CHCMHS012 Provide Support to Develop Wellness Plans and Advanced Directives Assessment Answer

Part 1: Short Answer Response

Read the below case study:

Jane and Fred

Jane and Fred are a married couple who live in the outer western suburbs of a major town in private rental accommodation. The family receive benefits from Centrelink, these benefits only just meet the needs of the family and as a consequence they are behind in the rent. Jane and Fred have been given a warning that unless the rent is up to date by the end of the month they will be evicted.

Jane is 33 years old and Fred is 37. Jane and Fred have three children, Max who is 10 years old, Sarah 7, and Samuel 3. Max has a developmental disability.

History

Jane has been diagnosed with bipolar disorder however disagrees with her diagnosis. Jane chooses not to take the medication prescribed to her as she experiences unwanted side effects such as weight gain and lethargy. Jane prefers to use cannabis and alcohol as she claims they don’t restrict her creativity. Janes mother was diagnoses as ‘manic depressive” when Jane was a teenager, Jane left home around the same time and they have been estranged ever since. Jane was an only child and never knew her father.

Fred uses methamphetamine and alcohol although can go weeks without using methamphetamine. After a period of abstinence Fred typically binges on both, going on what he describes as a ‘bender’. During these times Fred does not come home, he couch surfs at friends’ houses as he knows Jane will kick him out and call the police. On one occasion in the past Fred became violent with Jane and she called the police. The police put him in a cell for a night. Jane did not pursue it any further, she did not want a DVO, but she warned Fred “stay away from me when you are on your benders, if you come near me you’ll never get to see me or the kids again.” Fred and Jane are ok with this arrangement and apart from Fred being irritable for days when he is ‘coming down’ he has never laid a hand on Jane since.

Fred’s mother was an alcoholic and he believes it is genetic. Fred has not seen his mother for 10 years, the last he heard she was living in a nursing home and had alcohol related dementia. Fred has one brother who he never got on with and never sees, Fred has no idea where he is. Fred’s dad died when he was 6.

Jane and Fred are both musicians, they met in a band when they were teenagers, Jane sings and plays bass guitar, Fred plays the drums and the keyboard. Jane and Fred have described their life as unconventional, alternative and at times tumultuous.

In recent years they have ‘tamed down’ their life due to parenting responsibilities. When Max was 6 and Sarah 3 a report was made to what was then known as ‘Docs’ about a situation of possible neglect. The notification included reports of two unsupervised children naked in a front yard while a party appeared to be happening inside the house every night for two weeks with the unmistakable smell of cannabis always present.

Jane and Fred’s description of the event was that their new band was rehearsing, they did not believe in restricting their kids with clothes and people should mind their own business. They stated they loved their kids and no wonder society was so stuffed what with all the rules and expectations on how to conform

Questions

1) Which Social, Emotional, and Physical Wellbeing Issues Can you Identify?

The issues related to the social, emotional and physical well-being of Jane and Fred and their family have multiple sides. Firstly, the financial stress caused to eviction threats and rental arrears is a significant concern, as the benefits they get from Centrelink are barely enough to manage their expenses. Secondly, both Jane and Fred suffer from substance addiction that poses risks to their mental and physical health. Jane is often found consuming cannabis, and Fred engages in the intake of alcohol and methamphetamine quite frequently. Thirdly, they have a history of domestic violence, which, although it can seem controlled, can have a detrimental impact on their family life. Lastly, their unusual style of parenting and Jane’s state of denial regarding her bipolar diagnosis can affect the physical and emotional health of their children.

2) What are the Potential Impacts of the Identified Social, Emotional, and Physical Wellbeing Issues?

