Adult case study: Mr. B with borderline personality disorder and learning disability

The case study chosen includes a service user who has experienced cut-off and negligence from his relatives, friends and family especially during his childhood period. He has ever since longed to have contact or an attachment with a family securely. His condition has brought about anxiety which has made him unsettled. If the student is placed in an adult learning disability team whose role is to support adults with learning disabilities, the service users become screened or pre-assessed with fairness when it comes to caring. Such a process is useful in assisting individuals to meet their needs (Jenkins & Davies, 2011). It also ensures that those adults who are at low or moderate risk, are given advice and useful information are provided to them to assist in meeting their needs. Statistics show that nearly 1.5 million people in the United Kingdom have learning disabilities. Over 905,000 being adults aged 18 years and above.
There are several relevant legislation that protects the rights of adults with learning disabilities. Some of them are; the Human Rights Act 1998, the National Assistance Act 1948, the Data Protection Act 1998, the Mental Health Act 1983 and the National Health Service and Community Care Act 19990. There are also policies relevant to the protection of the adult with learning disabilities’ rights. Some of them include; Fair Access to Case – this needs the local delegates to eligibly classify this criterion into four categories of needs; low, moderate, substantial and critical (Brugha, Cooper, McManus, Purdon, Smith, Scott & Tyrer, 2012). All of these criteria are based on how serious the independence’s risk is if there is no address to issues.
For the protection of the individual’s privacy, his personal details have been anonymized. This is done in line with the provisions discussed on the Data Protection Policy and the Data Protection Act 1998. Section 6(2) of this act states that “local authorities have a general duty in common law to safeguard the confidentiality of personal information which they hold in connection with their social services functions.” This responsibility is managed and monitored by the Data Protection Policy and Team managers respectively (Jenkins & Davies, 2011).
Mr. B is the service user who was interviewed. He is a 40-year-old male individual with a borderline personality disorder and learning disability. He was born and brought up in Florida. By his birth’s virtue and the fact that the social care services got access of him first, under the National Assistant Act 1948, he became an ordinary resident in Florida State. Section 24(1) of this act gives mandate and empowerment to the local authorities to give residential accommodation for the individuals who are vulnerable. Mr. B provided information that his parents had a divorce when he was 5 years old. Since then, he got little contact with both of his parents. Of his three siblings, he is the eldest. Following allegations made by her sister against him for sexual abuse, he has had no contact with his only sister. Contacting his brother has been limited to occasional phone calls and cards (Jenkins & Davies, 2011).
Mr. B was diagnosed when he was 3 years old. Before his diagnosis, he experienced difficulty in reading and writing, clumsiness, poor memory, issues with concentration, difficulty in following instructions and being unorganized. His childhood was identified by hardship and trouble. As a result of that, he found it hard to form his own attachments because of the constant changes made in his living arrangements (Jenkins & Davies, 2011). While he was still living under the social care services, he made expressions of longing to move back to his hometown, back in 1999. He became a tenant with a housing association locally and was even given support intensively by the team. This arrangement broke down suddenly after Mr. B’s constant cravings for attention. He even got himself into self-injurious behaviors such as the tendency to set properties on fire and even harming himself.
However, the tendency of harming oneself is a common behavior among individuals with learning disabilities. A research was done in Wales and gave results that about 9% of children above age 5 and adults who use learning disability services were considered to injure themselves. A report was also made that individuals with several life problems are more likely to harm themselves (Jenkins & Davies, 2011). Important of all these being individuals with relationship problems involving either a family member or a partner. Other reported issues include those with financial, studies and unemployment problems. This literally explains Mr. B’s tendency to harm himself. In 1999, there were a series of threats received that Mr. B wanted to end his life. That was when he was detained in a local hospital according to the Mental Health Act 1983 under section 3. This was done for purposes of allowing Mr. B to receive his treatment intensively in an environment that is protected. Without the intervention of immediate treatment, Mr. B would have been endangered by harming himself and others as well by his tendency of setting items on fire.
The Mental Health Act 1983 is the law that allows a disturbed individual to be treated, detained and admitted in a hospital against their wishes. It further states under section 3 that an individual is allowed to be admitted in a hospital for purposes of treatment which must be obligatory for their safety, health and protection of other people. However, this treatment cannot be provided unless they have been detained in a hospital. In 2002, Mr. B was successfully treated and brought back into the community. Since then, he has successfully lived in several residential areas (Jenkins & Davies, 2011). Self-neglect and anxiety resulted due to his coping with life. However, Mr. B still needs support intensively. In 2007, he left his residential areas to look for his mother whom he at least saw when he was 10 years old. His main intentions were to develop a relationship with her mother. In the process of waiting to secure a placement, he lived with his mother and her partner as well for a while.
