MENTAL HEALTH AND SUBSTANCE MISUSE
Glenholme supports men with enduring mental health conditions and problems with addiction that often also have forensic backgrounds. Support is provided on a maximum ratio of two residents per key worker. Residents follow a genuinely person centred care plan or Wellness Recovery Action Plan, in which the concept of ‘choices’ are introduced as early as possible. They have supported access to local services and access to additional therapeutic services such as aromatherapy and music therapy. For those with problems with addiction we offer a dual-diagnosis programme which includes regular counselling, education and testing.
As part of recovery we make sure that those we support at Glenholme have access to our Community Builder Function which includes external vocational placements, college classes, leisure activities, support groups and networks.
MENTAL HEALTH AND COMPLEX NEEDS
Oakdene supports men and women with mental health conditions who also have complex needs. Support is provided on a maximum ratio of two residents per key worker. Residents follow a genuinely person centred care plan or Wellness Recovery Action Plan, in which the concept of ‘choices’ are introduced as early as possible.
They have supported access to local services and access to additional therapeutic services such as aromatherapy, music therapy. As part of recovery we make sure that those we support at Oakdene have access to our Community Builder Function which includes external vocational placements, college classes, leisure activities, support groups and networks.
We provide support at our facilities in:
Dual Diagnosis Programme (mental health and addiction)
We offer a fully integrated programme of care, based on an evidence-based model of practice: Integrated Dual Diagnosis Treatment (IDDT). The programme is designed to proactively help individuals recover by offering mental health and substance use services simultaneously, in the same setting, delivered by the same staff, with a consistent and holistic approach.
Our integrated model of care draws on several theoretical approaches, all highly evidenced based and effective. These are: Motivational Interviewing Enhancement; Psycho-education; Relapse Prevention; modified Cognitive Behavioural interventions; Community Reinforcement; and Contingency Management.
The Glenholme IDDT programme incorporates frequent individual key-working sessions, with both a Support Worker and a specialist Dual Diagnosis counsellor, together with a structured programme of psycho-educational group work. This is supported by behavioural boundaries and contracts that all service users will need to agree with and sign up for beforehand, as well as, regular drug screening and alcohol monitoring.
By promoting and delivering a holistic recovery methodology we aim to minimise chaotic lifestyles, offering a supportive inclusive structured day that will focus on positive activities as well as providing practical and emotional support to individuals by way of compassionate listening, motivational encouragement and engagement, and by tailoring person centred recovery support plans that will recognise both the person’s life experiences, as well as areas to focus on and work towards.
Learn about some of our Service Users’ success stories
CASE STUDY 1
Peter first had contact with psychiatric services in March 2004 and following an assessment at his home Peter was placed on a section 2 of the mental health act. His girlfriend had noticed a gradual deterioration in his behaviour, weight loss, isolating himself and self-neglect.
A few years later Peter was arrested for fighting in a pub and injuring a man with a glass bottle. He was charged with grievous bodily harm and detained in a secure service for assessment and treatment and placed on section 37/41 of the mental health act. Peter’s history included him smoking cannabis and taking other illicit drugs which had an adverse effect on his mental health.
Finally in 2007 Peter was re-called to secure hospital following a further relapse due mainly to misusing cannabis, other substances and alcohol. Peter had become unmotivated, his appearance was dishevelled and he was showing evidence of thought disorder and aggression towards his family.
Nevertheless he was generally compliant with his treatment programme but had stopped taking medication and disengaged with the doctor and social worker responsible for his supervision in the community.
Whilst in the secure hospital Peter did agree to join a drug awareness support group as this would contribute to him being discharged if he showed a commitment to reducing or stopping his habit. Subsequently Peter was admitted to Glenholme in 2008 his assessment showed that he was a very independent young man with an excellent record of academic achievement.
Peter had previously worked in IT and had demonstrated good career potential, but due to prolonged sickness had lost his job. He also struggled to accept his condition and the long term effects of this on his life.
Peter began working with our Community Builder at Glenholme looking for jobs and found a few positions of interest.
Peter although being a confident person admitted he was a little anxious about going to speak to employers. He was also embarrassed about discussing his illness and how it affected him. The Community Builder team member reassured Peter that he would go with him through every stage of enquiry and would support him even in the interview and explained that the employers he had found were OK with this approach.
Peter became far more relaxed knowing he would have support when he spoke to the employer. The interview went very well and Peter managed to secure a part time position in an IT repair centre.
Peter’s confidence and outlook on life were genuinely improved by securing this part-time role, he felt driven again and had something to aim for. Simultaneously and due to the marked improvement in his wellbeing Peter moved to one of Glenholme’s supported living independent flats (within the home) and started a programme of self-management, which included a weekly budget to purchase his own food shopping and to allow Peter to cook for himself.
He also agreed with his doctor to start taking responsibility for his own medication. As Peter had a history of non-compliance the doctor agreed that Peter keep his own medication in his bedroom but that he would take his medication in front of staff and would review his progress periodically. Peter was on Clozaril tablets (which are a closely monitored treatment by the company themselves). Therefore he was required to go to hospital every month for a blood test in order to monitor his white blood cell levels. Peter found this medication and plan really suited him with almost no side effects allowing him to have a good quality of life and go back to work.
Six months later Peter moved on from Glenholme to a supported flat in the local area with the support of his key worker and the clinical team. Peter still visits Glenholme from time to time and is enjoying life and his new job.
