Written and devised by ©John Eaton RMN RGN RN (New York) MSA, Dip RSA D32/33/34/36

Mental Health Manual

and Training Units

Picture below ‘The Scream at Tone Vale Hospital’

This Manual has been written and updated for over 20 years. It formed the basis of knowledge in my Home prior to the establishment of In-Service Training and NVQs. It has lots of great information, Training Units and Certification for internal Home consumption.

A short poem from a users perspective

Davids’ Story

I looked in the mirror, What did I see

I saw myself, looking at me

With skin so white, and eyes so red

I wondered why my mind had fled.

John Eaton 1990

Read David’s Real Life Story now


County Councils in partnership with the police and other health and social care providers has produced joint Procedural and Practice Guidance about the safeguarding of vulnerable adults.

A Vulnerable Adult is someone who is not able to care for or protect themselves for any reason. It might be because of age, mental or physical incapacity, sensory loss, or physical or learning disabilities. It might be someone who is usually able to manage but is unable to do so because of an accident or illness.

A vulnerable person may be abused by:-

  • A relative or informal carer
  • A paid or professional carer or advisor
  • A client who is receiving services for the same resource (e.g. day care, residential care)
  • A stranger

A vulnerable person may also

  • Abuse the carer
  • Abuse other vulnerable persons who are also receiving care in the same setting (e.g. fellow residents in a residential home, or other clients in a day centre)
  • Neglect themselves or deliberately harm themselves

For simplicity we identify six main types of abuse:

  • Physical – for example, hitting, slapping, burning, pushing, restraining or giving too much medication or the wrong medication
  • Psychological – for example, shouting, swearing, frightening, blaming, ignoring or humiliating a person
  • Financial – for example, the illegal or unauthorised use of a person’s property, money, pension book or other valuable
  • Sexual – for example, forcing a person to take part in any sexual activity without consent. This can occur in any relationship
  • Neglect – for example, where a person is deprived of food, heat, clothing, comfort or essential medication
  • Discriminatory abuse, including racist, sexist, that based on a person’s disability, and other forms of harassment, slurs or similar treatment
  • An individual may be experiencing only one form of abuse, or different types of abuse at the same time.

Causes may include:-

  • Poor quality long-term relationships
  • Carer stress
  • Mental health problems
  • Poor management
  • Inadequately trained staff
  • Poorly supervised staff
  • Staff working with little support in isolation
  • Drug and alcohol abuse

Signs to look for:-

  • Bruises
  • Burns
  • Frequent falls and injuries
  • Loss of weight
  • An uncared for appearance
  • Dirty clothing
  • May be depressed, frightened, withdrawn or anxious

Those most at risk are:-

  • Socially isolated
  • Live alone
  • Have health problems
  • Are dependent

If you are concerned about the wellbeing of someone you know, you should talk to them first and advise them to ask for help. If they are unwilling to do that, and you still believe that they are in danger, contact us and share your worries. You should tell the person how worried you are about them. Normally you should obtain their consent before contacting us, but if you believe they are in danger, you may have to contact us without this.

Do not talk to the person you think is responsible for the harm as this might put you at risk and give them the opportunity to hide evidence.

Once we have been notified of the problem, if the person is in immediate danger, we will consider what you have told us, talk to the person concerned and offer support to make them safe.

If they are not in immediate danger, the person will be contacted, possibly with your help if this is the best way to gain their trust.

A social worker will visit them and discuss their situation. If it is thought that the person is confused or is not able to make a decision for any reason, their emotional, physical, intellectual and mental capacity will be assessed.

The sort of help that can be offered may include:-

  • Support for a carer
  • Day Services
  • Meals
  • Short breaks and holidays
  • Help in the home.

The aim would be to help the person stay in their own home safely and with support if that is their wish. People have the right to refuse help that is offered. In the majority of cases we do not have the power to remove people from their homes. This can only happen in very exceptional circumstances when professionals involved will consider whether they should use the powers of the Mental Health Act 1983 or The National Assistance Act 1948. This course of action is very unusual.


The Government is keen to support all vulnerable people who are able to live independently but who may require some extra support to do so. These are likely to include the following groups:

  • People fleeing domestic violence
  • Single homeless people
  • People who have misused drugs or alcohol
  • Young vulnerable people
  • Older people
  • Ex-offenders
  • People with mental health problems
  • People with physical or learning disabilities
  • People with HIV/AIDS
  • Refugees
  • Vulnerable people from Black and Minority Ethnic groups