Case Study: Harry

Harry is a 45-year-old man who currently lives in a one-bedroom flat in a large market town. He has not worked for 2 years since he was made redundant from his post as a machine operator in a local factory, which has now closed. Harry is a single man, he has one brother, Pete, and visits his mother, Dot, several times a week, as she lives nearby.  During the past 18 months Harry has been experiencing depression, his mood has become extremely low, he has been neglecting his personal hygiene and has been going out much less. At one point his family were worried about suicide, as Harry intimated life was not worth living anymore. Harry has been referred to the Community Mental Health Team, and has met his new care coordinator, Sam, who is a Community Mental Health Nurse (CMHN). Sam wants to meet with Harry to discuss his care plan. Before they meet Sam rings Harry to say that she will send him some information in the post about care plans, so he has some idea what to expect (this information would need to be accessible and understandable). Sam is a busy CMHN and has asked to meet Harry at his flat, as she hopes they will have more time for their conversation there and less chance of interruptions than in the clinic setting.

When Harry and Sam meet, Harry says he is feeling a little better but wishes his life was very different. He talks about how important work is to him, and how he feels he has lost his confidence. Sam and Harry discuss local training opportunities, volunteering and ways to get back into the workplace, as well as developing relevant skills for CV writing and interviewing. Sam makes good use of Harry’s words and together they turn his wishes into short- and long-term goals (that need to be Specific, Measurable, Achievable, Realistic and Timely – SMART). Each of Harry’s goals says what, where, who, why, how and when, so it is clear how the goals will be achieved. Sam lets Harry know that the care plan is a living document and that it will be reviewed in meetings with Harry and people that he would like to be present. Harry says he would like his mother and brother to attend these meetings where possible. As Harry and Sam come to the end of their first discussion, Sam checks if there is anything else Harry wants to add, and says that further goals can be added in the future. Harry said he found the conversation helpful, but that he would have found this very difficult a few months ago (note that people may be more or less ready or able for involvement according to their level of wellbeing).