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Sheila is a lady in her late 50s who came to Heatherwood Court hospital from a prison in England.

Sheila had a long history of mental health problems with multiple agency contact.

Although Sheila presented with a number of undiagnosed mental health disorders her Local Authority had designated her untreatable and a protocol was established to withdraw any further Mental Health Services involvement.

Sheila felt alienated and her life in the community was chaotic; being characterised by an escalating series of anti-social and criminal incidents including racially abusing local children, fire setting, threatening behaviour and theft which resulted in her prison sentence and a subsequent restricted hospital order.

What did Sheila and her commissioners want to achieve?

  • A thorough-in-depth assessment of her condition
  • Development of a treatment and rehabilitation plan
  • To bring structure to her life
  • To provide her with stability through continuity and quality of care
  • To improve her behaviours so that a conditional discharge could be considered
  • To improve her socialisation so that she could reintegrate back into the community

What did we do to achieve these goals?

After referral to Heatherwood Court, Sheila was fully assessed including baseline and personality assessments and her past medical records re-examined, which allowed the clinical team to establish a schizoaffective disorder diagnosis.

This diagnosis then allowed the team to create an appropriate, robust treatment and rehabilitation plan, which included:

  • use of mood stabilisers and depot antipsychotic medication
  • Schema Therapy
  • Index Offense-related therapy
  • Anger and emotion management lead by the Psychology team
  • OT and nursing involved her in habilitation and rehabilitation, including use of community leaves – these being initially escorted and then unescorted
  • co- producing safety and support plans and coping ahead plans in relation to future discharge.

What were the Outcomes for Sheila?

Sheila was very resistive in the early stage of her treatment and 4 year stay at Heatherwood Court. However, the consistency of care and environmental stability, which she had previously lacked, allowed Sheila to achieve all the goals set at her admission.

Sheila’s behaviours have entirely altered and she can now be characterised as prosocial; she is friendly, personable and shows considerable care and empathy for others.

Sheila has received a conditional discharge and moved to an open rehabilitation facility. This was very successfully managed by creating a robust transition plan which included transition leaves and overnight leaves to build and establish a rapport with new team in England.

Sheila is now ready to take the next step in her rehabilitation and is being helped to find a suitable independent living placement.

“Thank you for almost 4 years of having to put up with me!

All through my ‘obstinate’ times when my ‘insight’ seemed to desert me totally.

You once said you wanted me to stay here until I could see the ‘bigger picture’, I think I have at last grasped what you meant!”

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