The potential impact of the identified issues can be severe and related to one another. Firstly, financial stress can lead to a sense of insecurity and instability, impacting the emotional and mental health of the family. Secondly, Jane avoiding taking the prescribed medication and relying on substances can have a harmful effect on her bipolar disorder, potentially worsening the symptoms and resulting in suffering and impaired functioning. Thirdly, Fred’s consumption of substances on a regular basis can lead to aggravation of issues related to mental as well as overall health. Lastly, the history of domestic violence and unusual style of parenting coupled with neglect can create an environment of fear and trauma in the children and affect their cognitive and emotional development and well-being.

3) Describe and Explain the Approach that a Worker Could Use to Assist this Client in Addressing the Identified Social, Emotional, and Physical Wellbeing Issues

The approach that a worker should use in this scenario should be compassionate and holistic. To begin with, for the facilitation of open communication, it is essential that trust and rapport are built. Jane and Fred’s financial needs, patterns of substance use, past and existing mental health issues and challenges faced in parenting should be assessed comprehensively. Secondly, collaborative goal-setting can be helpful in the identification of their aspirations and priorities, including their interest and passion related to music and creativity. Furthermore, Jane can be provided individualised support in the form of counselling related to mental health. Similarly, in Fred’s case, rehabilitation can help him with his problem of substance abuse. Lastly, the worker can create an environment for their children that is nurturing and safe by providing them with education and parenting support.

4) What Social and Cultural Wellbeing Factors would you Need to Consider When Engaging with this Client?

It is essential to understand and respect the lifestyle and creative pursuits of the client along with their unconventional belief system without any assumptions or judgements. For instance, it is important to take into account Fred's belief in genetic links to addiction, acknowledging his mother's alcoholism to foster cultural sensitivity. In addition to this, considering the estrangement of the family from their relatives will help in contacting potential support systems with care.

5) Describe the Difficulties the Client and the Worker Might Face in Achieving Desired Changes in the Client’s Life

There are multiple factors that can make it challenging for the client and the worker to achieve the desired changes in the client’s life. Firstly, it might be difficult for Jane to accept any kind of professional treatment due to her being in a constant state of denial regarding the diagnosis of her bipolar disorder, which can further act as a hindrance to her preference for self-medication. Secondly, Fred’s habit of substance use in an intermittent fashion, along with his patterns of binging, could result in him experiencing periods of instability. In addition to this, he might even feel inconsistent in seeking help as a potential after-effect. Lastly, Fred and Jane’s poor financial conditions can act as limiting factor when accessing necessary support and resources, leading to aggravated emotional and physical strain and psychological distress.

6) How Might a Wellness Plan Assist With the Client Overcoming that Barrier?

Jane and Fred’s involvement in the planning process and perceiving long-term goals as a series of manageable steps can result in the wellness plan being beneficial for them. The plan should be developed in a way such that it keeps mental health treatment as a priority in the case of Jane and counselling related to substance use in the case of Fred. Other resources that can empower the family include programs related to financial assistance, access to community resources and support related to parenting. Furthermore, a process involving monitoring and evaluation on a regular basis might lead to better opportunities and strategies for the future.

7) What Social Exclusions or Disadvantages Might this Client be Experiencing?

Firstly, the client, in this case, might undergo a feeling of social exclusion due to constant insecurity associated with housing and lack of social support. Secondly, the feeling of alienation from family members can give rise to emotions of isolation and add to their already existing emotional and financial challenges. Lastly, issues like mental health and substance use have their own stigma associated with them, which might lead them to get marginalised within the community.

8) Where Might these Clients Sit in the Stages of Change Model?

From what can be understood from the case study, Jane and Fred appear to be in the stage of contemplation in the change model. They understand that they are in need of specific improvements or changes related to their lifestyle, habits and parenting techniques but are not ready to show total commitment towards them. In this scenario, the worker plays a crucial role as it is their responsibility to guide Jane and Fred towards the preparation stage. For this, it is crucial the worker takes into account their motivations and reservations and helps the client in developing a comprehensive plan which involves support related to substance use and mental health along with establishing a stable and nurturing family life.

