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Archive for June, 2010

I visited Karen last week and, despite receiving a 16 week custodial sentence for her recent breach of ASBO, it was a very positive visit.  She was pleased that she would be released without being on probation or have any licence conditions.  We chatted about how she felt things could be different when she is released this time and she was very open and honest with me.  She knows that she will drink when she is released so we came up with some actions she could take, without too much difficulty, to minimise risks to her health and minimise the risk of her reoffending.  She agreed that she would try to stay away from vodka as she knows that she is out of control when she drinks that and it often ends up with her being arrested for drunk and disorderly behaviour.  She also agreed that she would try to drink in the house instead of on the street as it is a condition of her ASBO that she cannot have open alcohol on her when she is on the street. 

I explained to her that her tolerance of alcohol would be low as she will have been abstinent for a few months.  She understood this and she agreed to attend a GP appointment with me to discuss what medication she is on and the effect her alcohol use will have on this.  In the past she hasn’t acknowledged that she shouldn’t drink while she is taking her medication so this is a real breakthrough for us.  She also agreed that she needs some help with her mental health as she really just “wants to feel normal and happy” and she knows she will struggle to achieve this on her own.  We discussed what her options are regarding mental health services and she was really keen for me to look into a particular residential service out of Leeds which specialises in mental health and addiction.  This is such a positive step for Karen; for her to acknowledge that she needs help and to even show interest in a specific service is a huge breakthrough. 

I’m visiting her again next week and I’ll take her some information on this service and I’ve also offered to go with her so she can have a look round to see if it is suitable for her.  Part of my work with Karen has been to empower her by letting her know what her options are and arming her with as much knowledge as she can have to enable her to make informed decisions regarding her own care.  I’m really pleased that Karen is so upbeat at the minute, I hope it continues, its great to see her making such good progress and making positive decisions for herself.

Fiona

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If you would like to help Simon on the Streets support homeless people in Leeds, Bradford, Huddersfield please check this link to make a donation or here if you would be interested in volunteering

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Sally’s Tough Case

One of the biggest challenges so far has been accessing mental health services with someone who not ‘in the system’. J has a long history of mental health problems. She has had a diagnosis of schizophrenia in the past, but due to her inability to engage with services and a precarious housing situation, she had fallen through the gaps. J has been unmedicated, untreated and unsupported for a few years now. As a result of her ‘challenging’ behaviour her tenancy was at risk, and she was very close to losing her flat due to anti-social behaviour.

J has been open about the fact she has mental health problems, however she dislikes the stigma attached to schizophrenia, has had bad experiences of services and medication. It was clear that she was struggling with unwanted thoughts and the actions these provoked so I made enquiries about getting some assistance for J. She was not registered with a GP, so the options were very limited. The first port of call would be to call for an ambulance if she was presenting a risk to herself or others. If she was deemed to be too high risk for paramedics, she would have to be removed by Police officers, who would then escort her to specialist cells in Wakefield. Neither of these options would address J’s ongoing problems, and would be likely to cause her a great deal of distress.

I made further enquiries with the Mental Health crisis team. Again they were unable to help whilst she was unregistered. Even once registered, the crisis team will only respond to a person currently under their care and who is not under the influence of alcohol or other substances. This is further compounded by the fact that they will only visit at a known address and the response time can be up to 4 hours.

So J was again at risk and vulnerable, the one service she needed to access had no duty of care to her and the only other route risked making her feel criminalised for actions beyond her control.

J agreed to register with a local GP, although this took a lot of encouragement. She is wary and sceptical about professional services, so this was a big move for her. I accompanied her to the new patient assessment. She was quite guarded with the GP, but with some prompting it was clear from her mannerisms and speech that she was in some difficulty. A referral was made for a full mental health assessment, a move in the right direction, but this process would also take some time.

Whilst waiting for this referral to be processed and a Community Psychiatric Nurse to be allocated, several incidents occurred which further jeopardized her tenancy. As no up-to-date diagnosis had been made, Kirklees Neighbourhood Housing had little option other than to continue eviction procedures as normal, they needed a diagnosis in black and white before they could consider the situation to be anything other than anti-social behaviour.

All these factors, the threat of eviction, the upcoming Mental Health assessment and past traumatic experiences meant that J was really struggling and her mental health was deteriorating. It took a concerted effort and numerous phone calls to the assessment team before she was flagged up as an urgent referral. It was a relief when I received a phone call from J’s allocated CPN. She had made her first home visit and had immediately admitted J to a psychiatric ward for assessment.

The whole process has taken weeks, during this time J had little support, no-one to advocate for her and little prospect of receiving constructive help. The very service she needed to access was surrounded by barriers, successfully gate keeping support from a person who desperately needed their help.

J has now spent a couple of weeks on the ward. She is making slow progress and is on her way to receiving appropriate support and treatment. This can only be maintained by pulling together a number of different agencies, to ensure that when J returns to the community, she wont be allowed to fall through the gaps again.

Sally, Support Worker, Huddersfield

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We’d like to say thank you to the Year 11XL students and staff of Swallow Hill Community College who have been collecting donation of blankets, sleeping bags, food and clothes for us.  The students also made us some energy bars which we handed out at our Tuesday night soup run.  All the items which were donated will make a huge difference to our service users so thank you Year 11XL for all your support and for making us welcome when we visited your school.

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