CASE STUDY 2
Robert was a 28 year old young man of Bangladesh origin. He was born in north London and lived with his mother and father and two brothers. Robert was reported to be quiet and shy at school and somewhat introverted.
There was a great deal of domestic violence at home perpetrated by his father towards his mother which created a great deal of tension in the household. When Robert turned 12 his father directed the abuse towards Robert and his siblings. This eventually led to a breakdown in the marriage and his father left returning to Bangladesh. At 16, Robert began drinking alcohol and behaving aggressively towards his mother. He would often stay away from home for days on end and would return in a dishevelled condition. It became obvious to his mother that Robert was withdrawn, aggressive and neglecting his personal hygiene.
The local GP saw Robert at the surgery and referred him on for a psychological assessment. Robert was diagnosed with a simple form of schizophrenia and began treatment. There was a marked improvement in his condition; however he wanted to go out more than usual, often returning very late at night under the influence of alcohol. At the age of 17, his mother realised that Robert was engaging in risky and criminal behaviour to earn money for cannabis. It was not long before he relapsed and was admitted to hospital due to his extremely disturbed mental state and violence towards his mother.
On discharge Robert was sent to a bed and breakfast as there were no available beds in residential care homes in the area. He felt lonely and isolated and unsupported. In desperation Robert set a small fire on the bed in his room and called the fire brigade. He was then re-admitted to hospital, this time to a secure ward where he under-went a further mental health assessment and an assessment for attempted arson.
Robert was discharged to Glenholme where it was obvious that although he was independent and intelligent, he lacked in confidence and self-esteem.
Robert was very respectful of his culture and religion, but rarely followed the traditions and practices. He would go with his mother to worship every week, but only to please his mother. The key worker at the home assigned to Robert was experienced and happy to work with him. The key worker soon identified that Robert needed to develop assertive skills and become more aware of his illness and the potential of being exploited. The 1-1 work carried out at Glenholme, supported by the local psychologist, helped Robert in developing confidence and assertiveness skills.
Robert also required support to access drug and alcohol services as required by the risk prevention plan agreed with his doctor. The key worker supported Robert in visiting the local centre in Colindale as he was very anxious about discussing his index offence. The counsellor reassured Robert very quickly assuring him that in the first few visits he would advise him of the services available and to provide him with useful information as well as get to know him. Robert soon got underway attending the group every week with support from his own key worker. Robert decided that he felt confident enough to share his experiences with the group and felt he benefited from doing so. He also wanted to talk in the community meeting at Glenholme about the way drugs had affected his live. This was well received by the service users at Glenholme and was seen as a positive contribution for him and his peers.
Robert soon moved on to supported living near his mother and settled well into his new flat. The supported living service visit Robert three time a week to make sure he is well and taking his medication. Robert has already started attending college and work experience and is now feeling confident enough to travel on his own on the bus. He no longer needs to attend the drug and alcohol group but keeps in touch now and again.
Robert now has a full and meaningful life and has the confidence and assertiveness skills to prevent him from being exploited. His mental health is good and he is planning to work in a supermarket on a part time basis.
CASE STUDY 3
Trevor, who is 54, came to Glenholme from psychiatric hospital. He had also spent time in prison. He started sniffing glue at an early age, and has used heroin, cocaine, marijuana, and alcohol. When he started living at Glenholme, Trevor’s main problem was his daily drinking, which made his depression and anxiety worse, causing him at times to become paranoid and aggressive.
Trevor regularly attended the psychoeducational groups that are a core part of the dual diagnosis programme at Glenholme. He also met at least weekly with the dual diagnosis counsellor, and with his keyworker. He worked with the community builder, and engaged in activities that interested him such as fishing trips, visiting a bird sanctuary, and going on short holidays. Support staff worked with Trevor, helping him to be consistent in daily living tasks such as shopping, cooking, cleaning and budgeting.
Trevor did not find the programme easy, and was almost discharged several times, when his drinking caused him to behave dangerously. However, using a behavioural and motivational approach, Glenholme staff were able to continue to work with both Trevor and his community care team. Central to Trevor’s progress was a residential detox programme he underwent after 3 years with us. This enabled him to achieve abstinence from alcohol and stabilise his behaviour. He attended follow-up Aftercare services, and support groups.
After living at Glenholme for six years, Trevor has now moved into a one-bedroom flat. Glenholme staff continue to provide help, with a support worker visiting Trevor at his flat daily, and the dual diagnosis counsellor continues to meet with him twice a week.
CASE STUDY 4
Richard is a 30 year-old man, who suffered many traumatic losses early in life, including re-location from his country of origin, and the loss of his parents and other close relatives at a young age.
Richard’s first use of substances were butane gas and cannabis as a young teenager, moving on to alcohol and crack cocaine. He was excluded from school and taken into care. Richard has also spent time in prison. He was admitted to Glenholme from psychiatric hospital, and had been diagnosed with psychosis.
Richard engaged with the individual support provided at Glenholme, and did a lot of work around thinking through why his previous recalls had happened; understanding his relapses & relapse prevention planning; self-care planning and stress management. He also used Occupational Therapy support in the community. Richard no longer drinks alcohol or uses substances. He got involved at Glenholme by helping to organise activities, and acted as the service user representative at staff meetings. He did voluntary work 3 days a week for a local charity.
After nearly 2 years at Glenholme, Richard moved to a flat in the community, where he continues to receive support. He still meets with his Occupational Therapist, and works one day a week for a voluntary organisation. His ultimate goal is to train to provide mentoring for other service users.