Kate is a woman in her 30s. She has a long history of severe and enduring mental illness. She has been in Britain for nearly 10 years, most of which has been spent in various psychiatric hospitals. She has 5 children none of whom live with her. She has limited English and limited insight into her mental illness. She moved into St Martins in early November after a very long period in hospital.

Several issues arose within the first 6 weeks of her stay at the project. Kate’s lifestyle in the community disabled her from engaging in key-working with the project staff. She was not able to trust the staff as she believed that they were denying her access to hundreds of children who were in the loft. She chose to spend a lot of her time out of the project and refused to put money into the gas and electricity meters. She spent all her money on baby clothes even though her youngest child is 5 years. Our biggest problem with Kate was communication as she was unwilling to engage.

Further, due to a lack of insight into her condition, Kate continued to refuse medication, becoming increasingly
demanding and chaotic. This resulted in Kate being admitted to a local psychiatric hospital.

Over the next few weeks, staff visited Kate in the hospital regularly and built up a relationship with her. Staff  also had several meetings with the staff involved in her care to carefully plan the details of her care.

This influenced Kate’s discharge back to the Project in early March. Elements of her care included:

• the application for Appointeeship, so that Kate could be helped to budget adequately;
• regular attendance of an interpreter for key-work sessions for effective communication;
• periodic three-way meetings with the care coordinator;
• regular medication reviews by her team;
• arrangements for contact with her children

Since March, Kate has attended her weekly key-work sessions. She usually attends her appointment for medication every fortnight, and sees her children on a regular basis either here at the project or at her ex-partner’s house. Although the Appointeeship was not completed, Kate is putting money into the fuel meters and buying various bits of furniture to turn her flat into her home. She also takes part in communal activities and has developed a supportive network with other residents of the project.

Kate has proved that she can settle down in the community after having had frequent admissions and long periods in the hospital. We are working towards preparing Kate to get ready over the next 12 months to move on to less supported accommodation.

Details have been changed to protect the identity
of the client.