KSH moved to Avenue from MMO in January/February 2020. At the time of admission, he had an established prescription for PRN Lorazepam, which was used to support periods of agitation, heightened anxiety, and behaviours of concern. KSH was also under the care of the Community Mental Health Team (CMHT) and received six-monthly reviews to monitor his mental health and medication needs.

A few successful redirection techniques were developed and used consistently across the team, including:

• • • Changing the environment: Supporting KSH to move away from busy or overstimulating situations to a quieter, more familiar area.
    • Meaningful conversation: Redirecting KSH towards topics that he enjoys and is knowledgeable about (Reggae music), helping to shift his focus away from sources of frustration or anxiety.
    • Preferred activities: Encouraging engagement in activities KSH finds calming and enjoyable, such as listening to music, watching favourite television programmes, or participating in other calming activities painting and puzzles.
    • Offering choice and control: Providing KSH with simple choices regarding activities, meals, or daily plans to promote a sense of control and reduce feelings of frustration.
    • Humour and positive engagement: Using trusted relationships and light-hearted interactions to reduce tension and create a more relaxed atmosphere.
    • Reassurance and low-arousal support: Staff maintaining a calm tone of voice, allowing processing time, and providing reassurance without overwhelming him with information or demands.
    • Routine-based distraction: Refocusing KSH on familiar daily tasks and routines that gave him purpose, structure, and predictability throughout the day.

    As staff became more confident in recognising the early signs of agitation, these interventions were implemented proactively, often preventing situations from escalating further.

Over the last six years, KSH has demonstrated significant progress in managing his emotions and responses to situations that previously resulted in distress. The consistent use of positive behavioural strategies, coupled with strong relationships and a stable support team, has led to a gradual reduction in the need for PRN medication.

KSH has now reached the remarkable milestone of no longer requiring PRN Lorazepam. Furthermore, due to the sustained stability of his mental health and the effectiveness of the support in place, the CMHT are considering, after his ECG/blood test, to discharge KSH after his next appointment from their services and hand over his care to Primary Care.

KSH’s journey represents an outstanding example of the positive outcomes that can be achieved through person-centred  support, positive behaviour support principles, and consistency of care. KSH arrived at Avenue requiring PRN medication, and ongoing specialist mental health involvement has progressed to a point where these interventions are no longer necessary.

This achievement reflects KSH’s resilience and personal growth, alongside the dedication of his PBSP and key support team, who have remained committed to understanding his needs and implementing effective support strategies. The transition from Secondary Mental Health Services to Primary Care is a significant milestone and one that highlights the success of the support provided at Avenue. It is truly an amazing achievement and one that should be celebrated by all involved.