Paula has had life-long difficulties and both social and mental health services have been involved since her early childhood. She was born as a premature baby and later suffered extensive abuse followed by early behavioral and emotional difficulties. The latter resulted in repeated breakdown of the subsequent children’s homes and was compounded further with her early use of illicit substances. She has had extensive contact with mental health services with repeated admissions to hospital, with various psychotherapeutic interventions offered with little effect in minimizing her suffering or providing affective support.
Paula was assessed for her suitability for psychotherapy, however, given her chaotic lifestyle and excessive substance misuse, she was deemed not to be suitable for such interventions. Later Paula committed several offences which led to her been detained in prison. Waterloo Manor was asked at this point to consider Paula for placement and treatment.
Within the teams assessment we found that Paula appeared very suspicious and paranoid and had in the previous week ended up having several verbal altercations with other fellow inmates at the prison. It was clearly apparent that this young lady encountered enduring difficulties, which probably started before she was born (as she was a premature baby). She is also a survivor of an extensive form of childhood abuse with clear features to suggest an effect of trauma or the possibility of Post Traumatic Stress Disorder and it was not clear whether this had been appropriately addressed.
She was received into care early in her life with clear features of early disturbed behavior and emotional problems, which resulted in the repeated breakdown of her placements and the absence of any clear attachment figure in her life. All these difficulties were compounded with her extensive use of illicit substances and alcohol as a way of self medicating or a negative way of coping, therefore despite all the efforts by the professionals involved in providing her with any meaningful support, little was achieved due to her chaotic lifestyle and rapid default from follow up with a clear difficulty in establishing her needs.
Following a lengthy assessment by the MDT and a full review of her risk profile, the team at Waterloo Manor commenced treatment with an aim of stabilizing Paula’s treatment, equipping her with a better coping style and working towards reducing her risk. The entire MDT played a role within the delivery of these outcomes and using a recovery approach the patient remained at the centre of the process. Over the first 6 months since her admission Paula began to form better trusting relationships with the nursing team and the wider MDT. In the background to this her diagnosis was re assessed and the treatment plan revised. Medication was changed to offer less side effects and greater stability of mood, which in turn increased the rate of compliance.