1 (B) Read the below case study:

Peter

Peter is a 35-year-old man with two children Seb 5 and Sasha 7. Peter is a third-generation farmer living in a rural location, three hours’ drive from a major city. The farm has been in his family for 50 years, Peter didn’t really want to take on the job of a farmer, he dreamt of living in the city, having a nice car and an office job. Peter felt he was always a disappointment to his father (Ron) and knew if he didn’t take on the role he would be letting Ron down once again.

Peter’s mother (Sue) died of breast cancer 20 years ago leaving Ron and Peter without a wife and mother. Sue was the glue that held everything together and when she died everything seemed to unravel. Ron’s father (Syd) died soon after leaving the farm entirely to Ron to manage. Syd was a big drinker and while never diagnosed it was expected he died of liver failure. Peter recalls visiting his grandfather in hospital and being shocked at his yellow skin and eyeballs and his emotional decline. He was always a man larger than life with a quick temper, particularly after drinking. The man in front of him was wizened and sad, as a 15-year-old this vision of his once powerful grandfather was disturbing.

Ron began drinking heavily soon after. Ron’s temper was also quick to flare, and like his father was when drinking. Peter more often than not was on the receiving end of a tirade of abuse. Peter recalls being told he was ‘useless’, a ‘hopeless farmer’ and a ‘pansy boy’. Ron always showed remorse when sober, stating losing Sue was ‘a pain that never went away’. Ron used alcohol to fill the void and it became evident he was dependant. Life went along, Peter dreamt of another life but also knew his destiny was mapped out.

When Peter was 25 a young woman on a 457 visa needing to fulfil her regional Australia work commitments started working on the farm. Juliana was from South America and the most beautiful woman Peter had ever seen. It didn’t take long before a relationship emerged. The two fell in love and life was never better for Peter. Juliana obtained her Australian residency and the two were married on Peters’ 28 ^th birthday.

The drought brought stress to Peter and Ron, things were tough and money was scarce. Neither men were very good communicators and alcohol became the conduit that facilitated any form of discussion. Peter was aware of the family history of alcoholism and was worried about his increasing reliance.

Peter saw a doctor and the doctor prescribed anti-depressants, this medication appeared to help especially when he doubled the dose.

Juliana gave birth to Sasha. Juliana experienced some post-natal depression, she missed her family and went home for a visit. Before she left she gave Peter an ultimatum ‘Cut back on the booze or I’m not coming back’. This warning was a wakeup call to Peter, the thought of losing his family was too much to bear. Peter stopped drinking completely, Juliana came home and soon after Seb was born.

When Peter was 33 Ron was diagnosed with cirrhosis of the liver and the prognosis was not good. It was now up to Peter to take full control of the farm.

Life was pretty good for a time. Peter loved being a father. The farm was doing ok, he was not drinking and Juliana was happy.

There was a flood that wiped out all the crops, the bills were piling up, Ron was getting sicker and Juliana was becoming emotionally distant from him. Peter began drinking as an escape from everything, he knew it wasn’t the answer but just couldn’t see a way out of the mess. Peter also began using cannabis to recover from hangovers.

After Ron died, Juliana gave Peter his final ultimatum, stating she was falling out of love and losing respect for him, ‘Stop or cut right back or I’m gone’.

Questions:

1. Which Social, Emotional, and Physical Wellbeing Issues Can you Identify?

Peter faces various issues related to social, emotional and physical well-being that have had a notable impact on his life. The feeling of reluctance in Peter is solid and evident when it comes to taking on the role of a farmer. Secondly, the emotional trauma that Peter received due to his father’s abusive behaviour has left Peter feeling inadequate and having doubts regarding his self-worth and capabilities. Secondly, the death of his mother due to breast cancer resulted in the formation of an infinite void which was worsened by the death of Peter’s grandfather. Lastly, the struggling farm has added to his emotional burden. This has resulted in Peter developing a drinking habit that puts not only his financial well-being but also his family life and his relationship with his wife, Juliana, at risk.

