Dr Rachel Scullion, Consultant Clinical Psychologist and our Managing Director, led a discussion on mental capacity assessments at times of high risk for our young people with complex emotional needs. We also discussed how we can mitigate deficits in capacity to help our young people to make decisions at times of high distress.

Our Learning and Development Manager, Dominique Hooper, spoke about a review of our Safewards for Safe Homes (SSH) model.  We broke into groups and we heard about some great examples of creative and collaborative practice in our various residential services. ‘Know Each Other Dobble’ was a favourite adaptation of one of the Safewards interventions.  The SSH model provides  effective risk prevention and management through least restrictive practice.  We discussed a number of areas of development in our SSH model including the adaptations we have made for our Eating Disorder service.  We are excited that we will also be attending the International Safewards Conference in Prague in November when we will be presenting on our SSH approach.

Finally, our psychiatrist Dr. Oliver Woolf presented his audit of the work we are doing across the organisation to reduce benzodiazepine use. Too many young people are discharged to our care on BDZs and it can be hard to reduce them due to both physical and psychological dependency – but we are making good progress. Oliver enhanced his session by handing out ice creams to everyone which was a lovely gesture at the end of a long and hot day of learning and discussion.

All in all, the day offered a really well balanced and stimulating programme. We have such talented and creative colleagues at Care in Mind. Looking forward to the next one!

The post Clinicians and Managers learning together appeared first on Care in Mind.

Many young people with severe and complex eating disorders will have spent time in hospital settings. At times, even after long admissions they remain too unwell to manage their eating independently in the community. Options such as day services and community eating disorder services can really help in such circumstances, but at times even this is not enough. Sometimes young people find themselves in a cycle of repeated hospital admissions, deteriorating each time they are discharged. Sometimes they really struggle to maintain their progress in a community setting but an inpatient admission is not indicated.

Eating disorder focused residential care exists to fill this gap – offering structured, specialist care for young people and young adults who need more than outpatient input, but no longer require an inpatient ward.

For referrers, commissioners and clinical teams, it is clear in such cases that increased support is needed. They are seeking a setting that can safely manage risk, maintain engagement and create a realistic route towards recovery and independence. However, they may not be aware that such services exist. For families and young adults themselves, the question is often simpler and more urgent: will this placement help me to achieve stability and move toward recovery where other services have failed?

What eating disorder residential support is designed to do

Eating disorder residential support provides a clinically informed, highly structured living environment for people whose eating disorder cannot be safely or effectively managed through standard community services alone. That may include young people with anorexia nervosa, bulimia nervosa, ARFID or complex disordered eating alongside wider mental health needs such as self-harm, trauma, emotionally instability, anxiety, depression, ADHD or autism.

The purpose is not only symptom management. A good residential placement should stabilise risk, work on nutritional rehabilitation, build tolerance for routine, and help the person take gradual steps towards autonomy. In practice, that means support with meals as required, moving toward more autonomy in meal preparation. Close supervision from our in-house dietician and support from our chefs enable young people to learn about eating healthily and building routines around meal times and food. In addition to this, underlying issues can be addressed in psychological therapy and in sessions with our clinical nurse specialist. Our psychiatrist can support with medication management. Most importantly our residential team will support the young person to devlop their identity and interests outside of eating issues, working on daily living skills and therapeutic engagement, supporting young people with access to education and employment opportunities as well as group activities around young people’s interests. All these things are focused toward the ultimate goals of recovery and independence.

This matters because eating disorders rarely sit in isolation. Repeated admissions, failed placements and escalating risks often reflect a wider pattern of unmet need. A service that looks only at food intake without addressing trauma, relationships, neurodiversity, functioning and identity is unlikely to support sustained progress.

When residential support may be the right option

Residential care is not the first step for every eating disorder, and it should not be treated as a default. Many young people recover well with outpatient therapy, family-based work and regular medical oversight. Residential support becomes appropriate when such services are no longer enough to maintain medical and psychological safety or consistency.

This may be the case where there is persistent dietary restriction, rapid relapse after discharge, frequent hospital admissions or significant risk-taking behaviours alongside the eating disorder. It can also be suitable where placement instability has interrupted treatment, or where a young person needs a therapeutic environment that is more intensive than standard supported accommodation, with the specialist focus on the eating disorder that few services can offer.

There is always a balance to strike. Move too early into a highly supported environment and independence can be delayed. Move too late and patterns of malnutrition, eating disordered behaviours or emotional dysregulation may become even harder to shift. The best decisions are usually made collaboratively, with a realistic view of risk, readiness and the level of structure needed to make progress.

What good eating disorder residential support should include

Most residential settings are not equipped to support eating disorders well. They may offer risk management and staff support, but lack the specialist knowledge needed around re-feeding, meal support, body image issues, sensory needs and the relational dynamics that often accompany severe eating disorders.

Good eating disorder residential support should include 24/7 staffing, work on meal planning and meal support as required, medication management, risk assessment and integrated mental health input. A multidisciplinary approach is particularly important in severe and complex eating disorders. Eating Disorders can be life-threatening conditions and the physical health management of young people is as important as the psychological support. A specialist service should provide in-house medical input from psychiatry working closely with an in-house nurse and dietician. Physical investigations such as blood tests and ECGs can be required frequently to monitor physical wellbeing in accordance with the MEED Guidelines. Good liaison with local community and inpatient services is key. Alongside this, therapeutic work from members of the team, including clinical psychology and family therapy, allows for issues underlying the eating disorder to be addressed and meaningful longer term change to begin.

The environment also matters. A least restrictive, trauma-informed setting can make a substantial difference to engagement, especially for young people who have found hospital admissions frightening or destabilising. Autism-friendly practice is equally important. For some residents, sensory sensitivity, rigid thinking, social communication differences and distress around change are not secondary issues – they are central to how their eating disorder is experienced and maintained.

Why integrated care improves outcomes

Residential support works best when accommodation and treatment are not operating in separate silos. If therapeutic goals, nutritional plans and daily support are disconnected, young people receive mixed messages and progress can stall quickly.

An integrated model allows the whole team to work towards the same aims. Support workers can reinforce meal plans consistently. Clinicians can respond early to warning signs. Medication can be reviewed in context. Difficulties with sleep, self-care, social functioning or emotional regulation can be addressed before they trigger a wider deterioration.

This joined-up approach is often what reduces repeated admission cycles. Rather than moving between crisis responses and unsupported gaps, the young person experiences continuity. That continuity can be especially valuable for those who have learned to expect breakdown, rejection or abrupt discharge from services.

