Elizabeth is a 50-year-old woman with a developmental disability who maintains a spotless home. She routinely cleans her home with disinfectants and insists none of her roommates be allowed to clean. Recently, Elizabeth started to get angry whenever her roommates or the staff would move objects around the house. She was repeatedly scrubbing the tables where coffee cups were left. When redirected to a different activity Elizabeth would become agitated, and even try to hit the person redirecting her. She frequently expresses to staff that if its not clean bad things happen. When able to go back to her cleaning she calms quickly and apologizes to her staff. It was original thought by the team that she was having significant behaviour problems and a behaviour specialist was brought into the home to help. The data did not provide a clear reason why she was becoming so upset. It was also noted by staff that she also lacks social ties because she is afraid that when visiting her friends the house will get dirty and bad things will happen.

• What do you suspect as the possible mental health concern
• Provide reasons for your decisions (signs, symptoms, and possible causes of the illness)
• If you were part of this persons support team what daily support strategies would you recommend?
• What alternative treatments might you suggest (therapy - type, exercise, recreation, arts)
• Which health professionals would you recommend the person seek assistance from