Severe mental illness: John’s Story

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9 February 2023


John, 52, has suffered from severe obsessive compulsive disorder (OCD) for more than 25 years. This disorder causes him to spend hours every day washing and cleaning. This means he struggles to stay in a job and do everyday activities that most people take for granted. He won’t throw things out, and rubbish has gathered in his garden. His neighbours have complained, and the local authority has told him he might have to leave his home if he doesn’t do something about the mess. 

Treatment in the past 

In the past, John has found Cognitive Behavioural Therapy (CBT) useful, but sometimes it took too long to arrange. This was because the professionals helping him worked in separate teams. For example, he was seen by a community mental health nurse and a social worker. Both offered support, but for the therapy he wanted, he needed to see a psychologist from the Improved Access to Psychological Therapies (IAPT) team. 

John was assessed by a psychiatrist, who prescribed medication, but he had a long wait for the therapy he wanted – and his problems got worse while he waited. 

Treatment now 

Now, our integrated teams bring together staff from IAPT and the community mental health teams. John can start therapy quickly with an IAPT therapist. This therapist will be his key worker and coordinate John’s care with the other professionals who need to be involved:  

  • the social worker, who will give practical support to get John’s house cleared, and talk to the housing officer  
  • the psychiatrist, who will do full assessments of John’s physical and mental state, and explain the specialist medication available, so that John will understand the benefits and any side effects. 

John’s condition has made it difficult for him to keep a job in the past. We can help him through a programme that supports people with severe mental health problems to get into long-term work. He is interested in working as a delivery driver. The programme can help him start a paid placement, and will offer continuing support, both to John and his employer, without any time limit.   

Our new way of working will give John psychological therapy, medical input, social support and help to get back into work. Combining these different kinds of support will make a real difference in helping him to get better and live well.