Ethical Decision-Making in School Mental Health

2021 ◽  
Author(s):  
James C. Raines ◽  
Nic T. Dibble
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
School Psychologists ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
School Mental Health ◽  
Codes Of Ethics ◽  
National Association

Ethical decision making in school mental health provides mental health professionals with a seven-step approach to managing ethical predicaments. It combines guidance from four major codes of ethics, including the American School Counseling Association, National Association of School Nurses, National Association of School Psychologists, and National Association of Social Workers. Ethical issues are endemic for mental health professionals working with minors in a host setting like schools. New interventions, evolving technologies, and a patchwork of ethical and legal guidelines create a constant stream of new ethical dilemmas. Longstanding and complex questions rarely give way to quick and easy answers. The seven-step model presented here enables readers to apply a practical process that minimizes their liability and protects their students. Beginning with an introduction of the moral, legal, and clinical foundations that undergird ethical practice, the authors present an ethical decision-making model with seven steps: know yourself and your responsibilities, analyze the dilemma, seek consultation, identify courses of action, manage clinical concerns, enact the decision, and reflect on the process. The second edition includes meticulously updated chapters based on recent changes to all of the codes of ethics over the past 10 years. It also has a new chapter on the universal issue of ethical recordkeeping. This handy guide is written for multidisciplinary teams of mental health professionals, including school social workers, school psychologists, school nurses, and school counselors. It provides a trusty resource with the following elements: Clearly organized chapters that introduce a process approach to ethical decision-making; Interprofessional and collaborative approach to working with other stakeholders; Case examples and practice exercises illustrate real work application of ethical guidelines; and Glossary, web resources, and U.S. Supreme Court decisions on students’ civil rights.

Review and Document the Process

2021 ◽  
pp. 170-191
Author(s):  
James C. Raines ◽  
Nic T. Dibble
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Case Studies ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Decision Making Process ◽  
Iatrogenic Effects

After reviewing and documenting the process, this chapter argues that it is unethical to stop the ethical decision-making process with implementation. The chapter recommends monitoring and evaluating the consequences of the ethical decision by engaging in post-decision activities. It uses two case studies where well-meaning mental health professionals inadvertently created iatrogenic effects for their clients. It details what went wrong in each case and how outcomes might have been improved. In these situations, mental health professionals are strongly encouraged to re-engage the ethical decision-making process on behalf of their clients, including apologizing for missteps previously made.

Implement the Decision

2021 ◽  
pp. 154-169
Author(s):  
James C. Raines ◽  
Nic T. Dibble
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Ethical Decision Making ◽  
Golden Rule ◽  
Decision Making Process ◽  
Positive Outcomes ◽  
Course Of Action ◽  
Fiduciary Responsibility

Implementing the decision begins by double-checking that the course of action that is chosen passes six ethical tests prior to enactment. The chapter focuses on six final checks: the Golden Rule, fiduciary responsibility, justice and fairness, publicity, universality, and mitigation of harm. It recommends that mental health professionals be prepared to justify the decision by managing criticism. Criticism can be assuaged by emphasizing protection of the client, a focus on the present, and the positive outcomes achieved. It recommends that clinicians document their ethical decision-making process and use established parameters to justify their decision.

The scope of psychiatric ethics

2021 ◽  
pp. 3-10
Author(s):  
Sidney Bloch ◽  
Stephen A. Green
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Professionals ◽  
Moral Agency ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Professional Associations ◽  
Theoretical Frameworks ◽  
Ethics In Psychiatry ◽  
Evaluative Terms

Ethical decision-making is no easy matter, as absolutes of right and wrong, good and bad, should and ought, and other evaluative terms are elusive. Both providing the best attainable care for the patient and conducting scientific research guided by lofty ethical principles are paramount. This chapter, an introduction to the fifth edition of Psychiatric Ethics, outlines how the book aims to promote the moral agency of psychiatrists and mental health professionals when relating to patients and their families, colleagues, professional associations, and other organizations, and the society in which they work. It summarizes theoretical frameworks used in ethical decision-making and the range of topics discussed in the other 24 chapters, and offers guidelines to mental health students and graduate clinicians about how to master the field of ethics in psychiatry.

scholarly journals Embodied Ethical Decision-Making: A Clinical Case Study of Respect for Culturally Based Meaning Making in Mental Healthcare

2021 ◽  
Author(s):  
Megz Roberts
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Treatment ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Meaning Making ◽  
Hospital Setting ◽  
Mental Healthcare ◽  
Clinical Case Study ◽  
Culturally Based

