25th July 2025
Steve* is a man with learning disabilities, suspected autism and a fierce reputation.
Steve used to be locked up in a secure hospital’s Challenging Behaviour Unit and was on copious doses of antipsychotic medication. Now he’s free of medication and out of the secure hospital unit.
Steve communicates without words, and he gets distressed when his communication – Objects Of Reference or simple Makaton – is misunderstood. He damages buildings, has limited access to his local community and rarely sees his parents.
After Steve left hospital he moved into a Dimensions registered care service. His reputation preceded him and initially his behaviour and the support he received was none too different. Indeed, members of his local community once petitioned for him to be removed.
It took a behaviour assessment to turn things around. A new approach to communication was taken – an iPad with pictures and video. His home was also made more robust, meaning he could be left to get on with more household tasks. And his day was made far more predictable.
These things made all the difference. As Steve felt less distressed, colleagues felt more confident and relaxed and he could do more and more for himself. A virtuous circle was created. He can go to local shops, the pool and the pub.
Despite initial reluctance on the part of his doctor, he is now completely free of antipsychotic medication. Best of all, he has had his first family Christmas since childhood.
Steve’s reputation was cause for concern amongst those agencies familiar only with his past..
Steve’s locality manager
There remains a long way to go. Steve doesn’t get on well with his housemate, and so the team has been looking for supported living arrangements for him.
Once again, Steve’s reputation was cause for concern amongst those agencies familiar only with his past but Dimensions has been able to provide the behavioural data required to make the move.
As part of this, his previous support – 280 hours per week plus sleep in staff just a few years ago – will soon be down below 150.
We had to understand why Steve was getting upset, avoid taking it personally and avoid focusing on his behaviour.
We kept asking ourselves, ‘Why are you communicating in this way? What can I do to help you not feel the need to display this behaviour?’ Once the team had this mindset, meeting the needs of Steve was much easier
Steve’s locality manager
So few people believed Steve could change. His story should give belief to all those people currently locked in ATUs or having a hard time elsewhere, and their families. Life really can get better.
*name has been changed to protect identity. Photos are anonymous.
Steve’s achievements
- The ability to communicate with those around him
- Elimination of antipsychotic medication
- Moving out of an ATU
- Behaviours of distress all but disappeared
- Support hours halved
- Strong relationships with all those around him
So few people believed Steve could change. His story should give belief…Life really can get better.