Multi disciplinary- includes OT, social work, nursing, medical
Try to work out recovery style ways of working with the person
One to feed back 3 ideas to the large group
35 year old Asian male with paranoid schizophrenia, isolated,
family problems, multiple formal / informal admissions, heavy
In hospital, recovering. On Olanzapine 20mg. Referred to AO
with recommendation from inpatient team for CTO.
History of truancy, family breakdown, poor school
performance, never held down a job more than 2 months.
Was a good footballer in youth, involved in mosque in past
but not in last year. Minimal contact with family.
Previous interests include Persian poetry, Man Utd, into rap
35 year old Caucasian male with chronic bipolar disorder, poor housing,
self neglect, recurrent admissions, history of deliberate self harm and
chronic binge drinking. In community, on Lithium and risperidone oral.
Reluctant to accept support and has disengaged from services leading to
formal admissions 5 times in last 3 years.
Divorced, small social network, mostly around pub. Lives in poorly
Last worked as builder 8 years ago, poor work record after losing job
with IBM as middle manager following manic episode.
Affluent family, went to public school where experienced bullying, then
41 year old African Caribbean female with paranoid
schizophrenia, continuously troubled by voices of ‘ghosts’,
recurrent formal admissions, self neglect, very poor quality of
life, history of violence (including assaults & threats with
knife) related to paranoid beliefs about persecution by
neighbours. On IM depixol 40mg. Previously in Medium
Living in very poorly maintained flat, possibly being used as
‘crack den’. Concerns re exploitation.
Has a boyfriend, also on AO caseload, brother heavy drug
Difficult upbringing, mother SMI & in hospital repeatedly.
Acheived good grades at school & started teacher training,
Case Study 1: Imran
The goal of the care coordinator, ACT team and the inpatient unit is ideally to
work with Imran to manage risk in the community, supported by brief informal
admissions if concerned about mental health, rather than resorting to formal
Assess strengths, consider longer term work interests.
Look at accommodation, possibility of supported placement
Initially daily visits to monitor mental health and early warning signs
Involve in AO social/group activities (DJ sessions), close liaison with inpatient unit
Start to discuss drug use and impact on life, use a MI approach to assess change -
Assess family relationships, ideally joint visit to family home. Possible individual
family work around abuse/ trauma & early losses
Medication review: assess side effects, consider Clozapine, IM options, consider
The goal of the team is to support Peter with maintaining his
accommodation and helping him to feel more secure there, whilst
acknowledging the ongoing concerns regarding his alcohol misuse
Assess strengths, including interests in music/news, try to link with
local social centre, possibly join a book group.
Consider informal admission onto inpatient ward for alcohol detox
Medication review: look at compliance, lithium wihdrawal
AO visits twice a week (monitoring mental state, assistance with
activities of daily living, social activities, monitoring alcohol intake)
Support with attending gym / ongoing support with physical health
Work to improve 50% compliance with medication
Occupational Therapy assessment, look at return to work course
Ongoing support for accommodation staff: agreed to cleaner twice a
Encourage to attend Drugs and Alcohol Service weekly for
Explore individual work around bullying at school, trauma in acute
The goal of the team is to practically support Christine whilst
Assess strengths, including fashion/ TV interests
Contacted council and several respite admissions to supported
Accommodation contract drawn up (no use of street drugs on
premises / alcohol in room only). Some individuals banned
MARMAP involved, police investigated & started prosecution, re
Settled well in supported accommodation and offered further tenancy
Team visited 3 times a week / medical review monthly, involved in
Drug use reduced after move, work with dual diagnosis specialist
Individual work around early life, family relationships
Change to oral medication, under control of Christine: Quetiapine
Start to explore possible voluntary work options, agreed long term
Medicamento para transplantado tem aprovação da Anvisa Ter, 02 de Dezembro de 2008 15:04 A Secretaria da Saúde do Estado teve os cuidados devidos e necessário para substituir o medicamento Prograf, do laboratório Janssen-Cilag Farmacêutica Ltda, pelo imunossupressor Lifaltacrolimus, distribuído gratuitamente pelo SUS e imprescindível a pacientes transplantados para evitar a rejeiçã
DE LA PORTADA ¿Hubiera partici pado Bolívar? Sin dudarlo un solo segundo, estamos seguros de que Simón Bolívar jamás se hubiera prestado para apostar el destino de la Patria en unas elecciones organizadas y supervisadas por el imperio español. Para darle soporte fiel a nuestras más absolutas y radicales convicciones, reprodu- cimos aquí el decreto de guerra a muerte contra Esp