2. What are the Potential Impacts of the Identified Social, Emotional, and Physical Wellbeing Issues?

The potential impacts of the identified well-being issues are pretty extensive. Firstly, there is a risk of deterioration associated with Peter’s mental health due to his dependence on alcohol coupled with his stress and emotional trauma. Secondly, this constant reliance on cannabis and alcohol can result in severe physical and mental impairments affecting his ability to exhibit effective management of the farm and putting the livelihood of the family at stake. Lastly, this can also lead to further worsening of his relationship with his wife Juliana and, ultimately, separation, which can be emotionally detrimental for their children, Sasha and Seb.

3. Describe and Explain the Approach that a Worker Could Use to Assist this Client in Addressing the Identified Social, Emotional, and Physical Wellbeing Issues

From a worker’s perspective, for addressing the challenges faced by Peter, it is essential to approach him with empathy and understand the severity of his emotional struggles along with the cultural context behind his family’s history of alcoholism. In additon to this, the creation of an environment that encourages transparent and open-minded conversation. Furthermore, a holistic assessment will be needed to develop an intervention strategy that is effective and efficient.

4. What Social and Cultural Wellbeing Factors Would you Need to Consider When Engaging With this Client?

Mental health services, along with therapy and counselling related to substance use, can be helpful in dealing with Peter’s alcohol problem and his emotional trauma. Additionally, techniques like CBT and strengths-based approaches can act as healthier strategies for coping with emotional triggers and developing better communication skills. Furthermore, Petr and Juliana can benefit from family counselling as it would help them identify the challenges in their relationship and help them become better partners as well as parents.

5. Describe the Difficulties the Client and the Worker Might Face in Achieving Desired Changes in the Client’s Life

Firstly, Peter’s reluctance related to any kind of change can come across as a significant barrier due to a constant collision between his identity, dreams and aspirations, and his duty and responsibility towards his family’s tradition of farming. Secondly, the emotional baggage carried by Peter due to experiences involving abuse and personal loss might make it difficult to deal with unresolved traumas. Lastly, Peter’s addiction to cannabis and alcohol and his emotional stress due to his poor financial condition would also require handling in a considerate and compassionate manner.

6. How Might a Wellness Plan Assist With the Client Overcoming that Barrier?

The wellness plan would require active collaboration between Peter and the worker so that it can be developed in a way that is tailored according to the requirements of the client. It should be focused on setting goals that are achievable and measurable and take into account issues like emotional well-being, substance use and farm management. In addition to this, the plan should provide access to mental health resources along with support related to the management of finances and treatment of substance use. Furthermore, the involvement of his wife Julia and their children Seb and Sasha can also be beneficial as it would encourage open communication and facilitate the creation of a supportive environment.

7. What Social Exclusions or Disadvantages Might this Client be Experiencing?

Peter and his family live in a rural area which itself poses a situation of social exclusion with respect to treatment options, rehabilitation facilities and accessibility of resources and social support networks. It is crucial that the worker takes into consideration the limitations that come along with the location and explore locally available resources.

8. Where Might These Clients Sit in the Stages of Change Model?

Regarding Peter’s position, he sits somewhere between the stages of contemplation and preparation of the change model. He somewhere understands the need for improved health and life; this is evident from his attempts in the past to address his addiction to alcohol, especially due to the ultimatums given by his wife, Julia. The worker plays a part in motivating Peter to step into the action stage, where he takes concrete steps to overcome the challenges faced by him and prevent any relapse.

Part 2 Case Study and Advanced Directives

Task 1: Read the Following Case Study

Joanne is a 32 year old single parent of two children (currently aged 4 and 3).

She was diagnosed with schizophrenia in her late teens, and has been prescribed a range of antipsychotic drugs with poor effectiveness in controlling both her auditory hallucinations and suicidal thinking.

 Joanne has made several suicide attempts in the 10 years following her diagnosis, and has several admissions to her local mental health unit.

