From Long-Term Hospital Detention to Independent Living

This case comes from our partners at the PBS Centre of Excellence. Epona was not involved, but the outcome reflects the kind of progress that person-centred Positive Behaviour Support (PBS) can help unlock. ​

Joan (not her real name) had been detained in a secure hospital for over 30 years. She was supported 3:1 and caught in a cycle where her leave was frequently cancelled. This led to distress and behavioural responses, which in turn resulted in further restrictions. The system kept reinforcing itself, with little scope for change. ​

When the PBS team became involved, they focused on building a trusting relationship and understanding what a good life would look like for her. Joan was clear about what mattered: the kind of home, location, and community she wanted to live in. ​ The provider identified a property that aligned with Joan’s preferences. The environment was renovated with her input, and no fittings were installed without her involvement. Joan chose the colours, planned the layout, and selected each fixture and piece of furniture.

She visited the house regularly during the transition period, bringing items she had picked for her new home. These visits gave her something to look forward to and created a sense of ownership. ​ The support team was recruited based on characteristics identified during a community fit assessment. Relationships were built before the move, with regular visits and shared activities while Joan was still in hospital. ​ Joan now lives in a home she chose, with support from people she knows and trusts.

Within two months she moved from 3:1 to 2:1 support. She now travels by train, goes out daily, and enjoys baking. While challenges remain, she has developed coping strategies that help her navigate them without the distress responses that previously led to restrictions. ​

Why This Matters Joan’s story is not unique, but it is a reminder of what can change when people are listened to and supported on their own terms. Epona is designed to support this kind of work across services. The platform helps care teams document individual preferences, track progress, and build consistent, responsive PBS plans. It supports quality oversight and helps reduce reliance on crisis-led or restrictive approaches.

If you are supporting people with complex needs and want to embed this type of work more consistently across your service, we would be happy to show you how Epona can help. ​ If you would like to learn more about how Epona can support your service, get in touch.