Case Study: Amir’s Journey

Amir’s* history

Amir is a young man with paranoid schizophrenia. As a child he would often get into trouble with the police and presented with challenging behaviour at school. He was first detained aged 18 and has been in and out of mental health and secure services since. He has a history of behaving aggressively and needing hospitalisation due to some of the symptoms he experiences.

When Amir came to us

When Amir was admitted to Cygnet St Augustine’s he had no structure to his day and little confidence. He presented with chaotic behaviour and would sporadically engage with members of the multi-disciplinary team (MDT). Although the team could see he wanted to get better, he struggled with motivation and sleep hygiene. Due to vulnerability from others he could only access community leave with staff support.

When I arrived it was really daunting, I didn’t know what to expect and wasn’t sure how I was going to get through it. But staff were kind to me and reassured me.”

Amir’s care

Clinicians reviewed and optimised Amir’s medication which helped to alleviate some of the symptoms he was experiencing. It also allowed staff to better engage with him.

The occupational therapy (OT) team worked with Amir to implement routine and structure so that he could begin to focus on his goals. He started with a basic therapy programme and escorted activities, and gradually built up his community access.

Amir engaged well with his regular 1:1 psychology sessions, developing insight and understanding of his illness and learning coping skills. Following the success of these sessions he became actively involved in the group psychology sessions. These focused on developing skills such as compassion focused coping skills, thinking skills, and recovery focus; he was a positive member of the group, supporting others with their engagement.

“Before I came here I hadn’t really had much psychology, it’s a good way of venting and being able to get an outside opinion on things and it can help resolve any problems you have”

A therapeutic earnings position in the hospital was facilitated by the OT which, in time, progressed to a volunteer position at a nearby charity shop. This really boosted Amir’s self-confidence and allowed him to take positive risks with independent leave.

To support further employment skills, Amir enrolled onto English and Maths distance learning courses. As his confidence grew further Amir became a supportive figure at the hospital for other service users. He would often cook meals for them which always went down well!

Amir then began to look forward to a more independent future, his psychology sessions focused on plans for staying well following discharge and building upon his resilience and coping skills.

“St Augustine’s is the best place I have been to by far. There are staff here that I admire and that I look up to, I have only positive relationships here. At the moment I’m studying for my GCSEs and I’m hoping they will help me get a paid job. When I am discharged I’m most looking forward to riding my motorbike”

Amir today

A step-down placement in the local area has been identified for Amir and staff are working closely with the team there on a staged transition. He is getting to know the team and the community resources before he moves in. He continues to attend his volunteer position in the charity shop and he hopes this may develop into paid work in the future. He has also recently started an engineering course at the local college.

Overall, the team at Cygnet St Augustine’s are extremely proud of how far he has come.

“If I were to give advice to anyone coming to hospital, I would say to be friendly, build positive relationships and always see the light through the difficult times. Set your goals as early as possible and the staff will work with you to make a plan of how to achieve them” – Amir

*Name has been changed to protect his identity

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