The role of safety without over-restriction

One of the most important distinctions in residential eating disorder care is the difference between safety and restriction. High-risk presentations do require strong boundaries, close observation at times and clear response plans. But over-restrictive practice can undermine trust, increase shame and reduce a young person’s ability to develop genuine self-management.

Effective services hold risk carefully rather than reactively. They understand when supervision is necessary, when therapeutic challenge is appropriate and when a resident needs a greater voice and choice to remain engaged. This is rarely linear. A young adult may manage meals well for a period, then struggle after contact, change or trauma activation. The care model needs enough flexibility to respond without turning every setback into failure.

For referrers, this is a key consideration. The right placement is not simply the one with the highest level of restriction or observation, such often occurs in inpatient units. A more effective setting in terms of longer term change may be one with the clinical judgement, staffing and therapeutic consistency to manage complexity safely while still moving the person towards increased independence in a community context.

Supporting transition, not dependency

A successful eating disorder residential service does not define success purely by weight restoration or short-term stabilisation. Those outcomes matter, but they are only part of the picture. Lasting recovery depends on whether the young person can transfer gains into everyday life.

That means residential support should include preparation for what comes next. Young people may need help rebuilding education or vocational goals, strengthening community links, improving practical living skills and developing routines that will hold once support becomes less intensive. Step-down planning should begin early, not at the point of discharge.

This is where some placements struggle. If all support is delivered for the young person rather than with them, functioning may appear stable in placement but collapse afterwards. A more effective approach combines nurture with progression. Residents are supported to participate in daily living decisions, collaborate in developing their care plan and build confidence in managing ordinary demands.

What referrers should look for in a provider

For commissioners, social workers and clinicians, the suitability of a placement rests on more than a service description. The detail matters. How are young people supported in working toward a healthier diet, how are eating disordered behaviours managed, how is physical wellbeing maintained and monitored, what therapeutic options are available to support meaningful change, what happens at times of deterioration, how is autism or trauma accommodated and worked with, and how does the provider work with external teams and families.

It is also important to understand the provider’s threshold and scope. Some services are well placed for medically stable young people with significant psychological risk, but not for those requiring closer medical monitoring. Others may manage a narrower eating disorder profile but be less able to support co-occurring self-harm, suicidality or repeated absconding. Clarity at referral stage protects both the placement and the young person.

Care in Mind’s model reflects this need for specialist, clinically integrated support, particularly for young people whose complexity sits across mental health, eating disorder risk and placement instability.

A recovery pathway that makes sense

Eating disorder recovery is rarely neat. Progress often includes resistance, ambivalence, relapse and periods of apparent standstill. Residential support should be built with that reality in mind. It is not about expecting immediate compliance or presenting recovery as a straight line. It is about creating the conditions in which a young person can become safer, more stable and more able to participate in life again.

For some, the value of residential support lies in preventing another hospital admission. For others, it lies in offering the first placement that can genuinely hold complexity and provide some longer term stability. Either way, the most effective services provide more than accommodation. They offer a structured therapeutic environment, a coordinated multidisciplinary response and a clear pathway towards greater independence.

When the right support is in place, eating disorder residential care can become more than a pause between crises. It can be the setting where recovery begins to feel possible, practical and sustainable.

The post What is a Specialist Eating Disorder Residential Service? appeared first on Care in Mind.

For referrers, commissioners and clinical teams, the challenge is rarely identifying that risk exists. The harder question is what kind of support is most likely to stabilise the person, reduce repeated crises and create a realistic route towards recovery. In many cases, that means looking beyond short-term containment and towards a specialist residential model that can hold complexity over time.

Why high risk behaviour needs specialist mental health support

High risk behaviour is not a diagnosis in itself. It is often a sign that a young person is feeling overwhelmed, unsafe, dysregulated or struggling to cope with underlying mental health difficulties, trauma or relational instability – or a combination of factors which may also be excaerbated by neurodiversity. Behaviour that appears oppositional or chaotic on the surface can be an expression of distress, fear, shame, unmet need or repeated experiences of not being understood.

That is why effective support cannot focus on behaviour alone. Restrictive approaches, such as those often used in hospital settings, may reduce immediate risk in the short term, but they may of themselves be re-traumatising and they may escalate risk, reduce agency and lead to dependency. Such approaches do not build understanding, emotional regulation or promote independence. Equally, supported living community placements may be too light-touch for a young person whose risks escalate quickly or whose presentation has already led to multiple placement breakdowns.

The most effective response sits between those extremes. It combines consistent therapeutic relationships, mental health oversight and a clear recovery pathway. This is particularly important for young people who have moved in and out of hospital, experienced failed placements or become stuck in systems that react to crisis rather than preventing it.

What good mental health support for high risk behaviour looks like

Good support begins with a detailed assessment of risk, presentation and need. That includes understanding what the behaviour is communicating, what increases or lowers risk, how quickly the person can deteriorate and what level of supervision is required to keep them safe without creating unnecessary restriction.

A trauma-informed approach is central. Young people with high-risk presentations, who have often experienced psychological trauma, are often highly sensitive to control, rejection and inconsistency. A real trauma-informed model considers the person’s history, triggers, attachment patterns and coping strategies, and uses that understanding to shape care planning in a collaborative way, ensuring that the young person has real choices in the way in which their care and support is delivered.

Specialist support also needs to be clinically integrated. Risk is rarely static, and young people with complex needs require input from an integrated mental health team, offering psychiatry, psychology, nursing, dietetics, occupational and creative therapies. Where those disciplines work together rather than in isolation, and in close collaboration with residential teams and the young person, decision-making is more joined up and the care plan is more responsive.

Just as importantly, support should be developmentally appropriate. A 17-year-old leaving CAMHS, a 21-year-old with significant autism and a 28-year-old with an entrenched pattern of self-injury may all present with high levels of risk, but their communication style, life stage and goals will differ. Effective services recognise that recovery planning must reflect the person’s age, strengths, identity and future aspirations.

When hospital is not the answer

For some young people, inpatient admission is necessary and life-saving for a short period of time. But it is not the most suitable context for sustained recovery. Repeated admissions can create disruption, dependency and distance from ordinary life, particularly where the person is medically stable but behaviourally high risk. Hospital can contain risk to a certain degree; but the social, relational and practical factors that maintain it are more effectively worked on in a longer term community setting.

