Case Studies

Take a look at some of the great work and results that Brevin has achieved with clients.

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Dad suffered with severe agitated depression for many years. His illness responded to medication but his symptoms worsened from time to time, with high levels of agitation, severe feelings of depression and anxiety, poor appetite and sleep, and often telling us that life was not worth living, feeling hopelessness about getting better or that anyone could help. Mum was his full-time carer and was amazing with him but when we all felt that the consequences of his illness were too difficult for her, the only available option was for him to go into private psychiatric hospital. He would often be in hospital for a number of weeks up to a few months. Mum would still spend most of the day with him in hospital, as she was uneasy about others looking after him, particularly as he was often alone, reporting he had not seen anyone that day. He never attended therapy groups, as there were often younger patients that he didn’t relate to, and he couldn’t sit still for long. We came across Brevin following a recommendation by a friend when we were at the point of re-admitting him to hospital, as he was oncemore very needy and getting worse. Brevin requested previous psychiatric notes and a Brevin nurse assessed my father, spoke to us, my mother and father’s psychiatrist, and suggested a plan before we agreed to go ahead with a trial of the service. Three nurses rotated to provide live-in care over a period of a few weeks, liaising with the psychiatrist, helping to review his regular medication, offering him as-required medication when very agitated or to help him sleep, and distracting him when he was preoccupied. In fact, he received the same care as when he was in hospital, except he was at home surrounded by his family and belongings, and he had the same staff dedicated to him. Perhaps the most notable outcome was that Brevin staff undertook a carer’s assessment for mum, which highlighted quite how overwhelming it was for her to look after dad, and how difficult it was for her to ask for help. We held a family meeting where mum stressed she wanted to continue caring for dad. However, she agreed a plan to have more breaks to see her friends and family, go to the theatre, and have peace of mind that dad was being looked after. We continued to use Brevin to provide home visits to give mum breaks and live-in care during times when his symptoms became worse or she needed respite.
I have a bipolar affective disorder. Every 12-18 months I suffered manic episodes that required me to go into hospital, causing immense disruption to my life. As a result of my mental illness, I couldn’t work, and my family and friends were worried, frustrated and exhausted from the regular cycles of illness. Manic episodes made me feel powerful and sharp, overjoyed with life and angry with people who told me I was unwell or tried to get me to take medication. I also drank a lot of alcohol, as this seemed to maintain this feeling of being ‘high’ and that I was liked by everyone. I enjoyed being awake, thinking that I did not need to sleep. I didn’t realise how difficult and exhausting this was for my family. I required admission to psychiatric hospital on a few occasions previously, which was often not a great experience: I was Sectioned under the Mental Health Act in a ward with very unwell people; I was often looked after by different people who did not seem to have much time for me. After recovering from mania, I soon became depressed, and then I would spend months recovering from low mood, which was often interpreted by my family as laziness or not wanting to take responsibility for my life My family contacted Brevin when I was getting high. I had stopped my medication a few weeks earlier, as I felt it was slowing me down and not helping me to think properly. My family put pressure on me and I eventually agreed to 2 members of Brevin staff visiting me at home.They were patient yet firm over the need to recommence medication. However, I continued to deteriorate quickly and a decision was taken for Brevin staff to move in with me. They were able to offer me additional medication on occasions and although at the time I didn’t necessarily see the need for this, they were able to get me on side and to co-operate. I started to recover,initially with an improvement in my sleep and later I noticed my thoughts stopped racing. Brevin staff still kept an eye on me and advised me when to go out with them, and when it might be more sensible not to leave the house, and I remember spending time playing cards and board games with them, watching films and having discussions to pass the time. During live-in care, Brevin staff offered support to my family, and they started to understand how these different states of mind were symptoms of the same mental illness, and what they could do to manage my episodes differently, which I know they were pleased about. Brevin helped me to understand the importance of complying with my medication and having avoided a full-blown manic episode, I did not go into a drawnout depressive state. After the acute episode, Brevin staff supported me with home visits; they worked with me to identify early signs of becoming unwell and helped put in place contingencies in the event that I started to deteriorate. I will have further episodes of mental illness, as this is the nature of what I suffer, but I do know that I have a plan if I do and that my family will be in a better place to help me.
We approached Brevin when our sister, who was in a psychiatric hospital under a section of the Mental Health Act after suffering a psychotic episode, asked us to find her a service that could continue her treatment at home. With everybody realising she remained unwell, we were concerned she would leave hospital, stop her medication and become very ill again. After an assessment, which involved Brevin staff seeing our sister, meeting her psychiatrist in hospital, and speaking with us, two nurses were allocated to support her at home. This enabled the psychiatrist to trial Section 17 home leave from hospital within 48hrs of assessment. Our sister agreed initial care plans focusing on what might help to keep progressing and stay out of hospital, and she was successfully discharged from hospital the following week. Brevin’s specialist mental health staff alternated to provide live-in care for approximately 3 months, providing her with a very professional, caring and personal service through what was a very emotional and stressful time for our family. Thanks to their skilled guidance and support, our sister felt involved in her care and her experience of treatment was much more positive than it otherwise may have been. This gave us great peace of mind. Brevin continued to work with my sister’s psychiatrist, gradually reducing their support from live-in care to home visits, which were of less duration and frequency over a period of a year. As she regained her independence, she was eventually discharged back to the care of her psychiatrist.
