Lakshmi is a 9-year-old girl well known to the local primary healthcare professional because she has chronic asthma. The health professional has learned over the past 3 years since the diagnosis of asthma was made that understanding Lakshmi's mental health and the social conditions in which she lives has been really important in keeping her alive and able to go to school. Some of Lakshmi's asthma attacks come on when she has a cold or the flu or when she has been exposed to pollen in the spring. Some of her worst attacks are triggered by excitement and disappointment. Helping her parents to prevent Lakshmi getting too excited at the time of festivals and present-giving has reduced her attacks. A year ago, Lakshmi started to refuse to go to school because she was worried about having an attack there. The health professional was able to talk to the teachers to explain what should be done if Lakshmi had an attack in school and this reassured the teachers so that she was able to attend regularly. Lakshmi's family lives in an overcrowded shack in a poor part of the city. There is nothing that the health professional can do about the living conditions, but she was able to help her mother and father to stop smoking so that the air at home was less polluted and there was more money to spend on food. Now Lakshmi has started to be very disobedient and does not want to take the medication that seems to prevent the attacks. The health professional will have to try to understand this nonadherence with treatment and also help Lakshmi understand why it is important for her to take her medication regularly if it is to help.