This is where specialist residential care can offer a credible alternative. In the right setting, a young person can access 24/7 support, therapeutic structure and multidisciplinary mental health support while living in an environment that is less restrictive than hospital and more recovery-focused than emergency provision. The aim is not simply to manage crises, but to help the person build the trust, stability, insights and skills needed to move forward in their recovery and independence.

Finding the right balance between risk management, therapeutic structure, choice and future focus is key. If a placement is too restrictive, it can limit autonomy and reinforce institutional dependency. If it is not structured enough, risk may escalate and the placement may fail. If it does not allow for the young person to be a part of decision making and future planning, they will not develop the independent skills they need to move toward recovery. The right model sits in the middle: safe, specialist, relational and trauma-informed, with a clear rationale for every intervention offered.

The role of residential care in managing risk and building recovery

Specialist residential services are particularly valuable for young people whose needs have outstripped standard provision. This may include individuals with recurrent self-harm, suicidal ideation, emotionally unstable presentations, psychotic illnesses, complex eating disorders or autism with co-occurring mental health needs.

In these cases, stability is often the first therapeutic task. Regular routines, predictable staffing, supported medication, collaborative risk management and consistent boundaries can reduce the level of daily chaos that keeps a young person in survival mode. Once that foundation is in place, therapeutic work becomes possible and meaningful and lasting change can take place.

Residential care also allows professionals to observe patterns over time rather than making decisions on the basis of isolated incidents. Teams can identify early warning signs, test interventions, adapt support plans and monitor whether risk is changing in response to treatment. This is especially important where the presentation is fluctuating or where previous services have struggled to maintain engagement.

At Care in Mind, this model is shaped around clinically integrated, least restrictive support for young people and young adults with complex mental health needs. The value of that approach lies in its ability to hold high-acuity presentations safely while still keeping recovery, progression and independence in view.

Mental health support for high risk behaviour should not stop at crisis management

One of the most common weaknesses in fragmented care pathways is that support intensifies only when risk peaks. Once the immediate crisis passes, the package may reduce too quickly, leaving the young person without the consistency needed to sustain progress. This can lead to the familiar cycle of crisis, emergency response, short-term stabilisation and relapse.

A stronger model treats crisis management as one part of a longer term pathway. It asks what the young person needs not only to survive the next week, but to maintain safer patterns over the next six months and beyond. That will involve ‘relational security’, achieved through building trusting bonds with residential staff members on a day by day basis. It will also require skilled therapeutic work, family therapy where indicated, expert medication management and support with education or occupation. In this way a young person can achieve their recovery goals and take graded opportunities toward moving into a more independent setting.

Progress is rarely linear. Young people with high-risk presentations often make gains, then experience setbacks. Services need the confidence and skill to manage that reality without seeing every relapse as failure. What matters is whether the overall trajectory is moving towards greater safety, better emotional regulation, fewer admissions, placement stability and increasing daily functioning.

What referrers should look for in a provider

For local authorities, NHS partners and clinical teams, referral decisions often need to be made under pressure. Even so, a few practical questions can help distinguish a specialist mental health supported residential service from one that is simply offering accommodation with some therapeutic support.

First, ask how risk is assessed, reviewed and communicated. High-quality services should be able to explain their approach clearly, including staffing levels, residential practices, incident responses and clinical escalation routes.

Second, look at the multidisciplinary model. If a provider is supporting young people with high-risk behaviour, there needs to be meaningful access to integrated mental health clinicians, rather than ad hoc advice from outside the service.

Third, consider the philosophy of care. A least restrictive, trauma-informed and autism-friendly approach is not simply a marketing phrase. It should be visible in how staff build relationships, respond to distress and support young people to regain control through collaborative and empowering care where they are treated as the most important member of their care team.

Finally, ask about outcomes and progression. The immediate aim may be stabilisation, but the longer-term goals should include placement sustainability, reduced reliance on hospital, reduced risks, improved engagement and a realistic pathway towards independence.

A better path for young people with complex needs

High risk behaviour can place young people at the edge of multiple systems without allowing them to settle and recover in any of them. The answer is not always more restriction, nor is it leaving community services to manage risk that has already become too complex. More often, what is needed is the right level of specialist support at the right time.

When mental health care is integrated into residential settings, relationally consistent and focused on safety, therapeutic change and progression toward independence, young people have a better chance of moving out of crisis patterns and into more stable future lives. That should remain the goal in every placement decision: not simply where risk can be contained today, but where recovery can genuinely begin.

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For referrers, that moment usually arrives under pressure. Decisions may need to be made within hours, not weeks. Families may be exhausted, community teams overstretched and an existing placement unable to manage the level of risk. In that context, the quality of the new placement matters as much as the speed of access.

How should you choose a crisis mental health placement?

A rapid intake crisis mental health placement may typically be considered when there is acute deterioration, a history of repeated or failed hospital admissions, significant self-harm or suicidality, severe emotional dysregulation, a risk of absconding, exploitation concerns and/or current placement instability.

The key point is that a crisis placement should not mean emergency containment alone – and this is all that many crisis beds offer. A specialist crisis placement needs to be able to stabilise immediate risk while also beginning assessment, formulation and a pathway forward. Without that second part, the service can become little more than a holding arrangement, which may not provide the emotional containment needed and lead to further escalation and will certainly not promote any lasting change.

For many young people, especially those with a significant history of psychological trauma and a diagnosis of personality disorder or complex PTSD, particularly when also combined with autism or ADHD, a standard emergency option such as an inpatient hospital bed may be too restrictive or poorly matched to need and may lead to further deterioration. A short-term crisis bed, only on offer for a matter of a few days, may lack the expertise to manage complex presentations and significant risks and may not be able to effect any meaningful change within a short time period. As such, a specialist residential rapid-intake assessment, over a period of several weeks, can offer an alternative to hospital admission, providing clinical oversight in a therapeutic milieu that can lead to stabilisation and the beginnings of real change. Care in Mind is a specialist mental health supported residential care provider that offers a Rapid Intake and Assessment service for exactly such situations.

When a rapid intake residential placement is the right option

Not every period of instability requires residential care. Some young people can be supported safely through enhanced community input from NHS crisis services or home treatment teams. The threshold for a crisis placement is usually reached when risk is high, support needs are continuous and ordinary community arrangements are no longer sufficient.

That may include a young person being discharged from inpatient care who remains too vulnerable for unsupported discharge. It may involve someone whose foster placement or supported living arrangement has broken down because of high-risk behaviour.

