All the women admitted will be suffering from a mental or developmental disorder; the treatment offered will comprise evidence based pharmacological, psychological and nursing interventions guided by the assessment process. The aim will be to stabilise their mental health or challenging behaviours and begin the recovery process while being mindful of the need to monitor and manage any risks. It is likely that most patients in this group will progress to the Mews to complete their recovery.
At the point of transfer from Magnolia House to the Mews a key worker will be identified from the Mews and be tasked with liaising with the Magnolia House team to enhance continuity of care and sustaining therapeutic relationships, preventing a repetition of the fractured and damaging relationships most patients will have experienced in their early lives.
Once in the Mews the emphasis will rest more heavily upon optimising patients’ clinical and personal recovery using and developing their 10 life dimensions and any Recovery Star-focused Care Plans.
Referrals will be accepted for women above the age of 18 or those transitioning from CAMHS services with a diagnosis of a Mental or Developmental Disorder with challenging behaviour and who meet the criteria for admission to a locked rehabilitation service.
Referrals will be accepted from acute services, PICU, CAMHS (for those patients transitioning into adult care) other independent locked units or the community.
It is highly likely that all patients will have been detained under a Mental Health Act Section, and may currently still be detained.
Most initial admissions will be to Magnolia House and most discharges into the Community will likely occur by stepping down from the Mews, with a small number of exceptions.
All referrals should be made based on risk to self or others linked to a diagnosed of mental or developmental disorder. A diagnosis of Learning Disability is not specifically an exclusion criteria those diagnosed as border line but socially high functioning may be considered.
Pathway from Magnolia House to the Mews
The intention is to identify and plan early in patient’s admission, with all key stakeholders if the pathway is to move to the Mews. The Occupational Therapist along with the Psychologist and senior staff at the Mews are key to this process, as we need to avoid as far as possible unsettling the existing patient mix in the Mews.
Patients will be prepared for the Mews by ensuring they are assessed a safe to use sharps and engaging in a positive rehabilitation care plan which addresses their longer-term needs.
The patients care group will liaise with the Mews staff to begin the transition and hand over arrangements, this will include the team will be invited to CPAs.
Factors to be considered include:
Violence and Aggression
Level of incidents – to include self-harm
Engagement in therapies
Patient mix and incompatibilities
How leave is utilised