E is a woman in her mid 20s. She has a young son who is subject to a child protection plan. E has a history of abusing over the counter opiate-based pain relief for which she received support and a methadone prescription at North Yorkshire Horizons, Harrogate before moving to Leeds and transferring to a service there.
E was referred back to North Yorkshire Horizons, Skipton by her social worker on 24/10/16 and attended a comprehensive assessment on 04/11/16. E presented as extremely nervous, but willing to engage. She explained how she had a mental health diagnosis and suffered with what she described as crippling anxiety. She had moved back into the area alone but had the support of her mother and step father in a neighbouring village. The safeguarding child procedure was explained to E and she accepted a home visit explaining that she was willing to comply with all requests in order to look after her son well. The home visit was conducted with no concerns raised.
Following this, E attended a prescribing appointment and began engaging in regular psycho-social intervention sessions where her anxiety was discussed. On her third contact with me, E attended with her son and mother and was visibly distressed. She explained that she had stopped taking her anxiety medication and had been struggling to cope for a few days. She went on to explain that although she was struggling, she had noticed this within herself and contacted her mother, who moved in with her short term in order to ensure E’s son was cared for.
I discussed techniques that E could use to reduce her anxiety and recommended she seek her GP to restart her anxiety medication as soon as possible. Following this, E contacted to say she had restarted and was getting a Community Psychiatric Nurse from the Community Mental Health Team.
Following this session I also contacted E’s social worker and discussed the concerns with her. I was able to gain a clearer picture and found that while this was a common cycle for E, she generally coped well with it and was able to put in place the necessary protective factors for her son.
On 08/12/16 the first review meeting between all agencies involved occurred at the Skipton Hub. No concerns were raised and E attended with her son and mother. Further meetings have been organised at Skipton Hub and taken place. E has attended all of these appointments and also allowed subsequent home visits. Her mental health has stabilised and she has been able to progress her care of her son so that he now stays full time without her mother being there.
On initial assessment E was concerned and apprehensive about the future of her methadone and was reluctant to reduce. As she has attended sessions her confidence has grown and she has now started and maintained a steady reduction of her methadone and aims to be prescription-free in 6 months. Her social worker and CPN continue to report she does well and the protection plan for her son is due to end in the next month. She has requested ongoing support and is voluntarily entering into a child in need agreement.
E has has grown in confidence and has become more independent. Her engagement with services remains excellent. Also her methadone prescription is steadily reducing. E is confident she can be free of substitute medications.
By North Yorkshire Horizons worker, William Moyle