Complex Mental Health Needs Require More Than a Care Plan: Meet Case Manager Harriet Finlayson

Complex Mental Health Needs Require More Than a Care Plan: Meet Case Manager Harriet Finlayson

When a client is living with complex mental health needs following injury, illness or alleged clinical negligence, successful rehabilitation can depend upon far more than accessing individual therapies.

There may be safeguarding concerns, neurodiversity, cognitive difficulties, family pressures, educational needs, high-risk behaviours, multiple professionals and services, or difficulties engaging with treatment. For solicitors, finding a case manager who can bring those different elements together can be critical.

Harriet Finlayson, BSc (Hons), is a Registered Mental Health Nurse and Case Manager with Circle Case Management, based in Altrincham and able to support clients across the surrounding area within approximately one hour's travel.

With extensive experience across CAMHS, adult mental health, community services, inpatient care and complex multi-agency environments, Harriet brings a particularly valuable skill set to clinical negligence, medical negligence and personal injury cases involving significant psychological, behavioural, cognitive or neurodevelopmental needs.

From complex presentation to coordinated rehabilitation

For some injured clients, the greatest challenge is not identifying what support they need – it is making that support work together.

A client may simultaneously be involved with mental health services, social care, education, therapists, medical professionals, support workers and family members. There may also be issues surrounding capacity, communication, risk, engagement or transitions between services.

Harriet is experienced in assessing the wider picture and translating complex needs into practical action.

Her work includes:

• holistic assessment and care planning;
• risk assessment and management;
• coordinating multidisciplinary teams and external agencies;
• establishing and managing tailored care packages;
• recruiting, training and coordinating support teams;
• supporting clients and families to understand their options;
• safeguarding and crisis intervention;
• advocating for clients across health, social care and other services; and
• monitoring progress and adapting rehabilitation as needs change.

For instructing solicitors, this provides a case manager capable not only of identifying recommendations but of implementing, coordinating and continually reviewing the rehabilitation programme around the individual.

Specialist mental health experience across the lifespan

Harriet has supported children, young people, adults and families experiencing a broad range of complex needs.

Her specialist experience includes complex mental health conditions, autism, ADHD, learning disability, cognitive impairment, depression, anxiety, eating disorders and dementia, alongside clients presenting with significant levels of risk.

She also has experience supporting individuals with conditions including Functional Neurological Disorder (FND), PICA, dyslexia and dyspraxia.

This breadth of experience can be particularly valuable in cases where a client's presentation does not sit neatly within one discipline.

For example, an injured young person may have pre-existing neurodivergence alongside newly emerging psychological difficulties, disrupted education, challenging behaviour and strained family relationships. An adult may be struggling with cognitive impairment, anxiety, changes in independence and difficulties navigating statutory services.

In these circumstances, rehabilitation needs to consider the whole person rather than an individual diagnosis.

Significant experience with children and young people

Harriet's background includes substantial experience within Child and Adolescent Mental Health Services (CAMHS).

As an Acting Ward Manager and previously Deputy Ward Manager within a CAMHS inpatient service, Harriet worked with young people experiencing highly complex and high-risk presentations, including self-harm, suicidal ideation, aggression and absconding.

Her responsibilities included risk assessment, care coordination, CPA reviews, CETRs, multidisciplinary working, safeguarding, family liaison, staff supervision and discharge planning.

She has also worked as a CAMHS Practitioner within Pennine Care NHS Foundation Trust, undertaking mental health, duty and A&E crisis assessments and working collaboratively with families, safeguarding teams, Early Help, schools, SEN teams and other services.

For solicitors representing children or young adults following catastrophic injury, clinical negligence or serious personal injury, this experience provides Harriet with an understanding of the additional complexity created when healthcare, rehabilitation, education, family life and safeguarding intersect.

Understanding neurodiversity and communication

One of Harriet's particular strengths is her ability to adapt her approach to the person in front of her.

Clients experiencing autism, ADHD, learning disability, cognitive impairment or significant psychological distress may find traditional appointments, unfamiliar professionals or complicated rehabilitation plans overwhelming.

Harriet takes time to understand how an individual communicates, processes information and engages most effectively.

She uses adapted communication, psychoeducation and a calm, consistent approach to help clients understand choices and participate meaningfully in decisions about their own care.

This can be especially important where previous attempts at rehabilitation have struggled because of poor engagement or where a client's behaviour may previously have been viewed simply as "non-compliance", rather than exploring the underlying reason for that difficulty.