AbstractHow does embodied ethical decision-making influence treatment in a clinical setting when cultural differences conflict? Ethical decision-making is usually a disembodied and rationalized procedure based on ethical codes (American Counseling Association, 2014; American Dance Therapy Association, 2015; American Mental Health Counseling Association, 2015) and a collective understanding of right and wrong. However, these codes and collective styles of meaning making were shaped mostly by White theorists and clinicians. These mono-cultural lenses lead to ineffective mental health treatment for persons of color. Hervey’s (2007) EEDM steps encourage therapists to return to their bodies when navigating ethical dilemmas as it is an impetus for bridging cultural differences in healthcare. Hervey’s (2007) nonverbal approach to Welfel’s (2001) ethical decision steps was explored in a unique case that involved the ethical decision-making process of an African-American dance/movement therapy intern, while providing treatment in a westernized hospital setting to a spiritual Mexican–American patient diagnosed with PTSD and generalized anxiety disorder. This patient had formed a relationship with a spirit attached to his body that he could see, feel, and talk to, but refused to share this experience with his White identifying psychiatric nurse due to different cultural beliefs. Information gathered throughout the clinical case study by way of chronological loose and semi-structured journaling, uncovered an ethical dilemma of respect for culturally based meanings in treatment and how we identify pathology in hospital settings. The application of the EEDM steps in this article is focused on race/ethnicity and spiritual associations during mental health treatment at an outpatient hospital setting. Readers are encouraged to explore ways in which this article can influence them to apply EEDM in other forms of cultural considerations (i.e. age) and mental health facilities. The discussion section of this thesis includes a proposed model for progressing towards active multicultural diversity in mental healthcare settings by way of the three M’s from the relational-cultural theory: movement towards mutuality, mutual empathy, and mutual empowerment (Hartling & Miller, 2004).

scholarly journals A Framework for Authentic Ethical Decision Making in the Face of Grand Challenges: A Lonerganian Gradation

2021 ◽  
Author(s):  
Patricia Larres ◽  
Martin Kelly
Keyword(s):  
Decision Making ◽  
Business Ethics ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Codes Of Ethics ◽  
Human Beings ◽  
Human Flourishing ◽  
Invariant Structure ◽  
Grand Challenges

AbstractThis paper contributes to the contemporary business ethics narrative by proposing an approach to corporate ethical decision making (EDM) which serves as an alternative to the imposition of codes and standards to address the ethical consequences of grand challenges, like COVID-19, which are impacting today’s society. Our alternative approach to EDM embraces the concept of reflexive thinking and ethical consciousness among the individual agents who collectively are the corporation and who make ethical decisions, often in isolation, removed from the collocated corporate setting. We draw on the teachings of the Canadian philosopher and theologian, Fr. Bernard Lonergan, to conceptualize an approach to EDM which focuses on the ethics of the corporate agent by nurturing the universal and invariant structure that is operational in all human beings. Embracing Lonergan’s dynamic cognitive structure of human knowing, and the structure of the human good, we advance a paradigm of EDM in business which emboldens authentic ethical thought, decision making, and action commensurate with virtuous living and germane to human flourishing. Lonergan’s philosophy guides us away from the imposition of over-arching corporate codes of ethics and inspires us, as individual agents, to attend to the data of our own consciousness in our ethical decision making. Such cognitional endowment leads us out of the ethics of the ‘timeless present’ (Islam and Greenwood in Journal of Business Ethics 170: 1–4, 2021) towards ethical authenticity in business, leaving us better placed to reflect upon and address the ethical issues emanating from grand challenges like COVID-19.

Psychiatric Ethics

2021 ◽  
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Child And Adolescent Psychiatry ◽  
Social Contexts ◽  
Psychiatric Research ◽  
Liaison Psychiatry

Ethical issues inherent in psychiatric research and clinical practice are invariably complex and multifaceted. Well-reasoned ethical decision-making is essential to deal effectively with patients and enhance their care. Drawing on the positive reception of Psychiatric Ethics since its first publication in 1981, this highly anticipated fifth edition offers psychiatrists and other mental health professionals a coherent guide to dealing with the diverse ethical issues that challenge them. This edition has been substantially updated to reflect the many changes that have occurred in the field during the past decade. Its 25 chapters are grouped in three sections, as follows: 1) clinical practice in child and adolescent psychiatry, consultation-liaison psychiatry, psychogeriatrics, community psychiatry, and forensic psychiatry; 2) relevant basic sciences such as neuroethics and genetics; and 3) philosophical and social contexts including the history of ethics in psychiatry and the nature of professionalism. Principal aspects of clinical practice in general, such as confidentiality, boundary violations, and involuntary treatment, are covered comprehensively, as is a new chapter on diagnosis. Given the contributors’ expertise in their respective fields, Psychiatric Ethics will undoubtedly continue to serve as a significant resource for all mental health professionals, whatever the role they play in psychiatry. It will also benefit students of moral philosophy in their professional pursuits.

