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1.      What assessments would need to be carried out to enable effective care planning for Helen ? Your

answer should refer to the case scenario and also demonstrate an understanding of health promotion and recovery concepts utilising appropriate supporting references.

 Helen is a 22 year-old student in her final year at university. Helen is being seen by the practice nurse at her local GP surgery for a urinary tract infection. The nurse practitioner assessing her is struck by Helen 's low mood and sadness, so she begins to ask her questions about her low mood. Helen reveals having a number of unpleasant experiences after smoking cannabis over the past few years which has resulted in his hearing voices over the past year, The voices were pleasant at first and Helen was able to ignore them but recently they have become more distressing and a lot harder to ignore.

On further questioning, Helen reveals a history of drug and alcohol misuse which began at the age of ten. Helen also reports that she began to drink alcohol daily to relieve the stress from the voices. In recent weeks, Helen began to isolate herself from her friends, who she feels would not understand this and may see her as mad. Helen has become more withdrawn and does not like socialising as much as she used tq,- she prefers to stay in her room alone listening to music on her iPod and smoking cannabis which she says relaxes her. Helen plays the piano and has composed a

few songs in the past but has not had any pleasure lately in playing the piano and has also been missing a lot of lectures at university. Helen is concerned about her situation but does not know what else to do about the exam stress and the voices.

Despite drinking alcohol daily, Helen denies she has a drinking problem and says that the alcohol is helping to numb the voices in her head. She reports that recently she has begun to feel like people are out to get her and does not feel safe outside her room. Helen has a past history of suicidal thoughts but denies current suicidal ideation.

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