Questions on residential homes within mental health settings

While lying in bed, having left placement early today as not feeling well, and feeling sorry for myself, I thought it was time for a short blog post.

I’m not going to write another diary type one, this is a more pondering post…

I had a short chat this week with a senior staff member at my placement about whether we thought social workers should recommend clients to this place.

The setting for my placement is a residential home with groups including therapy group, art and music, gardening etc.

We discussed whether, although it was beneficial to a few people to be there, could it do more harm than good for others?

Whilst I very much like the recovery model, I do question how many of the clients in the house are likely to recover, and obviously recovery is in itself a relative term, but I mean recover to feel confident living in independent accommodation at the least.

While there is obviously a question as to whether this place or places like it can help as much as we’d like towards that goal, there also remains the question as to where these people might be if these places didn’t exist.

Perhaps the answer is the old style institutions. So in that respect, surely these residential communities are a positive step on.

The difficulty with places like this, in typical systems theory – is that everyone in the place has a big effect on others, every incident can be hugely impactful and can serve to slow down or halt other people’s recovery.

Equally, as people choose whether to engage with groups etc, if they choose not to engage with them, or even their therapy, or at worst not to comply with medication, often little progress is seen.

Whilst I understand the trend has been towards community mental health, it’s clear for some that’s not an option – so is there a better alternative than these places? And is it wrong to categorise them as “these places” – do they differ wildly? I assume if there were some renowned for amazing recovery rates it would be known, but maybe I’m wrong. Equally, just because one recovers doesn’t mean one doesn’t relapse shortly after – so it’s difficult to measure success.

Finally but importantly, there’s the question as to what the clients themselves want. There is one client who has been there 5 years, rather than the 1-2 years they predict – and is seen to have been barely progressing of late (although i understand since they joined has progressed a huge amount). But perhaps this person doesn’t want to move on, is comfortable where they are. If the aspiration is not towards independent living then the motivation to engage is low – what’s ideal then??

Anyway, what a disorganised ramble! Apologies!