The most appropriate referrals tend to have three features. First, there is a clear and present concern around safety or mental state. Second, the current environment is unable to contain or respond to that concern consistently. Third, there is evidence that a specialist structured, mental health supported residential placement is likely to offer greater stability than another short admission or a brief stay in a crisis bed.

What referrers should look for in a specialist crisis placement

Speed matters, but suitability matters more. A rapid referral process is only useful if the receiving service can meet the presenting need in a clinically credible way.

At a minimum, a crisis mental health placement should provide 24/7 staffing, clear risk management processes, medication support where required, and an environment that can tolerate distress without defaulting to unnecessary restriction. Young people in crisis often test systems because they are frightened, overwhelmed or expecting rejection. Placements that respond only through control can reinforce the very patterns they are trying to reduce.

A stronger model combines immediate safety with multidisciplinary assessment. That means understanding not just what the behaviour is, but what drives it. Self-harm, food refusal, absconding, aggression and disengagement may all look different on paper, yet each can serve a different function and require a different response.

Referrers should also look closely at whether the setting is genuinely trauma-informed and autism-friendly. Those terms are widely used, but in practice they should shape staffing, communication, sensory awareness, relational consistency and the use of least restrictive and collaborative approaches. For some young people, the difference between escalation and engagement lies in whether staff can recognise overwhelm early and respond in a predictable, attuned way.

Why placement failure happens

Many crisis arrangements fail for reasons that are understandable but avoidable. The placement may be sourced too quickly without enough clarity about risks, triggers or previous breakdowns. The receiving team may be experienced in support, but not in complex mental health presentations. Or the environment may focus on supervision without offering enough therapeutic input to help the young person move beyond crisis.

There is also a mismatch risk. A setting that works well for lower-acuity emotional support may not be able to manage frequent self-harm or significant eating disorder behaviours. Equally, an inpatient ward may be clinically necessary for some presentations, but for others it can increase dependency, remove opportunities to build everyday living skills and make community reintegration harder.

This is why specialist residential care sits in an important middle ground. It can provide more structure and clinical integration than unsupported community living, while remaining less restrictive and more recovery-focused than hospital admission for the right cohort.

The role of assessment in the first days

The first phase of any crisis placement should do more than prevent immediate harm. It should gather the information needed to reduce repeated crises.

That includes reviewing mental state, current risks, physical health needs, medication, developmental history, neurodiversity, traumatic experiences and the practical reasons that previous approaches have been unsuccessful. It also means understanding strengths, not only concerns. What helps the young person regulate? Who do they trust? What routines are important for them? What increases shame, distress or withdrawal?

A useful assessment period builds a shared picture between the residential team, the referrer, health professionals and, where appropriate, the family network. If everyone is working from a different understanding of the problem, consistency is difficult to achieve. In contrast, a clear multi-disciplinary formulation supports coherent care planning and more realistic future goals.

What good outcomes look like

In a crisis context, success is sometimes measured too narrowly. Reduced incidents are important, but they are not the whole picture.

A good placement outcome may include the avoidance of hospital admission, improved engagement with treatment, better nutritional stability, lower frequency or severity of self-harm, improved sleep, more consistent emotional regulation and greater tolerance of relationships and routine. For some young people, early evidence of progress may not be the elimination of risk per se, but rather that they begin to recover trust, accept support and remain in placement. After an initial assessment period, it may be that they are in a position to safely move back to a previous placement or a family home. However, it may also be that the initial assessment highlights the therapeutic benefits of a longer period within a residential setting to achieve more meaningful longer term outcomes.

Such outcomes should also include working toward independence. The best services maintain a clear pathway from stabilisation through therapeutic work to step-down planning, with support adjusted as the young person becomes safer and more able to manage daily life.

That is especially important for those aged 16 to 30, where mental health recovery is often closely tied to education, identity, social development and confidence in adult living. Stability without progression is rarely enough.

Partnership working is central to safe crisis care

No specialist placement works in isolation. Effective crisis support depends on active partnership with local authorities, NHS teams, social workers, commissioners and families.

For referrers, that means choosing providers who communicate clearly, make risk decisions transparently and can evidence how care is delivered day to day. It also means shared expectations from the start. What is the purpose of the placement? What would make it successful? What level of review is needed? What are the likely barriers to progress?

Where this is done well, the young person experiences less fragmentation. They are not asked to start again with each professional, and key decisions are made within a joined-up framework rather than in response to the latest incident alone.

Services such as Care in Mind are often commissioned for precisely this reason – they offer a clinically integrated residential model that can respond quickly while still holding recovery, safeguarding and independence in view.

Choosing the right placement, not just the fastest one

Under pressure, it is tempting to prioritise immediate availability above all else. Sometimes that is unavoidable. Even so, the central question should remain the same: will this environment genuinely help the young person stabilise and move forward?

The answer depends on fit. It depends on whether the placement can manage the current risk profile, whether it has the right therapeutic input, whether it understands complex presentations and whether it can create a realistic route towards lower restriction within a reasonable timescale.

A crisis mental health placement should offer more than short-term safety. At its best, it creates the conditions for recovery to begin in a way that is structured, specialist and sustainable. For young people who have experienced repeated admissions, fractured care and failed placements, that can make the difference between another disruption and the first meaningful step towards stability and recovery.

The post When a rapid intake crisis mental health placement is needed appeared first on Care in Mind.

For local authorities, NHS commissioners and clinical teams, the challenge is familiar. A young person may have experienced multiple admissions, placement endings at short notice, incidents of self-harm that residential providers have struggled to manage, disengagement from services, aggression linked to distress, or difficulties managing daily living safely. Each breakdown can narrow future options, increase risk, and increase hopelessness, reinforcing the idea that no setting can work. In practice, that is rarely the full picture. More often, the issue is the therapeutic model, timing and the level of specialist support available.

Why repeated placement breakdowns happen

Repeated placement breakdowns are not usually caused by a lack of willingness on the part of the young person alone. They tend to emerge when needs outstrip what a service can safely provide, or when the placement model is not sufficiently trauma-informed, autism-aware, clinically integrated or consistent enough to sustain engagement.

Mental health complexity often sits at the centre. A young person may be living with severe anxiety, emotional instability, psychosis, depression, an eating disorder or complex PTSD, often with overlapping neurodevelopmental needs. High-risk behaviours may be a response to fear, shame, sensory overload, attachment disruption or a long history of systems not feeling safe. If the response focuses only on behaviour management rather than formulation and treatment, placement breakdown becomes more likely.

