(refer to student sheet and support material `Reflection')

Ask the group to think about what mental ill health is. Ask them to come up with one word each, which they associate with it.

(refer to student sheet and support material `comments')

Discuss with the students that mental ill health and mental health are on a continuum.

Ask the students in groups of 4 to place the 15 statements on a line between two points mentally healthy and mental ill health.

Ask them to agree within the group as to where each statement must go.

Read the case study to the group.

Give a copy of the case study to each group of 4 and ask them to write a list of their concerns, on flip chart paper, for each individual described in the case study.

Organise the students into groups of 6. Give each member a role to play. Try to keep the genders the same but change the gender and name if necessary.

Ask the students to read their roles to each other as if they were that person.

On a sheet of flip chart paper ask the students to construct a spider diagram to create a relationship map of the case study.

Then ask the students for each character to get together. On a sheet of flip chart paper describe what they consider the needs of their character to be and how these needs could be met.

Ask each group to describe their responses for their character.

Ask the students to get into their original family group of six.

Ask the group to imagine that a social worker is about to visit the family. Carol has agreed, reluctantly, to the visit. She may or may not have asked Mary to be there. Write a play of the meeting, which takes place in the living room of Carol's house.

Carol had an ordinary and uneventful childhood until aged 11, only 2 months after starting at secondary school, her father left home. She has seen him only rarely since then. Carol, her older sister Sue and her Mum struggled on but Carol felt that all happiness ended on the day that her father left. Sue now lives in Norfolk with her own family. The two sisters get together 2/3 times a year.

Carol has been married twice. She married Colin and Lizzie's father who has the children to stay now and again and then 5 years ago she married Rebecca's father, John.

A year ago John told Carol their marriage was over but he wanted to keep in contact with all the children. John works abroad for most of the year but when he is back in Newbury he regularly sees the children.

Carol trained as a legal secretary after a college course and up until she met John, she always worked. Since her second marriage she has looked after the home and enjoyed being with Rebecca. John has made it clear that the house is hers until the children leave home.

For the last year Carol has been drinking heavily, almost every day. It is becoming harder to hide this from Colin and Lizzie. Quite regularly she is too drunk to drop Rebecca off at the nursery. Colin usually does this and is then late for school.

I live in a nice house in a nice part of town, I've got nice clothes, a nice car, and every bloody man I love leaves me sooner or later ­ that's the way it goes. My Dad upped and left Mum,. Sue (that's my older sister) and me when I was 11. That was it ­ happiness walked out with him, out through the front door. He used to call me his little love heart, but not enough love to bother seeing me after he left. I think he's had other kids ­ haven't seen him for years now.

Then I married Richard ­ Colin and Lizzie's father. Waste of space ­ left me, bye bye. Then I met John, Becky's father, the best of the lot. He swore he'd never leave me, never let me go. Called me his golden princess, because of my hair, but he left anyway. At least he's still around sometimes ­ when he's back from his work aboard. Sometimes I think I'll get a job again ­ I'm a trained legal secretary, you know, but most days I can't get out of bed, let alone apply for a job.

The thing is, I'm a really terrible mother. If Colin wasn't here I don't know how I'd cope, he's the man of the house now. I am drinking, but not too much really, nothing I can't handle. The kids have no idea. It helps, OK? I'll stop when we get through this period, OK? Look at my hair ­ I can't remember the last time I washed it. I'm worried about Lizzie ­ she's only 12 and she's going out all the time and I don't really know where she is.

My tutor's always asking if I'm OK and I always say yes ­ I'm not going to tell him anything. So long as you do your homework school doesn't notice much ­ I know my tutor's being kind, and he's right, really, it's not OK. I wish John, my step dad, was around more, I get on really well with him. My real Dad's useless. I don't say much when John is back from abroad, because Mum says we mustn't worry him or he'll turn out like my real Dad.

So it's just Mum and me really. Lizzy, my sister, is driving me nuts. I don't want to worry Mum, but Lizzy stinks of cider, and she's a rude little cow. If she starts missing homework and school, I'll kill her, `cos people will find out about us then. I'm worried about Becky as well, sometimes I can't eat, because I feel sick all the time. I can't sleep all that well either ­ that's what my tutors notice.

I'm supposed not to notice when Mum's so drunk she can't get out of bed, or worse, when she is out of bed and won't get dressed. I'm thinking of secretly destroying her dressing gown ­ it's dirty and so embarrassing. She keeps asking why I don't invite Hannah around any more ­ as if. My main aim is to spend as much time out of this house as possible ­ not that anyone notices.

I go with my mates down to the park and we drink cider, and sometimes, if I can find it at home, something stronger ­ vodka, I think. If Mum can do it, why can't I? Colin's acting like he's my Dad ­ last night he asked if I'd done my homework ­ well, I hadn't. I hate school, and I don't want to go ­ there`s no point. To be honest, it'd take about a year before Mum noticed.

Yesterday Colin bought me some love heart sweets, and there were three `I love you' sweets. I gave them all to Mummy, and she smiled at me.

I wish we had more food in the house. Sometimes I ask Mary (she lives over there) for some bread, `cos I'm hungry. I don't tell Colin, `cos he'd be cross, he says it's our secret.

I don't like nursery, all the children call me `smelly-pooh', and Claire won't sit next to me any more, because she says I'm a smelly-pooh.

I hate Lizzie, my big sister: she's really mean to me. She says `go away' even in the night when I've wet the bed ­ don't tell anyone, please. If Mummy's not poorly, I can go in her bed, and we snuggle up tight.

I hardly see Carol nowadays ­ we used to have coffee together every other day. When I have seen her out about, she's looked fine ­ she's a pretty woman, and she's always looked after herself ­ well, she used to. The problem is Becky. She's come to me three times now, asking for bread because she's hungry, and she looks so pale. I've asked at nursery how Becky is, and I know they're worried ­ she's just not the same little girl any more, and she shouldn't be wandering around outside on her own, should she?

Last week I took her home, and Carol answered the door. I was really shocked - she looked terrible, and she had on a filthy old dressing gown at 2 o'clock in the afternoon. I asked if everything was OK, but she didn't want to chat. I could see inside the house, and it was a tip - clothes, newspapers - I know for a fact they haven't put the rubbish bin out for the last three weeks.

And another thing. Claire says she doesn't want Becky around any more, because she's a `smelly-pooh', and all the girls think that. I've known the family since before Becky was born, and Carol's a wonderful mother, but something's wrong. I never see Colin. I see Lizzie now and again - she often seems to be out late, and I've seen her in the park with a gang of girls and boys, but that's teenagers, isn't it?

Becky's often hungry and always asking the nursery staff for biscuits and more food. She's regularly coming to nursery smelling of urine, even though she uses the toilet perfectly well at nursery. Other children have noticed she smells, and we feel Becky is becoming increasingly isolated in her class, and this was a little girl who had lots of friends, a popular child.

We haven't seen Becky's mother, Carol, for some time. We are aware Becky's brother often brings her into school, although this must make him late for school himself. We have written to Carol, but haven't had a reply.

Becky is quiet in class, whereas she used to be a real live wire. She seems to be tired, and she's told me she can't sleep at night. Becky has said her Mummy's not well, with a poorly tummy, and we feel this family is struggling.

Yesterday, Becky got really angry with me because she wouldn't put away her love heart sweets. She said she was doing important sorting, and she wouldn't wait until milk-break.