24/05/2012
23:59
Inpatient –
Nursing
Title:Night Shift
Li was at the nursing station at the start of the shift and asked if he could go to bed which was
agreed. He was observed to be asleep from 22:00 and has appeared asleep throughout the night.
– —————————- Confirmed By HNicholson@, 25/05/2012
24/05/2012
20:32
Inpatient –
Nursing
Title:Long Day
Li was awake at 08:00. At the start of the shift he has been in low mood, and confirmed this
verbally. He refused to attend groups and education, spending his time lying on the sofa and
listening to music instead. In the afternoon his mood picked up, as he began to interact with his
peers more. During which he was observed to be joking and laughing. Following a meeting with
doctor HG, his mood dropped again as he was informed that he will be undergoing a mental
health assessment. Subsequently he appeared withdrawn, spending most of his time lying on the
sofa and listening to his music. He interacted minimally. He ate adequately.
1:1
Li reported that he does not want to be here, and that he was feeling worse every day. He
reported not being happy here for several reasons: he feels this place is restrictive; he misses his
laptop and he does not like being around people as he is used to be alone. He acknowledges that
he needs help, but feels that he can receive sufficient help from the community. He was told to
think about the benefits of being here and the disadvantage of being at home. He acknowledge
that there may be more risk of self harm as he is not being watched as much, however he feels
there is more distraction that he can utilise at home. He also reported that he wants to talk to
doctor HG and his social worker regarding this issue.
We also discussed about how he was doing in terms of utilising his distraction techniques. He
reported that he punched the wall with his hand the other day. He did report attempting the
distraction techniques, but he did not apply it for a long time. He was praised for remembering to
use these techniques, as last time he punched the wall he did not even attempt any distraction
techniques. He was encouraged to try and utilise the distraction techniques for a longer period
next time. In addition, he was encouraged to get his carers to bring some additional materials that
he can distract himself with.
– —————————- Confirmed By HLee1@, 24/05/2012
24/05/2012
17:00
Psychological
Therapy
Title: Li was frustrated in our session. He expressed wanting to be discharged, and he was
annoyed that he might be put on a section 3. Li would much rather get input in the community. He
feels that it he would stick to this, basically through of having to return here. This would equally be
his motivation for not self-harming in the community. His coping strategies at home would be
talking to his foster carer and surrounding himself with people as he doesn’t self harm in front of
others.
We talked about how he could make the most out of his time here if discharge wasn’t possible. He
said he would continue to talk to me about his difficult experiences, as well as taking advantage of
the support from staff.
Li informed me that he has started to have access to his blackberry (two ten minute intervals)
where he can chat to his friends, one of these friends is a 12 year old boy in year 7 at his school.
Staff are going to pass this on to the social worker, in terms of vulnerability of the 12 year old and
Li. Li will continue to have restricted access to his phone, monitored by staff, whilst informal.
– ————————— 25 May 2012 10:30, Oliver Sindall
Event By: Oliver Sindall
24/05/2012
15:50
Inpatient –
Medical
Title:Foster carer informed about MHA assessment.
Call to Mr Thompson, to inform him that we are having to proceed to section 3 assessment, as he
has withdrawn his consent to remaining in hospital. He told me that on Monday, he was hopeful
that Li was going to be able to work with us.
– —————————- Confirmed By HGarrett@ 24/05/2012
24/05/2012
15:41
Inpatient –
Medical
Title:E- mail to tier 3 consultant
From: Garrett, Helen
Sent: 24 May 2012 15:41
To: ‘Nairac Bertrand (EAST KENT HOSPITALS UNIVERSITY NHS FOUNDATION TRUST)’
Subject: Update
Importance: High
Dear Dr Nairac,
I’m afraid the situation has changed (as you predicted) that the young man for whom we held a
CPA meeting on Monday has now withdrawn his consent to remaining here for treatment, so I
have requested a section 3 assessment.
Yours,
Helen Garrett
Dr Helen Garrett
Consultant Child & Adolescent Psychiatrist
– —————————- Confirmed By HGarrett@, 24/05/2012
24/05/2012
15:20
Inpatient –
Medical
Title:Requst for MHA assessment.
Phone call to Senior AMHP (Bob Kirby) to request section 3 assessment.
He will try to organise that as soon as possible.
If Li tries to leave in the meantime, section 5(2) or 5(4) should be considered.
– —————————- Confirmed By HGarrett@, 24/05/2012
24/05/2012
14:55
Inpatient –
Medical
Title:Li seen at his request
I suggested that he wait till tomorrow, so the Independent Advocate can support him. Li told me
he wants to see me as soon as possible and declined a nurse to support him either.
Poor eye contact and red, swollen right knuckle (heads of 3rd-5th metacarpals). Li said he did this
last night- punched a wall, as he is so frustrated at being here ‘this place is really getting to me’.
He informed me that it is different to Monday- he would not harm himself and would work with
Commumity support. Li told me that, if he is going to end up on a section, he will agree to stay ( I
had not mentioned that at all). \he said he is too angry and upset to stay here- that it feels like a
prison. Li said he has had a computer since the age of seven, but has not had one here for 3/52. I
informed him that I shall speak to Mrs Coles about this, but he did not appear at all satisfied by
this.He told me that he cannot support his friends. I reminded him that he has leave in the
grounds to use his mobile, but he told me that 10 minutes is not enough.
I explained to Li that I did not consider it safe for him to leave and so would be requesting a
further MHA assessment.He told me that he will probalby end up here for the rest of his life, as he
doesn’t want help and will not talk to us. At the end, he appeared upset- on the brink of tears and
angry.
Ward Dr to examine his right hand, once he is calmer.
– —————————- Confirmed By HGarrett@, 24/05/2012
24/05/2012
14:00
Nursing Title: RChapman had a conversation in which Li stated that when he uses his phone he contacts
his best friend who is 12 years old and has ‘a lot in common with him emotionally and
mentally’ advice was sought from Dr HGarrett and RBarton. It was agreed that as he is informal
we cannot prevent him using his phone at the moment, however advice should be sought from his
Social worker as they have parental responsibility.
RChapman then tried to contact Carly Ratcliffe leaving a message on her mobile and also
contacting the office. A message was left for Carly to contact the ward on the 25/5/12 as she is
out of area today.
– ————————— 24 May 2012 19:13, Rosaleen Chapman
Author
Li Jean-Luc Harris
Category
Date
January 7, 2025
Last Modified
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