Her three children were removed from her care by the Department of Communities and Justice 3 years ago. DCJ advised Joanne that she needed to get her mental illness in a stable state before she could be deemed as safe to care for her children. Joanne began attending her appointments and was prescribed a new antipsychotic, Clozapine. 3 months ago DCJ decided to restore Joanne’s children into her care.

Joanne is struggling with some of the side effects of Clozapine (weight gain, headaches, dizziness, blurred vision) and the requirement for regular blood tests (Clozapine causes reduction in white blood cell count).

Joanne has been a client of your Indigo Community Services and Health Hub community mental health support service for the last year. Joanne is aware that she is very overweight, and her diet is poor. She finds it difficult to be motivated to do household chores and is self-conscious about going out of the house because of her weight.

Joanne has no contact with her family, has no friends or supports in the area, and usually spends the day watching television. However, now she has the children back in her care, she would like to change her lifestyle and improve her physical health, and develop strategies to manage the side effects of her medication and promote recovery. 

Answer the following questions: 

1. Which Social, Emotional, and Physical Wellbeing Issues Can You Identify?

In the following case study, since her diagnosis of schizophrenia in her late teens, life has been quite challenging for Joanne. This has worsened over the years due to the non-effectivity of prescribed medications, failing to control auditory hallucinations and suicidal thoughts. This has resulted in Joanne attempting to commit suicide multiple times, coupled with frequent admissions to the local healthcare setting over the past decade. Her social well-being has also suffered due to isolation and lack of social interaction as a result of any kind of contact with friends and family. Lastly, she is very conscious about her appearance, which is often the reason behind her reluctance to leave her house and participate in social activities.

 2. What Are the Potential Impacts of the Identified Social, Emotional, and Physical Wellbeing Issues?

Firstly, with respect to Joanne’s social well-being, her habit of living in isolation may lead to her experiencing loneliness and hamper the pace of her mental health recovery. Secondly, in terms of emotional well-being, the symptoms of her schizophrenia can worsen due to unaddressed grief and trauma and can result in more severe outcomes. Thirdly, her physical well-being may be affected due to the side effects of Clozapine and her poor dietary habits, leading to increased insecurity about her appearance. Lastly, all these factors impact her parenting abilities and raise a question about her ability to provide her children with a healthy and stable family life.

3. Describe and Explain the Approach that a Worker Could Use to Assist this Client in Addressing the Identified Social, Emotional, and Physical Wellbeing Issues

 It is important for the worker to approach Joanne with understanding and empathy. In addition to this, establishing trust should be the utmost priority keeping in mind the mental and emotional state of Joanne. Furthermore, it is essential to build a strong relationship with Joanne such that she experiences support and safety and becomes comfortable opening up about her experiences and challenges. Moreover, Joanne should be encouraged to participate in social activities. She should be supported when it comes to enhancing her parenting skills. Lastly, the worker should ensure that Joanne receives regular support and care.

4. What Social and Cultural Wellbeing Factors Would You Need to Consider When Engaging With this Client?

Firstly, it is important to acknowledge the cultural background of Joanne. This would help in engaging in a conversation that is culturally sensitive and does not disrespect her values and beliefs. Secondly, it is also necessary to understand how the concept of mental health is perceived in her community, along with any associated stereotypes. Thirdly, creating a safe space is essential as it can help Joanne overcome her loneliness due to social isolation. Lastly, her role as a single parent should be considered to understand the challenges she faces with respect to her responsibilities.

5. Describe the Difficulties the Client and the Worker Might Face in Achieving Desired Changes in the Client’s Life

The first major challenge in achieving the desired outcomes is Joanne’s diagnosis of schizophrenia and her suicidal tendency. It is crucial to manage the symptoms and address any kind of emotional distress caused due to her previous attempts at committing suicide This might require extensive support and accessibility to mental health resources. Secondly, the side effects of medications like Clozapine might discourage Joanne and have a detrimental effect on her motivation to stick to the regimes of treatment and medications. Thirdly, staying in isolation for long periods might make it difficult for her to make social connections and interact with people. Lastly, as she is a single parent, it might b challenging for her to balance her duties as a parent and her personal well-being journey.

