Problem
Read the clinical scenario
• Describe your care plan for carrying out a collaborative assessment with Lola. Discuss (i) the needs you would like to talk to Lola about, using a person-centred approach, (ii) which communication skills you would use to ensure that you engage Lola and that your assessment is collaborative.
• Provide a care plan using the template for ONE of the needs you have identified ensuring that Lola's view is included. Include a strategy for evaluating the plan and comment on the strengths and limitations of the plan.
Clinical Scenario: "Lola"
Lola is a 23-year-old British Nigerian woman who has been a patient on your mental health admissions ward for 3 days. She lives with her parents and 3 younger siblings. This is her second admission to the hospital, the first being 3 months ago and she is known to mental health services. She has no formal diagnosis yet, as this is only her second episode of psychosis. Before this admission, she had been hearing voices telling her she was fat and ugly and would be better off dead. She had previously been taking 10mg olanzapine daily which she stopped 3 weeks ago. 3 days ago, she walked out into the street in front of traffic, and was nearly knocked down by a car. Lola was working as a teaching assistant in a local primary school while finishing her teaching qualification but has not been back to work since her first admission in July, just before the summer holidays. Her first episode of psychosis happened around the time an important OFSTED inspection was due at the school, and Lola was "very stressed" about it and describes waking up at night with worry and not being able to get back to sleep. Her school are now aware she has had mental health problems and are keen for her to come back as soon as she is feeling better On assessment, the following information was obtained:
Before her first episode of psychosis, Lola was described as being "normal", well adjusted and as someone who loved going out with friends, being around children and spending time with her family. There is a family history of mental illness; Lola's paternal grandmother was institutionalised for schizophrenia, and her uncle has a diagnosis of paranoid schizophrenia. There is also a family history of diabetes, Lola's mother and 2 of her aunts and an uncle have type 2 diabetes. Lola does not drink alcohol or use any illicit drugs. She is currently on 1:1 observations, as she remains very low in mood. When asked whether she had been trying to end her life by walking out into traffic, Lola had replied that she had, and when asked whether she was sorry she had not been struck and killed she said she didn't know. Her family have been to visit and brought in food for Lola which she does not want and has said "they are trying to make me even fatter". Before starting medication, Lola's BMI was 19, but since starting olanzapine in July she has gained 11 kg and her BMI is now 23. She said that he is "bored" in hospital and wants something to do, but finds she can't concentrate for long. She has also said that there is no point restarting her olanzapine because she does not want something that makes her fat and will not be happy until she has lost weight.