Tiffany Ward Case Study: Ashleigh’s Journey

Ashleigh’s History

Ashleigh experienced trauma at a young age when she was subjected to female genital mutilation which had an ongoing influence on her mental state.

Ashleigh has an established diagnosis of Bi-polar disorder and has had multiple admissions to hospital under section, with a history of assaulting staff when unwell. She had started a nursing course which she really enjoyed however had to take a lot of time out from her training as this coincided with the onset of her mental illness. She eventually stopped her course however continued to work in health care.

Ashleigh’s latest admission was to a PICU (Psychiatric Intensive Care Unit) . She found this time very stressful and it resulted in a relapse in her mental state. Whilst in PICU, Ashleigh was not progressing as expected. This was when she was referred to Low Secure services.

When Ashleigh came to us

Ashleigh had been secluded multiple times whilst in PICU due to aggressive presentation, therefore the team knew that they needed to take a robust approach towards Ashleigh’s care. Initially, Ashleigh was observed within the ward environment, however it was noted that a similar pattern was emerging and it was decided to take a different approach with a clear and plan around activities, reintegration time and pharmacology.

Ashleigh’s Care

The team implemented the long-term reintegration plan. Ashleigh was empowered with self-monitoring strategies and means of assessing her risk as part of the reintegration plan. She was supported to do this and take ownership through mood monitoring, self-assessment forms and meaningful co-produced goals. A Positive Behaviour Support (PBS) plan was also created. This enabled Ashleigh and staff to implement proactive, trauma-informed strategies which helped manage challenging behaviour and promote sustainable change.

Ashleigh also had a personalised therapy timetable which she co-produced with the Occupational Therapy (OT) team. This helped make her day more predictable and ensure there was a balance of meaningful activity. It was noted that Ashleigh would have more incidents towards the night time so a ‘wind down plan’ of pray, gratitude diary, stretches and other calming activities was implemented. This helped Ashleigh prepare for a good night’s sleep which further impacted on her recovery.

Ashleigh formed good relationships with the team and slowly started turning a corner. She reintegrated successfully onto the ward, continued to have a reduction in her risk incidents and reduction in observations and was able to utilise leave from the ward.

Ashleigh Today

Ashleigh now understands her mental illness. She takes a proactive approach to her recovery and uses her experience to have a positive impact on the hospital service. This includes assisting with training for new staff, contributing to the monthly service user newsletter and leading service user People’s Council meetings. Ashleigh participates well in groups and is a well liked member of the community. She has used leave with her family and has recently been safe enough to use unescorted leave after a year of being in hospital.

Ashleigh hopes to help others with mental illness and is looking into voluntary work in the community. She is now planning her discharge with the team and is ready to continue with her recovery journey.

*Name has been changed to protect her identity

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