6. How Might a Wellness Plan Assist with the Client Overcoming that Barrier?

Firstly, strategies such as group therapy, counselling sessions and support groups can be included to address Joanne’s mental well-being. This can also comprise approaches that can help her to cope with medications and expose her to alternate treatment options. In terms of physical health, the plan can include a schedule for exercise and a diet chart that can keep her physically active and healthy. Lastly, Joanne can be made to participate in community activities and indulge in practices that involve self-care to counter social isolation and stress and enhance her emotional well-being.

7. What Social Exclusions or Disadvantages Might this Client be Experiencing?

There are various social exclusion and disadvantages which Joanne is experiencing due to her mental health challenges. First is the separation of her children from her care by the Department of Communities and Justice has resulted in family separation, due to which the sense of isolation is increased. Second, she is a single parent, that too with a history of struggles with mental health which may have caused stigmatisation and social distancing from the community and peers. Third, Joanne's weight gain and self-consciousness about her appearance may lead to societal judgement, affecting her confidence.

8. Where Might these Clients Sit in the Stages of Change Model?

Joanne might be in the Contemplation stage of the stages of change model. This stage suggests that she is aware of the changes needed and is willing to seek options but may not be fully devoted in making listings yet. Although she still faces challenges in taking action, she expressed her ambition to change her lifestyle and work on her physical health.

9. Describe the Process you Would Use to Establish an Effective Working Relationship with the Client

To provide an adequate working relationship with Joanne, the workers must compute respect, empathy and non-judgemental communication. As Joanne has a history of mental health struggles, building trust is crucial. The workers should ardently listen to Joanne’s concerns and validate her experiences. A collaborative approach is necessary, including Joanne in planning treatment and goal-setting to make her feel empowered. To align with specific needs and cultural background the workers should also examine the preferences for communication and tailor interventions. 

10. What Would you Need to Consider When Reviewing the Client's Progress and the Possible Need for Referral to Specialist Services?

To identify any emergency challenges and to monitor the effectiveness it is essential to regularly review Joanne’s progress. The worker should use perceptible indicators to ingress the changes in Joanne’s medication management, physical health, mental health stability and comprehensive well-being of Joanne. If Joanne’s suicidal thoughts still persist despite new medication a referral to a psychiatrist or mental health specialist experienced in treating schizophrenia may be necessary to explore alternative treatment options. If the side effects of Clozapine continue to increase her weight and affect her well-being, the referral to a nutritionist may be beneficial.

11. Describe the Steps Involved in Case Closure and Exit Planning with the Client

The closure for the case and exit planning process should be done collectively with Joanne. There are basically six steps to be followed for the execution of the exit plan and case closure. First is accessing the progress of Joanne towards her goals and respective outcomes. Second is identifying the strengths and resources of Joanne, which will help her to progress continuously. Third is involving Joanne in the conversation related to her future aspirations and also acknowledging any ongoing support that she may need. Fourth is identifying any referrals to community support groups or specialist services which are crucial to assist the progress of Joanne. Fifth is the development of a comprehensive exit plan that drafts the steps that Joanne will take individually or with minimal support after the closure of the case. The last step is to appoint regular follow-ups to make sure that Joanne sustains her success along with any new difficulties that may arise.

Task 2 Read the Case Study Update Below and Answer the Following Questions

As a requirement of her children being returned to her care, Joanne must attend local support groups. You have helped Joanne enrol with a local playgroup and a mental health support group. Joanne has also enrolled in a course at her local TAFE. The children appear to be settled, and there are no concerns regarding their care. However, Joanne has come into the office saying some-one in her support group has talked about an advanced directive, and she would like to know more about this.

