After a history of trauma, vulnerability, and relapse, Mr A engaged in a structured rehabilitation programme at Priory Nelson House. Through multidisciplinary support and his own determination, he has achieved stability, gained independence, and is now working towards employment and further education.
Background
Mr A, a 24-year-old man with a diagnosis of schizophrenia, was admitted to Nelson House following a difficult period at another provider. At the time of admission, he was highly vulnerable, presenting with significant risks including non-concordance with medication, self-neglect, and risk of exploitation, particularly financial abuse and modern slavery. He was also considered at risk from others within the community.
Mr A arrived in the United Kingdom at the age of 12 as an unaccompanied asylum seeker from Afghanistan. His journey had been traumatic and perilous. His only current family contacts are his uncle and cousin, and he has had no contact with his parents or siblings, who remain in Afghanistan.
Assessment and goals
Initially, Mr A was reluctant to engage with the service and expressed apprehension about his admission, asking numerous questions before agreeing to a period of structured rehabilitation. The primary aims of his care were to identify an effective medication regime, provide psychological support to distinguish between symptoms of psychosis and post-traumatic stress disorder (PTSD), build insight into his diagnosis and its relationship with substance misuse, develop daily routines, and support reintegration into the community.
Mr A’s personal wishes were central to his care planning. He expressed a desire to gain unescorted community leave, live independently, obtain employment, and eventually return to his country of origin.
Interventions and progress
Mr A was regularly reviewed by the consultant psychiatrist, and a medication regime was established that successfully stabilised his mental state. Once stable, he engaged meaningfully in therapeutic work with both the psychology and occupational therapy (OT) teams.
Psychologically, Mr A participated in regular sessions with the clinical psychologist and psychology assistant, focusing on PTSD, trauma, substance misuse, and developing insight into his mental health. Although initially guarded, he built therapeutic trust over time and went on to engage fully in the process.
The OT team supported Mr A to establish a daily routine, beginning with structured sessions focusing on domestic skills such as laundry and housekeeping. He received support and prompting to maintain personal care and to purchase essential items such as clothing and toiletries. As his independence improved, he progressed to community-based skills, including shopping and using public transport. Mr A also participated in weekly cooking sessions, where he demonstrated pride in preparing traditional dishes from his country of origin.
As his confidence grew, Mr A expressed an interest in returning to education and exploring employment opportunities as a delivery driver or support worker. In line with these goals, he was supported to enroll in a local college to complete English and Maths qualifications. Initially escorted by staff, he progressed to attending independently as his confidence and functioning developed.
Discharge and outcomes
Towards the end of his rehabilitation, Mr A worked closely with the OT team to explore suitable discharge placements near his uncle and cousin. He was actively involved in visiting potential placements and selecting the one that best met his needs. A structured discharge plan was implemented, including daily visits and overnight leave, ensuring a smooth transition to community living.
Since discharge, Mr A has remained settled in his community placement and has made significant progress. He has successfully completed level 2 English, passed an online health and social Care course, and is due to begin his Maths qualification in September. Mr A has been accepted for a supported living flat and is now actively seeking employment within the health and social care sector.