There are also practical reasons placements fail. Some services are not set up for rapid deterioration in mental state. Others cannot maintain continuity when risk fluctuates over hour or days rather than months. In some cases, a young person has been moved too quickly from hospital or crisis settings into a setting that is simply inadequately specialist or supported. In others, they have remained in restrictive environments for too long and then struggled to cope with the sudden freedom of the community and an unrealistic expectation of independence.

What an effective solution to repeated placement breakdowns looks like

An effective solution for repeated placement breakdowns is not about offering more of the same. It is about creating a placement pathway that is clinically informed, relationally consistent and realistic about risk.

The starting point is a detailed understanding of why previous placements ended. That goes beyond incident reports. Referrers and providers need to look at patterns across settings: what escalated risk, what helped de-escalate distress, when engagement improved, and which environmental factors made day-to-day living harder. A good assessment asks not only what went wrong, but what was missing.

A specialist residential model can be particularly valuable in the gap between inpatient care and unsupported community living. For some young people, a 24/7 setting with therapeutic structure and multidisciplinary mental health input provides the stability needed to reduce repeated crises. And providing an intensive and tailored support package such as this can still be provided in a least restrictive model. In fact, the most effective settings are often those that combine clear boundaries with a least restrictive ethos, helping young people feel safe without feeling controlled. Care in Mind has developed Safewards for Safe Homes as a specific approach to managing risk and complexity in a least restrictive way.

Consistency matters as much as clinical skill. Young people who have experienced repeated endings often expect relationships to break down. Staff teams need the training and support to stay psychologically informed under pressure, respond to distress without escalating it, and maintain boundaries that are predictable rather than punitive. Stability is built through repeated experiences of safety, not through promises alone. Care in Mind recognises the essential value of providing their staff with intensive training and regular opportunities for reflective practice in order that they can remain emotionally available to the young people they support.

The role of integrated clinical support

One of the clearest differences in an effective specialist model compared to a standard supported living or residential placement, is that clinical support is built into the care model rather than added on around the edges.

Where repeated breakdowns are linked to serious mental health need, the placement has to do more than supervise. It should support assessment, intervention and ongoing risk management in a coordinated way. That may include in-reach from nurses, psychologists, psychiatrists, dieticians or therapists, alongside residential staff who understand the treatment plan and can apply it in everyday practice.

This integrated approach can reduce the pattern in which a young person moves between services that each hold only part of the picture. It allows concerns about mental state, medication, eating, sleep, self-care and relational functioning to be considered together. For commissioners and clinicians, that joined-up model often improves both safety and placement endurance.

Trauma-informed and autism-friendly care

Solutions to repeated placement breakdowns should also reflect on how trauma and neurodivergence shape behaviour, communication and risk.

A trauma-informed service recognises that apparent resistance may actually be an expression of fear, that aggression may be survival-driven, and that disengagement may be linked to previous experiences of not being understood or feeling cared for. An autism-friendly service goes further by working to adapt the environment, communication style and sensory demands so that the placement does not continually trigger distress.

This matters because young people with complex presentations are often misunderstood across multiple services before reaching the right support. If staff interpret every incident through a narrow behavioural lens, opportunities for prevention are lost. If they understand the function of behaviour, they are more likely to intervene early and effectively.

What referrers should look for in a specialist placement

Not every service that accepts high-risk referrals is equipped to sustain them. When considering options, referrers should look closely at how a provider manages complexity over time, not just at the point of admission.

A strong placement offer will usually show evidence of structured assessment, clear risk planning, multidisciplinary input, and a realistic transition pathway. It should be able to explain how it supports young people through periods of instability without defaulting immediately to increased restrictions or placement ending, unless safety genuinely requires it. That distinction is important.

Referrers should also ask how the service works with external professionals and families, how progress is reviewed, and what support is available when a young person begins to move towards greater independence. A placement that contains risk well but has no onward pathway can create a different kind of blockage later.

At Care in Mind, this principle shapes how support is delivered across outreach, crisis, residential and step-down pathways, with the aim of creating stability first and then building towards recovery and autonomy at a pace the young person can manage.

Stability and independence are not competing goals

A common tension in commissioning is whether to prioritise immediate safety or longer-term independence. In reality, young people with repeated placement breakdowns need both, and the right placement can offer a model where one naturally leads to the other.

If a placement is too focused on containment, the young person may become stuck and lose confidence in their ability to progress. If it pushes independence too quickly, risk can rise and another breakdown may follow. The most effective pathway balances support with gradual opportunity – increasing responsibility as emotional regulation, engagement and practical living skills improve.

That might begin with stabilisation after crisis, moving toward more consistent therapeutic work and daily structure, and then stepping down to a more independent setting. The pace will vary. Some young people respond quickly once they feel safe. Others need a longer period of relational consistency before change becomes visible. That is not failure. It is often the real work of recovery which takes time.

A better response to repeated breakdowns

When placements keep failing, the answer is rarely to lower expectations of the young person. It is to raise the quality and specificity of the support around them.

Specialist provision can help break the cycle by offering environments that understand complexity, manage risk with confidence and hold recovery in view even during difficult periods. For professionals making placement decisions, that means looking beyond availability and asking whether the service can provide the right level of therapeutic structure, clinical integration and progression planning.

With the right support, repeated placement breakdowns do not have to define a young person’s future. They can become the point at which the system stops reacting to crisis, reflects on the longer term needs of the individual and starts supporting them to build stability that lasts.

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That matters particularly where there is a pattern of repeated admissions, placement breakdowns, high-risk behaviour, emerging personality difficulties, eating disorders, trauma-related presentations or co-occurring autism and mental ill health. In these situations, hospital can be necessary at times, but it is not always the setting most likely to reduce risk over the longer term. A more specialist, less restrictive residential model can sometimes provide the structure, therapeutic input and continuity that young people need to move forward.

What makes hospital admission the wrong fit for some young people?

Psychiatric inpatient care has an essential role in acute mental health treatment. Where there is immediate and severe risk, detention under the Mental Health Act, or a need for intensive medical monitoring, hospital may be the right and safest option. The difficulty is that not every high-acuity presentation is best managed on a ward.

