had support from staff. Health/wellbeing were a priority for John to feel better about himself.
- Maintaining tenancy was important as he did not want to sleep rough again.
- Learning to budget and have money to spend on food, items he enjoyed such as books.
- Learning to cook again.
- Stopping smoking cannabis was a priority.
E developed a great relationship with his keyworker, who E supported E to attend a cannabis user group. Staff were trained in supporting people with addiction and E felt supported by them. Living in a safe environment helped E focus on his goals which he couldn’t when he was homeless. Regular treatment regime implemented to manage eczema included taking care of his personal hygiene, grooming and he loved to have clean and laundered clothes. E was supported to manage household tasks supported tenancy management including finance management. E loved the cooking sessions, these improved his understanding of healthy eating, this in turn reduced his eczema further, improving E's self-confidence, esteem and motivation. As a result, cannabis use began to reduce.
Outcome
Positive feedback for every goal achieved had a big impact, with new goals agreed with E who once again felt in control of his life. Moving on from the service was a long-term goal, this was always discussed as target for E, the target was to stay for 2 years and then move to his own flat. E took longer, (pandemic began), Staff continued to support E to focus on his goal of having the confidence/ skills to move to a more independent setting during the pandemic. As the pandemic progressed and everyone got back to normality, E's Care Co-ordinator reviewed progress and E stated he was keen to take the next steps and he wanted to secure his own accommodation. Staff supported E in this, and staff worked with other professionals including the care coordinator, Housing Department and E secured his tenancy of his own flat this took less than 5 years of moving in, this was such a positive outcome for a young man who had worked very hard to get his life back on track.
F's Story - Moderate Learning Difficulties
F was a 35-year-old lady living at home with her mother. She had a diagnosis of a moderate learning disability, and was referred to Outlook Care because her relationship with her mum had deteriorated significantly.
F became suicidal and ran away from home. F was assessed to have limited capacity regarding decisions about her health and well-being but could make fundamental daily decisions. F told staff that she wanted a boyfriend, but her mother would not support her and felt that her mother was not helping her with finances the way she wanted. When Outlook Care staff met for a first assessment meeting, the Social Worker identified that F would benefit from being supported in a service where there were always staff available to her. F visited many services and chose ours as she felt staff were very nice and she liked the house she visited.
Transition Plan
As part of the assessment outcome, a transition plan agreed with F, her mum and funding authority included 1 6 hours of 1:1 support per week to assist with emotional support, build her confidence, teach her the skills to live independently. Plus support her to make friends and find a partner. F was fully involved and liked that she was going to be supported to live with others and to find a friend.
Support Delivery
F lacked confidence and had not been undertaking any daily living tasks. She was a quiet person and found it hard to talk about how she was feeling and tended to bottle her feelings up, becoming emotional, locking herself in her room, and sometimes having suicidal thoughts. We needed to get to know F's thoughts and triggers, and when she was upset, we maintained a detailed record of the support given, to establish approaches that supported F and/or did not.
Within 2 months, F trusted us and we slowly started to work with her to improve her confidence. F opened up to staff about her frustration / mental health. She wanted a boyfriend and did not understand why her mother would not support her. As sessions progressed, F shared more about her worries about relationships. We found it helpful to use alternative means of communication:
- We wrote stories about made-up characters together on the themes of relationships/break-ups, which gave F enough space to speak more openly about these topics.
- F created a document filled with words/pictures about her likes/dislikes and day-to-day activities and made a ‘Tree of Life’ over several sessions, covered with words/sentences/images all about daily life, her background, family history, her skills, the crucial people in her life, her hopes/goals.
- F was referred to a psychiatrist and supported to join ‘Happily Dating Agency’ as a result.
- F set independent living goals for herself learning to cook, clean, and complete laundry without prompting from staff.
- With F's consent, we shared progress with her mum and involved mum in care reviews, decision-making.
Outcome
After 3 years: F met a boyfriend and secured employment in a charity shop. Her suicidal thoughts are rare. F meets with her boyfriend regularly, and mum supports her decision. They got engaged, and F wants to live independently with her boyfriend. F moved back home with mum and is preparing for a future with her partner. The 16 hours of 1:1 support per week have ceased.
