Case Study: Community Mental Health Team

Jamal is 20 years old and experiencing loss of sleep, poor appetite and is worried that others are trying to harm him by poisoning his food. He seems to be experiencing voices but denies this when asked. The CMHT have been asked to see him but he has failed to attend a number of appointments and the team are aware he has been contacting other agencies for help. His housing situation is precarious, he has lost his job and he is missing out on some benefits to support his living expenses. His parents are worried that he is not physically well and he is accusatory towards them when they contact him. The CMHT have allocated a community mental health nurse, Dave, to assertively make contact with Jamal to build trust and rapport with him. Dave has similar music interests to Jamal and they connect around this and the offer of help with benefits. Dave arranges for a full psychosocial assessment for Jamal and agrees to meet and transport him to the assessment. The assessment considers Jamal's strengths, his interest in music and his recent job skills to link him with some training in sound recording at a local college. Dave is aware that helping Jamal to arrive at shared decisions that include an understanding of risks and benefits is the best way of engaging and maintaining Jamal in the process.  One outcome of this approach is that Jamal refuses to take medication but agrees to talk with Dave at a weekly visit about his experiences and worries. Dave works with Jamal to agree on a plan of care that includes dealing with his housing and benefits but also help with training and seeking job experience.

Consider this case study and consider the following:

• What is the care coordinator's responsibility here?
• Who does Dave need to work with the assist Jamal to access appropriate benefits?
• In the event that Jamal does continue to see Dave at weekly intervals, but appears to be becoming unwell, what might Dave do that would further support Jamal?

Note: Reflect on how you might approach these situations. If you’re not sure, discuss with your tutor or placement mentor