Care planning should be a collaboration between the service user, caregivers and the relevant professionals. It is based on recovery principles, where clients identify their goals and how to work to reach them, rather than concentrating on illness, symptoms and problems. Mental health nursing students were taught the theory but observed that, in their clinical placements, this approach was often not followed in practice. These issues were explored in two teaching sessions with six students. Subsequent focus groups were recorded, transcribed and analysed, yielding four main themes: care planning custom and practice, collaboration, organisational culture and student assumptions about their mentors. Participants detailed how care planning might not be person-centred in practice. It was suggested that this might be due to clinical customs, strains and restrictions, lack of collaboration between service users and the multidisciplinary team, and inept organisational culture. The main challenge for services has been how to manage risk as well as the person-centred approach, and the ‘competing dilemmas associated with care-versus-control issues’.
