Lovely Day.

Me with Prime Minister Gordon Brown, 21st January 2009.

www.communitychannel.org/content/view/829/74/

On my return home, this evening, I received my copy of the following letter clinic date 13 January 2009 in the post:

Letter date: 16 January 2009

Dear Dr Hartman,

Re: Yvonne Stewart-Williams...

Diagnosis: Schizo-affective disorder

Medication: Trifluoperazine 'Stelazine' (reduced to 1mg once daily)

I reviewed Yvonne for a CPA meeting with her care co-ordinator, Wendy Douglas in clinic today. She has been working with Wendy for an interim period whilst Grace Isiaka completes AMPH training and she is scheduled to return in March/April of this year.

Yvonne is doing extremely well and has not had any signs of deterioration in her mental state. She feels the things to look out for are lack of communication, lack of eye contact, not wanting to go out, stopping taking medication and stopping keeping appointments. She initially credited the improvement in her mental state to the support and gradually reduction of medication, but it soon became clear in her discussion that she has mad a huge shift in her life by taking on the position as a Support Worker for Thames Reach Broadway and becoming actively involved in advocacy issues, writing anti-stigma campaigns and coicing the concerns of mental health service users. In addition, she is also standing for a position as a Local Councillor and has a full social life and continues to be actively involved in the care of her son.

We spent most of the meeting discussing a transition point that she has reached in the context of the recovery model. To that end, she wanted to continue being on enhanced CPA for the moment whilst she gradually comes off medication altogether, but we takled about the next step after this. We discussed the fact that many mental health professionals chose to get some ongoing support for example psycho-dynamic psychotherapy or mentoring and this might be the next natural transition point for her after coming off the enhanced CPA. She was quite keen on this idea and has had successful group treatment in the past so I have referred her to the Maudsley Outpatient's department. They have a very long waiting list, so hopefully by the time she reaches the top it will be at the right stage for her.

There were no issues raised about her physical health today although she has a past history of fibroids.

She is in stable accommodation. There were no significant financial issues at present and as mentioned above, she is managing alright in terms of her daily living and has a full and active social and work life. In terms of cultural and spiritual matters, she is part of a Church of England congregation and was recently an usher at a church service specifically held for members of the LGBT Christian community.

In terms of issues of risks, her son is coming up to the end of his Primary school years although is at a Rudolph Steiner school and the main thing she is trying to decide at present is about which school will best meet his needs as he's got specific skills in Maths and Science and an interest in Aviation Engineering. He is looked after by Foster carers with whom Yvonne has an extremely good relationship, and the striking in consultations is how clearly she puts his needs first. There are no current issues of risks for herself or other people.

Care plan:

1. To remain on enhanced CPA with fortnghtly meetings with her care co-ordinator, Wendy

Douglas.

2. To reduce dose of Trifluoperazine from 2 to 1mg and review in May 2009.

3. I will complete a referral to the Maudsley Psychotherapy unit for either individual or group

therapy. This will be a medium term plan as part of moving from being on enhanced CPA

towards a regular supportive and reflective space as she builds her professional career.

Yours sincerely

Dr Kitty....

Specialist Registrar...

A view from one of the Mental Health Foundation windows.

Today, I spent my first morning working for the Mental Health Foundation http://www.mentalhealth.org.uk/ in my role of Assistant Fundraising Volunteer. Next month the Mental Health Foundation will celebrate sixty years of providing a service of excellence.