Some young people deteriorate in inpatient environments. They may struggle with the intensity, the loss of autonomy, the disruption to education or routine, or the impact of being cared for alongside others who are also highly distressed. For autistic young people in particular, ward environments can be overwhelming and dysregulating. Others may become caught in a cycle of admission, discharge, relapse and readmission, without enough time or relational continuity to address the underlying drivers of risk.

For referrers and commissioners, this is often the point at which the question changes. It becomes less about whether the young person needs support, and more about what type of support is most likely to deliver stability, engagement and a realistic pathway towards independence.

An alternative to psychiatric hospital admission can fill a critical gap

Between acute inpatient care and unsupported community living, there is a service gap that many professionals know well. Young people who are too high risk for generic placements may also be too clinically complex for standard supported accommodation. At the same time, they may not require the restriction of hospital, or may actively need a more relational and developmentally informed setting.

This is where specialist residential mental health care can act as an alternative to psychiatric hospital admission. The model works best when it combines accommodation with 24/7 staffing, risk management, therapeutic support, medication oversight and access to a multidisciplinary team. Rather than responding only to crisis points, it creates a stable environment in which risk can be understood, patterns can be reduced and progress can be sustained. It is also important to recognise that often it can be difficult to access specialist residential care quickly, and in a crisis situation time can be of the essence. In such situations, a rapid intake and assessment to a specialist mental health support residential setting can make all the difference in offering a realistic alternative to a hospital admission.

The value of this approach is not simply that it avoids admission. It is that it offers a clinically integrated setting where young people can practise daily living, build trust, engage in therapy and move gradually towards greater independence, without the abrupt step from ward to community that so often leads to further breakdown.

What a strong residential alternative should include

Not every non-hospital setting is suitable for a young person with complex mental health needs. The quality of the alternative matters. For a placement to be credible, it should be able to demonstrate clinical oversight, a clear risk framework and a proven ability to work with high-acuity presentations.

In practice, that means more than providing a bed and basic support. Effective residential services should offer round-the-clock staffing, trauma-informed care, positive behaviour support where needed, medication management and regular input from professionals such as psychologists, psychiatrists, nurses and dieticians. For those with eating disorders, self-harm, suicidal ideation or severe emotional dysregulation, the support plan must be specific, responsive and embedded into everyday care.

The environment matters as well. A least restrictive approach is often central to progress, but it must sit alongside strong safeguarding and well-defined clinical boundaries. Young people need consistency, not over-control. They need a service that can manage risk confidently while still promoting autonomy, dignity and development.

Who may benefit from an alternative to psychiatric hospital admission?

There is no single profile, and decisions should always be based on assessment. However, residential alternatives are often particularly relevant for young people and young adults who have experienced repeated admissions, failed foster or residential placements, delayed discharges, or escalating risk in the community without a workable support framework.

This may include those living with severe anxiety, depression, complex trauma, emerging personality disorder, psychosis in recovery, eating disorders, self-harm, suicidality or significant emotional dysregulation. It may also include autistic young people whose needs are poorly met in generic mental health settings, and who require an autism-informed environment with predictability, sensory awareness and relational consistency.

The key question is not whether the young person presents with risk. It is whether that risk can be managed safely in a structured residential service with clinical input, and whether the environment is likely to support engagement better than an inpatient ward. For many referrers, that assessment sits at the centre of effective pathway planning.

Why outcomes often depend on continuity, not just containment

One of the common limitations of inpatient care is that it is designed primarily for acute containment and stabilisation. That can be life-saving, but it does not always create the conditions needed for sustained recovery. Young people with long-standing relational trauma, attachment disruption or repeated service breakdowns often need more than short-term crisis management.

They need consistency across days, weeks and months. They need staff who know their triggers, their communication style and the early signs that risk is increasing. They need support with practical routines such as sleep, nutrition, appointments, education, budgeting and community access, because these are often the foundations of stability.

A specialist residential placement can provide that continuity. It allows therapeutic work and risk management to happen in the real context of daily life, rather than in isolation from it. That makes it easier to measure progress in meaningful terms: fewer incidents, reduced admissions, improved engagement, stronger emotional regulation and a more realistic transition towards independent living.

What referrers should look for in a provider

For local authorities, NHS teams and clinicians, choosing an alternative placement requires confidence that the service can hold complexity safely. This means looking closely at staffing, governance, clinical integration and evidence of outcomes.

A strong provider should be able to explain how referrals are assessed, how risk is reviewed, what multidisciplinary input is available and how the service manages crisis without defaulting immediately to hospital. It should also be clear about the limits of the placement. A responsible provider will not present residential care as a substitute for every form of inpatient treatment, because there are situations where hospital remains necessary.

It is equally important to ask about progression. The most effective services do not create dependency. They build towards greater independence through planned transitions, step-down support and close partnership with the wider professional network. That collaborative approach is often what prevents a stable placement from becoming another dead end.

Care in Mind is one example of a specialist provider working in this space, with a clinically informed residential model designed for young people whose needs sit between hospital and unsupported community living.

A better pathway is often a less restrictive one

The phrase least restrictive can sometimes be misunderstood as less intensive. In reality, the opposite is often true. A well-designed residential service can be highly structured, clinically informed and closely monitored, while still giving the young person more agency, more normality and more opportunity to develop everyday coping skills.

That balance is often what makes it effective. When young people feel safer, better understood and more involved in their care, engagement tends to improve. When support is consistent and multidisciplinary, crises can be identified earlier and managed more proactively. Over time, this can reduce the need for repeated admissions and create a more stable route towards recovery.

For professionals planning care pathways, the goal is rarely to avoid hospital at all costs. It is to match the young person with the setting most likely to keep them safe and help them make progress. Sometimes that will be inpatient treatment. Sometimes the better alternative to psychiatric hospital admission is specialist residential care that offers clinical support, relational stability and a clear path towards independence.

The most helpful question is not simply where a young person can be placed next, but where they have the best chance to recover, remain safe and build a life beyond crisis.

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We are proud to offer care with a difference, and strive to ensure that our staff are well supported in doing the amazing job they do. Here, one of our Clinical Psychologists, Emma Williamson, shares why working for Care in Mind has differed from her previous experiences:

What makes us different?

Before coming to work here, I worked in other NHS services locally, and came to know about Care in Mind from working on an inpatient ward. We had referred some young people to the service, and I had heard good things. While I didn’t know anything in detail, there was just a general sense of the service being good. They seemed like a nice place to deal with and refer young people to.

