Jodie is in her early twenties. She has Autism and mental health issues. Jodie was placed in a Psychiatric Intensive Care Unit (PICU) under a section of the Mental Health Act.

Jodie self-referred for advocacy support by approaching Stella, a POhWER Advocate, while she was at an advocacy drop-in on the ward. Jodie told Stella that she found it very difficult to communicate verbally and so Stella gave Jodie her email address and asked her to get in touch that way if she needed any support. Jodie then emailed Stella to ask if she could support her at her ward round the following day. Stella did so and has continued to support Jodie on a regular basis ever since.

On the most recent occasion Jodie asked Stella for support at her ward round to have the restrictions that had been put on her reviewed and removed.

Jodie said she is significantly triggered by ceramics and glass and over the last few months there had been a number of incidents whereby she has managed to get access to these items and has harmed herself. This has resulted in significant restrictions including:

• 2:1 staff supervision 24/7
• all of her clothing, stationery and soft toys removed from her room
• use of a flexible toothbrush and cutlery
• community and ground leave stopped.

Jodie is an avid pen pal and can write dozens of letters a day so not having access to stationary has, in particular, caused a massive deterioration in her mental health.

As Jodie finds it very hard to communicate verbally Stella and Jodie devised a pattern of working whereby Jodie would email Stella with details of all the restrictions she wished to discuss at ward round and her reasoning for changes to be made. Stella would then meet with Jodie face-to-face before the ward round and go through her list and discuss with her how she wanted to present her case to the doctor and how she might respond to any questions he would raise. If she was particularly anxious Stella would accompany Jodie to the ward round but often it was enough for Stella to be a sounding board for Jodie to practice presenting her case to the doctor. This system worked really well and Jodie became increasingly confident, self-aware and articulate in presenting her case.

As a result a number of the restrictions on Jodie were either lessened or lifted and Jodie was able to have access to her stationary so she could resume writing to her pen pals. Jodie’s mental health has improved significantly and she is now waiting for a bed to become available on a ward for people needing less care and support.

Jodie thanked Stella for all her support “I have really appreciated all of the support you have given me whilst I have been on the PICU, even when I pushed you away you would always keep coming back and checking in on me and I grew to trust you. Your support, particularly around issues I wanted to discuss at ward rounds, has been so helpful.”