Supporting stability and recovery for a patient with paranoid schizophrenia at Baldock Manor
A real outcome service user case study
DS has a diagnosis of paranoid schizophrenia and experiences active command hallucinations which can compel them towards self-harm and violence. During periods when their mental health deteriorates, their vulnerability to harming themself or others can increase significantly.
Following a period of instability and a short stay at another mental health service, DS was admitted to Mulberry Ward at Baldock Manor Hospital.
At the point of admission, establishing greater stability and providing a safe, structured environment were important priorities. DS also described their sleep prior to admission as “erratic”, regularly struggling to settle at night.
Although DS remains in our care (at time of writing) and is still relatively early in their admission, there have already been positive changes in his day-to-day wellbeing.
Our approach
Supporting DS has involved creating consistency around them while taking the time to understand what helps them feel safe, comfortable and engaged.
The structured ward environment provides predictable routines around meals, activities and therapeutic engagement, alongside the clinical oversight required to support his complex mental health needs and associated risks.
A key part of this has been the development of therapeutic relationships with staff. Rather than focusing solely on DS’s diagnosis and clinical presentation, the team has worked to understand them as an individual and identify the everyday factors that contribute positively to their wellbeing.
For DS, having people around them is particularly important.
“I’ve had people around me, which I like.”
This social connection, combined with consistent staff support, has helped DS adjust to the ward environment and reduced the sense of isolation he can experience.
His care is supported through a multidisciplinary approach, bringing together nursing, psychology, occupational therapy and support staff. This allows different aspects of DS’s needs, risks and recovery to be considered together, while enabling the care to respond as their presentation changes.
Building stability through everyday routines
Some of the early improvements for DS have come from relatively simple but important aspects of daily life.
Regular meals, improved sleep, social interaction and a predictable routine have all contributed to them feeling more settled.
One of the clearest changes has been their sleep. Having previously described it as erratic, DS now reports:
“I’ve been sleeping well.”
While improved sleep alone does not represent recovery from the complexity of DS’s presentation, it is an encouraging change and forms part of the wider stability the team is working to establish.
The consistent presence of staff has also been important. When asked about their experience of the service, DS simply said:
“They look after me.”
That sense of being cared for and supported has helped them feel safer and more comfortable during their admission.
What quality care means to DS
An important part of person-centred care is recognising that what professionals consider important may not always be how a patient describes good care themselves.
For DS, quality care comes down to very human things:
“Good company, good food.”
They value having people around them, being able to talk to others and knowing staff are there to support them.
These everyday experiences sit alongside the clinical elements of their care. Meaningful conversations, encouragement to engage with activities and consistent emotional and practical support all contribute towards building trust and creating an environment in which DS can continue their recovery.
The team works within a culture of compassion, patience and respect, supported by regular supervision, reflective practice and clear leadership. Maintaining a stable staffing structure also helps provide the continuity required to develop meaningful therapeutic relationships with patients experiencing complex mental health difficulties.
Progress so far
DS remains at Baldock Manor Hospital and continues to receive support from the multidisciplinary team.
His admission is ongoing, so it is too early to measure longer-term outcomes. However, there have been encouraging signs of progress since their arrival.
They are sleeping better, has adjusted positively to the ward environment and reports feeling well supported by those caring for them. Structure, regular meals, social interaction and consistent support have helped create a more settled day-to-day experience following the instability that preceded their admission.
Perhaps most importantly, DS himself speaks positively about the care they are receiving.
“Good people here.”
And, reflecting on how they have been supported:
“You looked after me well.”
For someone whose mental health can deteriorate to a point where the risks of self-harm and harm to others increase significantly, creating an environment in which they feel safe, supported and connected is an important foundation.
DS’s progress is still at an early stage, but the changes seen so far demonstrate the value of consistent, structured and person-centred care, alongside multidisciplinary clinical support, in helping them move from a period of instability towards greater day-to-day stability.
At time of writing, DS was still in our care with the team continuing to support his recovery and work towards positive longer-term outcomes.