1. How Would you Explain the Purpose of a Crisis Plan/Advanced Directive to Joanne?

An advanced directive, also known as a crisis plan, is a dedicated and empowering tool that helps in treatment related to mental health and also supports during the difficulties faced by the patient. In this case, the directive helps Joanne to communicate her needs and preferences to professionals dealing with mental health. This ensures that Joanne gets the care she deserves even if she is not able to point out her wishes in the crisis. The idea of an advance directive is to give Joanne a sense of control and liberty in addressing mental health care, resulting in peace of mind for Joannes and her family members. 

2. What Might Joanne Include in an Advanced Directive?

An advanced directive includes several elements. First is personal information and emergency contact who can be connected in case of emergencies. These contacts should be of any family members or any trustworthy healthcare professional. Second, is the preferences of the treatment, which include the type of interventions, therapies and medication which will help to cope with the crisis. Third is the identification of the warning symptoms, which helps to know that the patient is heading towards crisis. The timely support is provided by the mental health professionals when these signs are recognised timely. Fourth is the coping strategies that are considered to be very beneficial at the time of crisis. Fifth is the communication style which helps Joanne to get engaged in the time of crisis. Sixth is medication management and hospitalisation preferences, where the information about the medicines taken currently or taken in the past can be used during a crisis. During a crisis, the preferences for hospitalisation include the comfort level and facilities to get admitted. Lastly, cultural consideration affects the mental health of joannes. legal authorisation in some areas is provided for the advanced directive.

Task 3 Read the Case Study Update Below and Answer the Following Questions

Joanne tells you she is considering asking her prescribing doctor to change her antipsychotic medication. While she recognises that Clozapine is effective in controlling her symptoms, she has not been able to lose weight, and she is concerned about the health risks associated with clozapine. She wants to include a statement I her advanced care plan that she no longer wishes to be treated with Clozapine if re-admitted to hospital. You are aware that previous antipsychotic medications have not been effective for Joanne, and are concerned that if she becomes unwell again that the children will be removed from her care.

1. How Will you Respond to Joanne?

I would approach Jonnae with empathy and understanding, with an appreciation for her consideration of her medication and the effect on her overall health. I would acknowledge her feelings and decisions to adjust the medication by seeing her previous observations dn experiences with several antipsychotic medications. It is crucial to address the mental health stability after her children have returned to her care. The weight-related side effects of Clozapine will also be taken into account for her well-being and ability to gain confidence in herself. The advanced care plan discussion will involve the importance of collaborating with the mental health care team to establish a plan which relates to her preferences. I would recommend Joanne include descriptive information about the potential medication, treatment preferences and concerns that she may have in her advanced directive. Moreover, I will explore several strategies with her to acknowledge her weight concerns, like changes in lifestyle patterns, workout plans and support systems which will help maintain her mental stability.

Joanne decided to stop taking antipsychotic medication altogether 2 months ago, and is starting to experience symptoms of her illness. Joanne is hearing voices, is emotionally distressed, finding it difficult to manage daily living tasks, neglecting basic hygiene of herself and the children and she has not been attending the playgroup or the mental health support group.

2. What do you Need to do? In Addition, How Would you Go About Address your Concerns with Joanne?

In this case, it is crucial to address the safety and well-being of Joannes first, including the safety of her children. As her mental health support worker, the first step is to reach out to Joanne immediately and attempt to establish contact with her. To improvise, it is also important to have face-to-face meetings to monitor the current situation of Joannes. While addressing the concerns with Joanne, it is essential to have the conversation with complete empathy and non-judgemental understanding. During the conversation, the concern for her not taking the antipsychotic medicines must be addressed. Encouragement to openly discuss her feelings and concerns without any fear of judgement. Remind Joanne about support groups as a part of her well-being plan. Encourage Jonnae to meet her mental health support group and professionals to acknowledge the current challenges.

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