St Peter's Hospital - Joseph's Journey

Joseph is a 50 year old gentleman who has a diagnosis of Huntington’s Disease. He has a significant forensic history that led to his detention under Section 37/41 of the Mental Health Act. Joseph presents with behaviours that challenge and his mobility and swallow reflex have deteriorated significantly.

He was referred to St Peter’s Hospital as he required expert management of his mental and physical health needs, whilst being able to provide him with the relational and procedural security that his risk profile requires.

Joseph's mental health problems were effectively managed with the introduction of psychotropic medication. He refused to engage with therapeutic activity, presenting with marked apathy, which is a feature of his Huntington’s presentation.

By introducing a core team, to implement positive behaviour support plans it was possible to improve rapport with Joseph. He was able to communicate more effectively with the use of written notes and could be involved in his care and treatment planning.

Joseph remains impulsive and presents a risk to others. The team at St Peter’s utilise HCR20 structured risk assessment, and it has been possible to offer Joseph regular Section 17 leave, with the consent of the Ministry of Justice.

Joseph has started to show deterioration in his mobility and also his swallow. He is regularly reviewed by a Physiotherapist and Speech and Language Therapists. Joseph now requires a modified diet, which he was reluctant to accept, but is gradually complying with.

Joseph will require long term management of his neurodegenerative condition and the associated risks. With its specialist multidisciplinary team and living environment, St Peter’s is ideally placed to meet his complex, and changing needs. We are also able to provide psychiatric assessment and liaison with the Ministry of Justice to ensure that his risks are appropriately managed.


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