◄Previous: 2 ‘My child won’t go to school’

# 2.1 The case study of Lily

The case study of Lily that you look at next is based on a real-life young person who accessed child and adolescent mental health services (CAMHS). All key details have been changed to ensure this young person and their family cannot be identified.

## Case study: Lily

Lily is 14 years old and lives at home with her mother and father. She is worried that her family, especially her mother (June), will die in a natural disaster, like an earthquake or volcanic eruption – events that are very unlikely in the UK. These are topics her class began studying in geography last term. She has had problems attending school for many weeks now. Lily gets very angry with her parents and has a ‘meltdown’ when they try to force her to go to school and she has been in effect home-schooled for almost a whole term. Lily’s school is insisting on a return-to-school plan and her parents are finding it hard to agree about this.

## Activity 2 Lily and returning to school

Allow about 45 minutes

#### Part 1

Watch the following video of Lily with her parents.

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Transcript

Observing her body language and listening to what she says, note down the ways in which you can tell that Lily is distressed.

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### Discussion

Lily’s body language suggests she is distressed, based on her clutching a hot water bottle and her pained expressions. She also expresses her distress when stating, ‘You don’t understand, I’m not going. I don’t feel well, I’ve got stomach ache’ and ‘I’m not going to school, I hate it’.

#### Part 2

Spend less than 10 minutes thinking about what your initial response is to the statement below and then pick from one of the five options to indicate whether you agree that forcing Lily back to school is the right course of action.

Lily is experiencing difficulties but should return to school in-person imminently.

#### Part 3

The activity below is designed to encourage your ethical reasoning concerning the dilemma of Lily being made to return to school. You will draw on two key concepts (paternalism and autonomy) in completing the activity. These concepts are briefly defined below:

- Paternalism = Decisions are made for someone else, but these need to be in the person’s best interests (e.g. when a parent makes decisions on behalf of a child or young person, because this is for their ‘own good’).
- Autonomy = A person’s (e.g. Lily’s) ability to manage their own matters and make their own important life decisions.

Answer the following questions, in each case deciding whether the statement given is an example of paternalism or autonomy.

1. ‘Lily might not like it, but it’s what the adults think is best for her.’

Paternalism
Autonomy

2. ‘It’s Lily’s life, she should be able to decide what she does.’

Autonomy
Paternalism

3 ‘It should be Lily’s choice, she says it’s too hard for her at the moment, end of.’

Paternalism
Autonomy

4. ‘School isn’t optional, Lily needs to go, irrespective of what she says.’

Paternalism
Autonomy

5. ‘Lily needs to go to school as it’s for her own good.’

Autonomy
Paternalism

6. ‘No one should be forced to go to school if they don’t want to go.’

Paternalism
Autonomy

In the next section, the case study of Lily will continue and you will consider the sources of support available.

◄Contents►Next: 2.2 Lily’s parents seek help

OpenLearn - Child mental health: is it in crisis?
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