Patient’s documentation: (Name: Ava Morgan Age: 15 Diagnosis: • Schizoaffective Disorder (depressive type) • Obsessive relational delusions (fixed belief that certain staff members have a “special connection” with her) • History of emotionally unstable attachment patterns.)

Current risks: • Fixated on Dr. Elias Vale, a newly appointed consultant psychiatrist. • Believes he is secretly communicating with her through “coded language.” • Recently developed an intense attachment to you, her primary nurse. • Alternates between idealising you and becoming distressed if boundaries are enforced.

Start of Role-play:

You are Nurse. Evening shift. Ava is on enhanced observations — 2:1 staffing earlier due to agitation. She’s sitting on the floor outside the nurses’ station, knees to chest, watching you.

Ava: Tilts her head slightly, eyes fixed on you. “You came back. I knew you would. They said you were off yesterday but I told them you wouldn’t just leave me.” She stands slowly, stepping closer to the glass panel.

Ava: “Dr. Vale didn’t come today. Did you tell him not to? He only listens to you. He pretends he doesn’t, but I can see it.” Her voice lowers. “You talk about me when I’m not there, don’t you? I can feel it. Like… like a string pulling in my chest.” She studies your expression intensely. “You wouldn’t lie to me. You’re different from the others.”