NHS England Clinical Expert experience

Alongside her case management work, Harriet works as a Clinical Expert for NHS England's Care, Education and Treatment Review programme, completing inpatient and community CTRs and CETRs for adults and young people with learning disabilities, neurodivergence and complex mental health needs.

She works alongside clients, families, multidisciplinary teams and commissioners to examine care, risk, barriers and outcomes.

Using the Key Lines of Enquiry framework, Harriet identifies practical actions and considers how individuals can be supported within psychologically safe and least restrictive environments, including opportunities for appropriate community-based support.

That experience gives Harriet a valuable perspective when working with clients whose rehabilitation involves complicated statutory provision, commissioners or multiple agencies.

She understands not only what an individual may require clinically, but also the practical challenges involved in turning recommendations into services that work in everyday life.

Managing risk without losing sight of the person

Some of the most complex claims involve clients where substantial risk must be managed alongside the need to promote independence and quality of life.

Harriet has significant experience dealing with acute and high-risk presentations and liaising with safeguarding services, police, social care, mental health teams, commissioners and families.

However, effective risk management should not mean creating unnecessary restrictions around someone's life.

Her experience within CTR and CETR processes has reinforced an approach that considers both safety and the least restrictive means of supporting the individual.

Within case management, this can help create rehabilitation plans that are realistic, proportionate and centred around what the client wants to achieve.

Supporting families as well as clients

Serious injury and complex mental health difficulties rarely affect one person alone.

Parents, partners, siblings and wider family members can find themselves attempting to navigate unfamiliar healthcare systems, manage risk, attend appointments and advocate for services while simultaneously adjusting to significant changes within their own family.

Harriet has extensive experience working directly with families.

She is warm, approachable and able to provide a consistent point of contact, helping families understand what is happening while ensuring the client's own wishes, needs and independence remain central to the rehabilitation process.

Her ability to establish trusting relationships can be particularly valuable in cases where families have experienced lengthy or challenging interactions with health and social care services before case management begins.

What Harriet brings to a litigated case

For a solicitor, effective case management needs to produce practical progress.

Harriet's combination of clinical experience, leadership, mental health expertise and multi-agency working enables her to step into complicated situations and begin identifying priorities, barriers and achievable next steps.

She can assist with:

Assessing rehabilitation needs
Looking beyond individual diagnoses to understand psychological, cognitive, social, behavioural, educational and practical needs.

Coordinating multidisciplinary rehabilitation
Bringing together therapists, medical professionals, support workers, education providers, statutory services and other professionals.

Establishing tailored care packages
Identifying appropriate support, recruiting and coordinating teams and reviewing provision as circumstances change.

Managing complex risk
Providing experienced oversight where there are safeguarding concerns, self-harm, suicidal ideation, behaviours that challenge or other significant risks.

Supporting neurodivergent clients
Adapting communication and rehabilitation planning for autism, ADHD, learning disabilities, cognitive impairment and complex communication needs.

Working with children and families
Drawing upon extensive CAMHS and family mental health experience to support young people within the wider family and educational environment.

Navigating statutory services
Working constructively with NHS services, social care, education teams, commissioners and other agencies while advocating for the client's needs.

Most importantly, Harriet brings consistency.

For clients whose lives may already involve a revolving door of appointments, professionals and services, having one experienced professional overseeing the rehabilitation picture can make an enormous difference.

A calm presence in complex cases

Harriet describes her approach through the qualities that have underpinned her nursing career: being positive, warm, empathic, organised and practical.

These qualities matter.

Case management frequently involves meeting people at an extremely difficult point in their lives and building enough trust to help them move forward.

Harriet combines that personal approach with extensive clinical experience, strong risk-management skills and the ability to coordinate complicated packages of care.

For solicitors dealing with a client whose rehabilitation involves mental health, neurodiversity, learning disability, cognitive impairment, high-risk presentation or complex family and multi-agency circumstances, Harriet can provide the specialist case management oversight needed to help move rehabilitation from recommendations into meaningful action.

Instruct Harriet

Harriet Finlayson, BSc (Hons)
Registered Mental Health Nurse & Case Manager
Based in Altrincham, covering surrounding areas within approximately one hour's travel

Harriet is available for case management instructions relating to clinical negligence, medical negligence and personal injury claims.

To discuss your Case Management requirements, or request Harriet’s C.V, please call 01297 24145 or email casemanagement@circlecm.com

Circle Case Management – Small enough to care. Large enough to cope.