So, when I saw a job advertised, I applied for it partly because it felt like somewhere I wanted to work, it seemed like a place that was very caring and compassionate and when I read up a little more, I really liked the therapeutic models and the general approach. Hearing about the homes, the environment provided, the ethos and how Care in Mind thinks about supporting young people just all sounded great. I thought, this is a place I would really like to work because it fits with everything that, during clinical training, you think you would like to be able to provide for someone.

Then, when I came to interview, what I really liked was that the Executive Management Group (EMG) at the time were all clinical with a background of working with young people in a clinical setting. They all seemed to really understand it from experience, and that is quite different to some other services, where sometimes those at the top making the decisions have not been able to have the clinical background experience, which really helps to provide a full understanding of what is important and needed. So, I really loved that from when the company had started, it had been clinicians who had created Care in Mind, and that their aims and ethos were based on that experience.

Also, in the years that I have worked here, I have experienced a real culture of openness, so it feels like it is okay to question. For example, if I was to say I think this process could be improved, it will then be a question of how can we better understand or act on that, and let’s look towards making changes. It’s not about doing things reactively, but more planning how we can understand something properly, how we can build processes around it, as well as considering what the research tells us and what kind of models are out there. There is a real commitment to working collaboratively, improving and understanding how to do things well.

How do you think the care we offer to young people is different compared to what other mental health residential services offer?

The complexity of how we understand young people, and the amount of time and attention we pay to really understanding them and what will help them individually to begin to be able to live well independently is definitely different here to my experiences in other settings. Having been through clinical training and worked in a variety of other environments, I think I hadn’t truly understood how to unpick and formulate risk, and to plan well to support someone with that until I joined Care in Mind. I had seen a lot of structured tick box assessments, descriptions of risk behaviours and incident logs. Here it is very different. At Care in Mind, we look a lot more at the context and what the function is, and how we might be able to support people in managing it differently.

Being with Care in Mind is certainly the first time I have truly felt therapeutic risk management has been understood and embraced. There’s a lot of talk about it in other care settings, but there are often difficulties in implementing it and there’s often a fear of ‘what if’. I think that having that least restrictive practice model and having the collaborative way of managing things together, and that understanding of what is going on with people is just brilliant; it makes things feel so much better.

What do you think has been our key to success?

I think we have a lot of fabulous staff throughout the company that have strived hard and are dedicated to providing the best care for our young people. Also, having seen across services what can influence culture, the commitment of the EMG is just amazing. Their ability and dedication to openness and to promoting a culture where it is possible to question, understand, and try new things out to strive to improve is something very special. I think some of it comes down to personality, but also many years of experience and really caring about striving to do the best possible for the staff teams and young people we support. So, there is certainly something really special about those people who are leading the ship! I think there is always that dedication to improve things and make changes where they need to be made, and I think that is really what has gotten us to this point.

How do you feel about our 10-year anniversary?

Reflecting on how the service has grown has been amazing. Having been with Care in Mind for just over four years, I remember staff telling me when I first arrived how much the service had grown just in the few months beforehand. We had started off as a very small service with the whole team based in one place, and when I joined we had just moved into Head Office, new people were joining, and staff teams were growing. Now, four years on, things have grown even more, and I think it’s great that we’re able to provide placements for so many young people.

It’s been quite challenging to say the least through Covid-19 working remotely and not seeing each other often, but our support staff and service user involvement teams have done so well in supporting our young people. They have found amazing ways to work creatively during a difficult time and seeing the work they’ve been doing has been impressive. There is just such an ethos of pulling together and getting each other through.

It’s a big milestone and I’m very excited. I think because it can be hard sometimes for people to understand our models and why we take the approach we take but the proof is in the pudding. Look at how we have grown; all of the young people and the positive outcomes highlight that there is a need for what we do, for care that is provided in this least restrictive, collaborative and supportive way. It’s not always easy but it’s so great to see that we have reached this milestone and have grown so much.

How do you see the future of Care in Mind?

There is such a need for a shift in mental health care to become more collaborative and move away from restrictive practices so with that in mind I can’t see anything other than continuing growth. Not just growing in the way that we have been, I think also a growth in the way we share our approach and aim to inspire other services too. I think that there is also a need for a shift in the way things are done sooner on in the process, even before hospital. It would be great to see us provide more support for how care is provided in other settings, and I think many ways this is already happening. Hospitals and other care providers often see the work we do and think that they want to try those methods too, which I think is really great. I’d really like to see this collaboration and outreach work continue and expand into other settings too.

The post What Makes Us Different? – Clinical appeared first on Care in Mind.

The dilemma of risking or restricting risk comes down weighing up long-term benefits with present day risks. So, why do we believe in long-term benefits and managing risk therapeutically and with the least restraint?

When a young person spends lots of time in a hospital, it can lead to a heavy reliance on others to protect them. Additionally, it can be easy for them to unlearn, or become fearful of, various normal areas of life, such as making a cup of tea or using metal cutlery. Essentially, it can significantly hinder their ability to learn the value in responsibility and independence. This is especially true of young people who may have been in and out of hospital during their early teenage years.

As well as a loss of independence and reliance on others, heavy restrictions can cause young people to feel out of control. Losing this control may lead them to take increased risks as time goes on, thus they find themselves in a dangerous cycle of risky behaviour.

Of course, it is understandable that restrictive care has become the norm, as what is a natural reaction to someone hurting themselves? It is to take away that risk and stop them. However, at Care in Mind, we have intensive training in place for our residential staff so that this reaction can be challenged. Instead of restrictive care, we focus on assertive care and train our staff to support young people in keeping themselves safe. Our least restrictive model is very much based on the principles of Therapeutic Risk Management.

The Principles Of Therapeutic Risk Management

There are five principles of Therapeutic Risk Management and they each underlie our Therapeutic Risk model, which is paramount to successful risk management in a least restrictive manner.

The first principle is focused on collaboration, therapeutic rcaelationships and informed decision making on the young person’s part. Care in Mind young people are put at the forefront of their own care and work alongside our comprehensive MDT to ensure they receive care that is most helpful for them. Much of those relies on an open and honest relationship between staff and young people, which gives them the confidence to trust those who care for them.

The second principle is about creating a strength based, person-centred approach to recovery. This is done utilising the “Managing Mental Health Ladder” and the “Mental Health Recovery Star” (Recovery Star™ (4th Edition) – Triangle (outcomesstar.org.uk). The ladder is all about progressing how you manage your mental health issues. To assess how young people progress and to ensure we focus on the necessary areas of recovery, we utilise the “Mental Health Recovery Star”. These will be filled out on a regular basis throughout the young person’s time within the homes to document how they are doing.