Providing Primary Prevention and School Mental Health Services to LGBTQ+ Children and Youth

2021 ◽  
pp. 661-680
Author(s):  
Elizabeth K. Rhoades
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Sexual Minority ◽  
Psychosocial Development ◽  
Health Professionals ◽  
Growth And Development ◽  
School Mental Health ◽  
Children And Youth ◽  
School Based ◽  
Healthy Growth

This chapter provides an overview of the difficulties facing LGBTQ+ youth in schools and their barriers to healthy psychosocial development. The risk and resiliency model is applied to these challenges, and specific risk factors and resiliency factors are explored. The focus is on means to foster healthy growth and development in sexual minority students through developing school-based programs and practices that have been proven to increase resiliency. The chapter provides specific strategies for school-based mental health professionals to use to increase resiliency in sexual minority youth through the application of school-wide policies and practices. Strategies for making such systemic changes and garnering support are also presented.

Students Responding to Natural Disasters and Terrorism

2012 ◽  
pp. 229-250
Author(s):  
Ryan P. Kilmer ◽  
Virginia Gil-Rivas ◽  
Steven J. Hardy
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
School Mental Health ◽  
School Setting ◽  
School Personnel ◽  
Emotional Needs ◽  
Cultural Considerations ◽  
School Based ◽  
The Impact

This chapter seeks to help teachers and school mental health professionals understand the needs of students who have faced a disaster or terrorism and identify strategies for school-based responses. The chapter provides an overview of the effects of these events on school children and youths, including relevant developmental and cultural considerations, and the impact on the school setting. Then, the discussion emphasizes recommendations for, and possible responses by, teachers, school-based mental health professionals, and administrators. Indeed, just as these traumas can affect multiple levels of school children’s lives, the needed response of school-based professionals can be framed as multi-level, ranging from curricular modification to interventions specifically targeting youngsters’ socio-emotional needs. The sections that follow seek to inform and guide responses for school personnel and provide clear, “actionable” recommendations.

scholarly journals Profiling mental health professionals in relation to perceived interprofessional collaboration on teams

2019 ◽  
Vol 7 ◽  
pp. 205031211984146
Author(s):  
Nicolas Ndibu Muntu Keba Kebe ◽  
François Chiocchio ◽  
Jean-Marie Bamvita ◽  
Marie-Josée Fleury
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Knowledge Sharing ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Knowledge Integration ◽  
Interprofessional Collaboration ◽  
Professional Role ◽  
Mutual Trust ◽  
Participation In Decision Making

Objectives: This study aims at identifying profiles of mental health professionals based on individual, interactional, structural and professional role characteristics related to interprofessional collaboration. Methods: Mental health professionals ( N = 315) working in primary health care and specialized mental health teams in four Quebec local service networks completed a self-administered questionnaire eliciting information on individual, interactional, structural and professional role characteristics. Results: Cluster analysis identified four profiles of mental health professionals. Those with the highest interprofessional collaboration scores comprised two profiles labeled “highly collaborative female professionals with fewer conflicts and more knowledge sharing and integration” and “highly collaborative male professionals with fewer conflicts, more participation in decision-making and mutual trust.” By contrast, the profile labeled “slightly collaborative professionals with high seniority, many conflicts and less knowledge integration and mutual trust” had the lowest interprofessional collaboration score. Another profile positioned between these groups was identified as “moderately collaborative female psychosocial professionals with less participation in decision-making.” Discussion and conclusion: Organizational support, participation in decision-making, knowledge sharing, knowledge integration, mutual trust, affective commitment toward the team, professional diversity and belief in the benefits of interdisciplinary collaboration were features associated with profiles where perceived interprofessional collaboration was higher. These team qualities should be strongly encouraged by mental health managers for improving interprofessional collaboration. Training is also needed to promote improvement in interprofessional collaboration competencies.

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