Subsequent to the arrival of the illness, 'maturity' from that point on - adding from further experience is less well done.
Life around them moves on but they are left stranded.
What is going on now, does not readily fit it in with what was going on before, does not reach and from current goings on, update the learnt and stored away previous experience, that is normally called up and mulled over, and updated
That makes entering into the shifting life outside, incomplete.

[ An extreme example in the mental hospitals, was that in the routine and repetitive annual examinations, that both the age and the date and facts, were more tied to the times of admission, than at the current time of an interview. ]

That applies also to the interests and ambitions, and how they were being realised at the time of the onset of the illness.
They will be still there but not adapted to 'now'.

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There is a considerable difference between the illnesss starting during late adolescence and early adult time, from if it arrives later. later. Gender experience is alo different.

So is the aftermath of upbringing.
Childhood conduct disorders, and unsettling home environments, leaves hangover influences and unworked out relationship skills
Adolescence is one of much setting aside of received parental values and expectations, so as to find the experience for the themselves; finding out how to 'do it yourself' in personal care; how to deal with, and sustain, mutual companionships in peers and other adults, including the skills of sexual companionship; how to find continued learning; how to balance personal care, personal interests and own values, with earning a living.

Adulthood is incomplete, in many areas of responsibility.

But there will remain the residue of the skills and interests as they were before illness.
and the for future it may be that these memories, having a body of associate networks already there,
will be able to be built on, and extended more easily, than starting up or encountering new situations.

Rehabilitation is bound into what was the circumstance of the patient before illness.
A full record of the narrative life of the particular individual, and the support system which remains, that they were part of, is a major consideration. As will be particular interests, skill levels, educational achievement, and inelligence levels

For the future aftercare service will keep in mind that the person affected will be trying to deal two concerns at once; with the inner effects of illness, as well as the challenges of living.
They are bound to be tired , and better off without the pressure of too demanding full time work, and occupation.
Sheltering, mentoring and protection will be necessary

carers week survey the website is well worth a visit.
carer week survey people [ thank you, Sushila ] pulled out mental health for me ... 11.5% = around 270 were adult mental illness carers: 76% said they had been near beakdown.

Surveys of this kind combined with the recently reviived National Institute for Clinical Excellence [ NICE ] recommendations below give the way forward for campaigning on facts .... a survey of what 'breaks within the week from caring' you have .. .. from which will/would come out, what sufferers are doing during their day and week
Carers Strategy One Year On - More Help For Carers

A one-stop information and advice service for carers

The Carers Direct hotline should make England's five million carers' lives easier and reduce the time and stress of searching out essential advice, including:

Details of support available, including assessments, benefits, direct payments, individual budgets and time off.
Help to maintain, leave or return to employment.
Help in education or training.
Advice on how carers maintain or improve their social and emotional well-being, and their physical and mental health.
Access to health and social care for the person being cared for.

How to access information about, and support from, health and social care services for the person being cared for

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a letter in respnse to comments on the outreach services

Your letter about Assertive outreach [ I prefer Active outreach, it's more peaceful and is easier to see that often it is inactive ] having to go further for subsequent recovery, going on with keeping contact and providing a Recovery programme of activities, is very pertinent.

It resonates with the alarm at the unexpected and unsettling rise in the rate of homicides down to schizophrenia.

A problem in providing and delivering this aftercare for schizophrenai is that most with schizophrenia will not meet the current preference in funding agencies for getting people back into fulltime work.
Those with residual schizophrenia do still need to have a programe in the week
which mediates for them, at their level of experience and educaton,
a regular routine of some activity in the week ahead, - training, education, interest pursuits, which hold them onto outside engagement and into some appropriate company.
The National Service Farmework [NSF}standards end this month.

The service to the other serious and enduring mental illnesses have much improved.
It may be that in some replacment statement they should lose the priority that the NSF afforded to them hitherto.

But there is no such improvement in service to schizophrenia.

It should remain as the unfinished priority for commissioning and delivery.
The national service to the illness must receive a more prominent oversight,
and awaits an ovedue urgent and continuing review from the National Director and the Royal College

D H Yates FRC Psych family carer

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