Dmitry has a diagnosis of schizophrenia and has had five previous hospital admissions in the past few years. After moving out of the family home, Dmitry stopped taking his medicines and quickly became unwell, as well as getting into trouble with the law. He was suffering from psychotic episodes and severe anxiety due to past trauma.
Following another admission to an acute ward, Dmitry was transferred to Priory Hospital Solihull for a period of rehabilitation, with the aim to improve his quality of life and reduce the potential of future recurrent hospital admissions.
Dmitry’s condition was initially stabilised with Clozapine, such that his psychotic illness went into remission. He spoke more about anxieties relating to past traumatic experiences, which he was able to work on with the psychology team to good effect. Under the direction of the psychology and nursing teams, he was also able to develop a better understanding of his mental health condition, including working on relapse prevention, early warning signs and coping strategies. He came to accept the importance of long-term medication for his condition and his adherence improved as a result.
Personal vulnerabilities with money management and internet safety were addressed by the team in a culture of personal growth, as well as supporting him to budget, save and keep his finances safe online. The team worked with him to recognise and adhere to appropriate boundaries in social contact, which he had been known to frequently struggle with earlier in his admission. He developed his self-catering skills by being able to forward plan, and his self-care also improved under the supportive direction of occupational therapy.
Once he had built his confidence up, Dmitry was keen to work, and he took on various real work opportunities within the hospital, including car valet, painting and decorating. He was supported to attend the local college where he improved his English skills (throughout his admission, we were able to support Dmitry with the use of an interpreter).
The team ensured his mother was able to remain a close and supportive ally, and she attended the majority of professional meetings either in person or remotely. Over the course of his rehabilitation, Dmitry was supported to spend time out of the hospital, in the company of family.
Dmitry expressed some anxieties about spending time by himself in the community and was supported to address this through graded exposure. Dmitry’s confidence developed across many domains throughout his admission, such as gaining an increased awareness of the link between physical activity and mental wellbeing, with him now regularly attending the gym and using his bike for leisure. He was able to further develop his interests and became more open to trying new things with support from the occupational therapy team.
During his time at Priory Hospital Solihull, we observed sustained improvements in a range of outcome measures, including Health of the Nation Outcome Scales (HoNOS) and Camberwell Assessment of Need Short Appraisal Schedule (CANSAS). The Attitude to Relapse Scale (ARS), completed in the latter stages of Dmitry’s admission, demonstrated low levels of fear and high levels of perceived control, with regards to potential relapse. The VAGUS-SR demonstrated that he had developed an awareness of the negative impact his mental health condition has had on his life.
Dmitry maintained contact with his community team throughout his admission and is now looking forward to his upcoming discharge to a supported placement.