His relationship with the mother later broke down because of his threatening and violent behavior. At one time, he even threatened to set his mother’s house on fire. His mother has to call the police for help. As a result of that, he got a detainment as required under section 2 of the Mental Health Act. This was mainly for a reassessment of his mental health. His condition reached a point where if untreated, he would represent a risk of harming himself and also people around him (Jenkins & Davies, 2011). According to the Mental Health Act 1983 under section 2, an individual is allowed to necessary treatment for their condition. Under section 2, being admitted to a hospital is used when the patient has not been assessed in a hospital before or for a considerable period of time.
Under section 2, detention shall be for a maximum of 28 days. However, in the case of Mr. B, detention was necessary because he was last assessed in 2002. After he got assessed and treated, Mr. B got released and sent back into the community. He requested for his own flat so he could be close to his relations. A supported living placement that met his needs was identified and secured for him after his approval in 2007 (Torrente, Del Blanco, Moreno-Ger & Fernández-Manjón, 2012). On behalf of Mr. B, contact was made with the local learning disability service. In case he became anxious, he would receive support locally from them. The learning disability nurse and psychology team tried to work with him regularly. However, he explained that he wanted to move from where he was but unfortunately there services were unavailable. As a result, the services were discontinued as not doing as per his wish was viewed ad oppressive and a violation of his rights.
The Mental Health Act 1983 states that the diverse needs of any service user must always be respected and recognized. Their feelings, views and wished, as long as they are reasonably ascertainable, must be followed and considered with consistency and practice with decision purposes. However, discrimination that is unlawful must not be present. Discrimination can be defined according to the Webster Online Dictionary as the treatment of an individual on prejudice basis or unfairly. Social workers are also expected to not be oppressive and discriminatory in their practices as captured in the codes of practice in the National Occupation Standard (Torrente, Del Blanco, Moreno-Ger & Fernández-Manjón, 2012). In code 4, there is an emphasis on the need to respect the service users’ rights while at the same time seeking to ensure that their behavior does not harm them or people within their environment. There is also emphasis on the need to have respect, recognition and value to the experience, expertise and diversity of communities, families and individuals.
When Mr. B moved to another city, he loved there for over 14 months. Since then, his skills have developed over time especially in handling domestic chores such as ash cleaning, budgeting for healthy meals and cooking (Brugha, Cooper, McManus, Purdon, Smith, Scott & Tyrer, 2012). His present functional and cognitive level of skills is seen through his performance level. He is now able to wash his own clothes, cook his own food and even reach out to things he didn’t before.
Mr. B’s learning disability impacted his academic settings. His reading achievement in terms of speed and accuracy was substantially below the expected level depending on his chronological age. His difficulty in reading was an indication of a sensory deficit which interfered with his academic achievement (Torrente, Del Blanco, Moreno-Ger & Fernández-Manjón, 2012). His reading was characterized by slowness and full of errors. He had difficulty in composing written texts which were full of punctuation, spelling and grammar mistakes. He also had poor handwriting and organization of his paragraphs. He exhibited limited fine motor skills in both his hands as observance was made that he needed help to grip the arms of his spoon when feeding or a pen for writing.
He later moved to a new area so he could be close to his family. This is the point where the implementation of a care plan and review was carried out. He gave an expression of having the desire to learn how to drive, get into a relationship and even do the community’s volunteer work. He stayed in this environment for 3 years which also helped him engage in his personal development.
After living in his residential home for a year, he found it hard to settle and to deal with the change of staff. It was during his regular review that Mr. B agreed to be supported and be part of receiving life programme where he would be assessed on what he wanted for his future. However, because he wanted to return to his hometown, he rejected the offer. He has now abandoned his recent placement and moved in with his maternal uncle. However, he is still in touch with the council in his hometown to place him where he was born (Torrente, Del Blanco, Moreno-Ger & Fernández-Manjón, 2012). This is his interest at the moment. His current support needs are placed mainly around his disorder according to his report. He even finds it hard to get along with other residents who often complain of being scared of them when around him. This usually makes him restless and anxious hence creating the desire of moving out again.
When Mr. B felt inconsistency with his expectations like his desire to move, he became upset. This led to several phone calls being made to the police and social services. He has recently threatened to kill himself by either taking an overdose or jumping off a bridge. His constant desire for relocation has made it hard for him to engage in activities that help in his personal development (Torrente, Del Blanco, Moreno-Ger & Fernández-Manjón, 2012). This could help him develop skills that are interpersonal. Additionally, he has been unable to establish a long-term link of his own socially.
Placement with a Council Community adult learning disability team would help with the integration of several professionals such as community nurses, care workers and social workers. Its purpose is to provide a single access point form with the target adults with learning disabilities. The role of the student is to provide an assessment of the individual’s needs comprehensively. This often forms the basis for the development of a care plan to meet the assessed needs. The student, as well as his team members, also monitor the care plan through reviews (Torrente, Del Blanco, Moreno-Ger & Fernández-Manjón, 2012). This is done regularly to ensure that there is proper implementation of the care plan.