Mental Health Ethics Flashcards
How to promote good within a mental health setting?
-
How can medical teams restrict your freedom as a mental health patient?
- Coercion
- Restrict movements and keep within establishment
- Confidentiality broken
Who described stigma at first in the 1960’s?
Erving Goffman
How would you describe stigma?
Originally, described as character traits that people have rather than more positive outlooks.
… (modern outlook)
Perceptions of mental health in the media
- Us VS Them. Mental health has a justification to protect ourselves from mentally ill individuals
- No representation of people living well with mental health issues.
What are the risk factors of developing mental illness?
- Low income, single mothers
- Children & adolescents exposed to violence
- Workers with repetitive work and little decision-making power
- Women who have been victim of sexual and domestic violence
- Frail elderly who live at home.
What population is currently the most at risk for mental health illnesses in Canada.
First Nations population
What proportion of people in Canada receive the mental health care they need?
1/3
What is the belief associated with mental illness & violence?
That people living with mental health issues are necessarily more violent and dangerous.
They are more likely to be victims of crime than the perpetrators.
What is the classification system used for mental illnesses?
DSM (Diagnostic and Statistical Manual)
Article 1 Declaration Human Rights
All humans beings are born free.
Article 3 Declaration Human Rights
Everyone has the right to life.
What act is used when people are a danger for themselves and others?
P- 38
Why is mental health considered a «Unique Moral Practice»?
- Forced admission and forced treatment.
- Refusal of care.
- Inherently moral as illness impacts self, behaviors, etc.
- Imbalance of power and institutional history
- Differences in treatment modalities and ideologies.
- Moral distress
Examples of refusal of care
- May not want treatment
- May have certain demands on how their treatment should go.
etc.
Mental health moral practice example
- Mental health impact all spheres
What are the different types of coercion?
- Formal
- Informal
- Perceived
From less coercive to more coercive, what are the steps on the spectrum of coercion?
- Persuasion
- Interpersonal leverage
- Inducements
- Threats
- Compulsory Treatment
Criteria for autonomous decision-making?
- Informed
- Not coerced
- Voluntary
Example of persuasion
- Nurse mentions that discontinuation of medication will often lead to relapse
- Least problematic form of coercion
- Appeal to reason and emotions.
- Treatment is discussed
Interpersonal leverage
- Nurse looks sad and displays this to the patient.
- Baseline relationship of trust, which allows opportunities for nurses to pressure patients.
- Emotional dependancy of patients onto nurses, which they seek to please.
- React to signs of disapointments.
Inducements
- Nurse offer free tickets to patients.
- Condition is the patients must comply with treatment to receive tickets.
- Inducements seem ethically grey since they are used within establishments to maintain stability with patients.
- Inducements might have uses within a clinical context to build trusting relationships by offering privileges.
Examples of threats
- Nurse mentions that higher pension is available if patient fills out form. However, nurse mentions she won’t help patients to fill it if they don’t comply to treatment.
- Its the value of the prize withheld that determines whether its an inducement or threat.
Nurse’s experience in MH and stigma
- Struggling in silence: hiding suffering, diagnosis, need for leave from colleagues.
- MH concern is sign of weakness; accessing care in secret
- Fear of being «found out»
- Concerns their competences as a clinician would be questioned
How is stigma a fundamental cause of population health inequalities?
- Influences physical and mental health outcomes
- Disrupts or inhibits access to multiple resources
- Enables the creation of new, evolving mechanisms that ensure the reproduction of health inequalities of socially disadvantaged populations.
Stigma & Nursing and Health Care
- In general medical setting, lack of dignity and caring
- Nurses held common stereotypes - fear, blame, hostility
- Attribution theory - Weakness of morals as cause of illness
- Devaluing of needs of patients with mental illness
- In-ward stigmatization
What are the 3 aspects of Equity-Oriented Healthcare
- Trauma & Violence-Informed Care
- Harm Reduction
- Cultural Safety & Anti-Racism
TVIC Principles
- Trust
- Safety
- Choice
- Collaboration
- Empowerment
TVIC Understand Impact
Understand impact of trauma and violence on people’s lives and behaviors.
TVIC Create Safety
Create emotionally and physically safe environments for both clients and service providers.
TVIC Foster C’s
Foster opportunities for:
- Choice
- Collaboration
- Connection
TVIC Support Resilience
Provide strengths-based and capacity-building approaches to support client coping and resilience.
Three vital components of Social Connection
- Structure (numbers and variety of relationships)
- Function (Degree to which relationships serve various needs)
- Quality (Positive and negative impacts of relationships)