The third principle is about effective team-working and building risk-sharing partnerships. This is about the way we always care for young people being understood and consistent, including when liaising with Emergency Services, Social Care and Safeguarding teams. Maintaining a stable level of least restrictive care is vital in minimising the risk of further setbacks into a risky cycle of behaviour.

The fourth principle is providing a safe culture for both residential staff and the young people. A significant part of this is through reflective practice and a no blame culture. We try to take every opportunity to learn from where we may have gone wrong and improve upon our practice, both individually and as an organisation. Rather than having one way of doing things and strictly enforcing that, we encourage staff to bring forward any innovative ideas they may have.

The fifth and final principle is about providing least restrictive interventions. Rather than removing risks, using physical restraint, or conducting observations on people, we utilise less invasive ways to care for our young people.

Naturally, a least restrictive environment is not suited to every individual and their mental health journey. In cases where young people are actively suicidal, have a means to end their own life or lack capacity, we may not necessarily recommend a least restrictive model of care. It all comes down to assessing potential risks and weighing up the potential benefits for each unique individual.

For some young people, a least restrictive environment and therapeutically managed risks can allow them to gain the necessary independence to thrive once they leave residential care. It can help break the cycle of readmission and give them the self-belief that they can take responsibility for their own safety.

Therefore, we choose to risk (where appropriate), because it can help the young person learn to live their most safe, satisfying, and meaningful life.

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Behind the scenes, Care in Mind is very much like a well-run machine with various vital components to keep things running smoothly. One component of our organisation that helps us to remain high-quality, compliant, and reflective is our Quality Assurance Department.

The White Paper “Working for Patients” introduced the audit of clinical care initiative in 1989. The purpose of the initiative was to improve the quality of patient care and to ensure best practice is being undertaken. Whilst this process originated within the NHS, it is now embedded across many healthcare organisations, including Care in Mind. Additionally, our auditing process does differ from that of the NHS as we have a unique model of care.

The auditing undertaken within Care in Mind is used to measure performance across all areas of the business:

Residential audits

• Medication and physical health equipment audits are completed by the CQC champion of each home.
• Health and safety audits are completed by the health and safety champion in each house.
• File audits are completed, which review areas such as, care plans, risk management plans, daily notes, and incident reports.
• We also have a Service user involvement audit completed by the service user involvement champion for each home.

Other areas we audit

• Medication management
• External communications
• Risk assessment and management
• Quality audits set against the model of care
• Annual young person feedback survey

Why is auditing so helpful?

• Clinical audit provides the framework to improve the quality of patient care in a collaborative and systematic way.
• Through Audit we can identify emerging trends, which enables us to identify risks and implement actions before it becomes a bigger issue.
• Auditing allows us to identify which services are performing well and promote good practice, which improves the quality of the services and outcomes to users and similarly to identify where services require improvement.
• During the pandemic, auditing has played an important part in protecting the physical health of our young people and residential staff.
• Additionally, audits can help shed light on how young people cope with external factors (such as a pandemic). This allows us to be better prepared going forward and provide the best care.

To ensure we learn from audits they are reviewed across the organisation through our Audit Committee and Governance processes.  Data is scrutinised to ensure we gain all that we can from it and move forward making the necessary changes to support best practice.

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When someone dissociates, their thoughts, feelings, behaviours, how they see their environment, memory, how present they are, and how they view the world disconnects. Their mind no longer works in harmony, and instead becomes separated. There are many theories of dissociation, but one is the idea that dissociation is a continuum, and that symptoms can range from mild to severe. In fact, for many of us, it may be a surprise to realise that we often mildly dissociate in our day-to-day life.

Dissociation for some may mean ‘zoning out’ or ‘daydreaming’ – it may present itself as missing your exit on the motorway or losing track of time during in a dull meeting. However, for someone who has experienced trauma, dissociation can show itself in a more pronounced way. It may impact their memory, sense of who they are, and how they perceive the world.

Severe dissociation may occur in many ways, such as forgetting past experiences, depersonalisation (feeling detached from yourself), or unusual experiences such as seeing/hearing things other people cannot. It may also cause vivid and realistic flashbacks to past trauma, whereby you feel like you’re ‘reliving’ a past experience. This can be a very frightening experience for the individual.

Dissociation is not a necessarily a bad thing though; it actually provides the individual with a psychological escape. It allows those who have experienced trauma to go about their normal daily living whilst coping with emotional distress. For some, many aspects of dissociating is a comforting, positive experience but it can also be a frightening reminder of upsetting experiences, causing your brain to jump into ‘panic mode’.

Caring for someone with dissociation, whether in a personal or professional capacity, may feel daunting. However, with understanding, you learn that they have simply found their own way to survive. Sometimes individuals get stuck an unhealthy habit to survive, which challenges their ability to recover from whatever they were trying to survive in the first place. Therefore, paying attention to dissociation is an important part of recovery.

At Care in Mind, we use evidence-based methods for helping our young people in the most effective way. One of these methods is a three-step technique, based on regulating, relating, and reasoning. This can especially help during a flashback.

For regulation, the purpose is to help the individual to manage their response to the flashback. This may be done through encouraging grounding techniques. A comforting smell, relaxing song or hot drink may help assist someone in their grounding. It is also helpful to remind the individual that they are safe, and that the flashback will pass. Additionally, it is also important to promote self-care and soothing methods at this stage.

The second step, relating, is about connecting to the individual by being sensitive to their needs. We do this primarily through validation, which is a key element of our model of care. Validation is all about recognising someone’s feelings and allowing them to feel heard. However, it goes beyond words – it’s also about seeing and hearing the young person and connecting with them and their distress.

Finally, it is important to help the individual reflect on what just happened. It is at this point that, together, you can both reflect on what happened and what may help going forward. It can be useful to make a note of triggers and consider why your brain had the response that it did. At Care in Mind, it would be the young person’s assigned therapy session where they may do further reflecting on the incident, and thus find methods to avoid future episodes.

Dissociation is a normal and understandable coping response but if you find that it is causing you distress, please seek support. There are also ways in which you can care yourself. The mental health charity, Mind, has several helpful suggestions and information about coping with dissociation.

The content of this blog post is a summary of a recent webinar facilitated by Dr Lena Marden and Dr Christy Laganis, Clinical Psychologists at Care in Mind.

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