My brother has suffered obsessive compulsive disorder for most of his adult life. He received all types of medical treatment and therapy, but nothing seemed to completely get him better: when very unwell, he would stop seeing his therapist and psychiatrist, and he would refuse to go into hospital. The consequences of his mental illness were that he was unable to work, often being alone at home, and lacking confidence to go out. There were periods of time when he deteriorated further, and he would move in with me and my young family. This was great for a little while, although it was difficult for me to be able to provide all the support he needed, and he felt that he was in the way, which made him feel guilty. It was during one such period of time that I contacted Brevin to see whether they could help. Within a couple of days, he was assessed by a nurse and we agreed that my brother would start meeting with a nurse and psychological wellbeing practitioner alternatively every day. The nurse explained the care plans and the goals to my brother and myself. They visited him at home for a couple of weeks at first until he started to feel more confident about leaving the house. Brevin staff took him to appointments with his psychiatrist and therapist, and they incorporated their recommendations into my brother’s care plan, keeping an eye on him and reporting back to his clinical team. This was very helpful, as my brother had a tendency to embellish his symptoms even when he was getting better. My brother continued to suffer obsessive thoughts and engage in compulsive behaviours but as symptoms improved, he kept to the plan with regards to leaving the house, working on his CV with Brevin staff and being accompanied to job interviews. Brevin reduced the frequency of visits until he was being seen weekly and from time to time during exacerbations of his condition, they would increase sessions that week but quickly reduce it again when he was over the worse. The joint effort by the whole team made it possible for my brother to focus his energy on identifying a couple of areas of his life that he could improve on, and they supported him to achieve that.
Our son suffered an acute psychotic episode in the context of cannabis abuse that required him to be admitted into psychiatric hospital under section of the Mental Health Act. This was his third admission in 3 years; his psychosis had also manifest in high levels of aggression, even throwing a chair at me during an argument. He responded well to medication and abstinence from drugs in hospital, but as soon as he was out of hospital, the cycle repeated itself. Local community psychiatric services were helpful but unable to offer more than a visit a week, and previously withdrew their support once they felt our son was stable, although they accepted that he remained unwell and was probably still smoking, which we knew he was We found Brevin on the Internet and within 48hrs, they were able to see our son for an assessment. They liaised and worked alongside his local NHS services and consultant psychiatrist to agree a plan, which included regular home visits. Two members of Brevin staff befriended our son, identifying that he was still smoking cannabis and not taking his medication regularly. For some time, our son had appeared aloof and disengaged, unable to organise himself and just sitting at home, withdrawn, with seemingly no awareness of his problems and certainly no sense that he wished to do anything about it. He seemed to simply exist. Brevin staff explained what was going on to my wife and me, and some of the reasons behind his appearance and behaviour. It took a while for them to establish a relationship with our son. Slowly, he seemed to respond to them encouraging him to look at things differently. They worked out a rehabilitation programme with him, and we felt that he was working through things at a pace that he was happy with. They also remained in touch with his consultant psychiatrist and home treatment team, attending professionals meetings and sending them and us his progress reports. My wife and I were at times frustrated by the apparent lack of improvement and occasional resumption of cannabis, but they explained that this was not uncommon and invited us to stay on track in supporting him. Our son did start to see some of his friends after a while and started to enjoy going for walks. He seemed to respond well to the structure that Brevin staff put in place for him and this seemed to help hm to stop taking cannabis. He volunteered in a friend’s shop carrying and hanging clothes, and Brevin staff liaised with our friend for our son to work on his self-care (he was quite malodorous) and problem-solving, which reduced his anxiety when talking to customers. Brevin remained involved with my son with varying degrees of input for over a year before he was discharged back to his GP.
We were put in touch with Brevin through my daughter’s psychiatrist after she had been in private psychiatric hospital for an episode of schizophrenia. She had responded somewhat to medication but we all noticed that some of the symptoms continued and she seemed rather ‘knocked-off’. Her psychiatrist did say that she was still a little over-medicated but that the type of schizophrenia my daughter suffered meant that she would continue to suffer delusions and hallucinations, and have problems with motivation and drive. In essence, that she would continue to have difficulties for the foreseeable future, including in her day-to-day living, decision-making, problem-solving, looking after herself, and complying with her treatment plan, which included seeing her psychiatrist and attending her GP for an injection every month. A member of Brevin staff assessed my daughter and spoke to my husband and I, and her psychiatrist, as well as reading her medical notes.She identified a number of areas that she and a colleague from Brevin would work on and what the goals were. They included checking in on her 5 times a week for an hour initially to build a relationship, understand her symptoms, educate her on the need for medication, take her out, helping her to make decisions, support her with her shopping, and essentially acting as role models whilst encouraging her to gain independence. They supported my daughter with broad rehabilitation goals where she could see improvements in certain areas of her life My daughter is not able to re-establish full independence but the availability of a dedicated and expert team of specialist mental health professionals, specifically allocated to my daughter, allowed her to form an enduring therapeutic relationship. Home visits removed barriers for her where she may have otherwise found it difficult to engage, for example reducing the stress and inconvenience of travelling to appointments. It certainly reduced the need for admissions to psychiatric hospital, which helped her to build a more stable life for herself.
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