A homeless individual with severe mental illness, anosognosia, and a history of persistent treatment nonadherence is persuaded to come to the day program at the community mental health center
Which intervention should be the team's initial priority? a. Educate him about the importance of treatment adherence.
b. Help him obtain employment in a local sheltered workshop.
c. Interact regularly and supportively without trying to change him.
d. Teach appropriate health maintenance and prevention practices.
C
Given his history of treatment nonadherence and the difficulty that exists in achieving all other goals until he is psychiatrically stabilized and adherent, getting the patient to accept and adhere to treatment is the fundamental goal to address, and the intervention here that is most likely to help meet that goal at this stage is developing a trusting relationship with him. Interacting regularly, supportively, and without demands is likely to build the necessary trust and relationships that will be the foundation for all other interventions later on. No data here suggest the patient is in crisis, so it is possible to proceed slowly and build this foundation of trust.
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