Ethical Issues with Mental Health Diagnosing: What We’re Doing Wrong Delon N. Brewer Northwestern Oklahoma State University Ethical Issues with Mental Health Diagnosing What We’re Doing Wrong When it comes to mental health and diagnosing there is many challenges that a therapist or clinician could encounter. In any professional occupation one has to consider all of the ethical principles put in place as well as the legal laws; if one is incompliant to these ethical guidelines in a mental health field, in varying circumstances, failure to comply with these codes could involve legal issues which could even result in lose of licensure. Common ethical issues involved in the mental health field could include: misdiagnosis or missed diagnosis, legal incompetence, and health care fraud (misdiagnosis for insurance reimbursement). According to Szasz (2005), “In principle, the mental patient is considered competent (until proven [otherwise]). In practice, the client is regularly treated as if he were incompetent and the psychiatrist who asserts that he needs treatment is treated as if he were the patient’s guardian” (p.78). During the 1940’s patients who were mentally ill were considered “legally incompetent” when committed into a mental health facility. Relatives of the patients could release them by providing care in their homes for the client. Unfortunately, Szasz (2005) claims, that “the treatment of mental diseases is no more successful today than it was in the past” (p.78). Intentional Misdiagnosis A common struggle for counselors can sometimes be to find the right balance between “the demands or managed mental health requirements and obligations to clients” (Braun & Cox, 2005, p.426). Often times counselors may be t... ... middle of paper ... ...urces for other interventions outside of the medical model that have proven to be effective in children with this disorder. As the role of a clinician it is important for them to continue in their education and training, keep up to date with the most current ACA code of ethics as well as state laws and regulations. Often times clinicians or counselors believe they are behaving in ways that benefit their client when in reality it was for the benefit of the professional and the client feels betrayed or mislead, giving them a negative view of the counseling profession. Butkus & Mutchler (2012) state that as a preventative method that when an accurate diagnosis of ADHD is recognized it is the responsibility of the clinicians “to share all the options available to youth and their families in treatment for ADHD [and/or other mental health] related issues” (p.933).
As a result of the lack of regulation in state mental institutions, most patients were not just abused and harassed, but also did not experience the treatment they came to these places for. While the maltreatment of patients did end with the downsizing and closing of these institutions in the 1970’s, the mental health care system in America merely shifted from patients being locked up in mental institutions to patients being locked up in actual prisons. The funds that were supposed to be saved from closing these mental institutions was never really pumped back into treating the mentally ill community. As a result, many mentally ill people were rushed out of mental institutions and exposed back into the real world with no help where they ended up either homeless, dead, or in trouble with the law. Judges even today are still forced to sentence those in the latter category to prison since there are few better options for mentally ill individuals to receive the treatment they need. The fact that America, even today, has not found a proper answer to treat the mentally ill really speaks about the flaws in our
In the book “The Mad Among Us-A History of the Care of American’s Mentally Ill,” the author Gerald Grob, tells a very detailed accounting of how our mental health system in the United States has struggled to understand and treat the mentally ill population. It covers the many different approaches that leaders in the field of mental health at the time used but reading it was like trying to read a food label. It is regurgitated in a manner that while all of the facts are there, it lacks any sense humanity. While this may be more of a comment on the author or the style of the author, it also is telling of the method in which much of the policy and practice has come to be. It is hard to put together without some sense of a story to support the action.
The fight for improved health care for those with mental illness has been an ongoing and important struggle for advocates in the United States who are aware of the difficulties faced by the mentally ill and those who take care of them. People unfortunate enough to be inflicted with the burden of having a severe mental illness experience dramatic changes in their behavior and go through psychotic episodes severe enough to the point where they are a burden to not only themselves but also to people in their society. Mental institutions are equipped to provide specialized treatment and rehabilitative services to severely mentally ill patients, with the help of these institutions the mentally ill are able to get the care needed for them to control their illness and be rehabilitated to the point where they can become a functional part of our society. Deinstitutionalization has led to the closing down and reduction of mental institutions, which means the thousands of patients who relied on these mental institutions have now been thrown out into society on their own without any support system to help them treat their mental illness. Years after the beginning of deinstitutionalization and after observing the numerous effects of deinstitutionalization it has become very obvious as to why our nation needs to be re-institutionalized.
Mental illness has been around as long as people have been. However, the movement really started in the 19th century during industrialization. The Western countries saw an immense increase in the number and size of insane asylums, during what was known as “the great confinement” or the “asylum era” (Torrey, Stieber, Ezekiel, Wolfe, Sharfstein, Noble, Flynn Criminalizing the Seriously Mentally Ill). Laws were starting to be made to pressure authorities to face the people who were deemed insane by family members and hospital administrators. Because of the overpopulation in the institutions, treatment became more impersonal and had a complex mix of mental and social-economic problems. During this time the term “psychiatry” was identified as the medical specialty for the people who had the job as asylum superintendents. These superintendents assumed managerial roles in asylums for people who were considered “alienated” from society; people with less serious conditions wer...
As time goes on, the law has put more emphasis on facility just like Bridgewater State Hospital in which many of the actions of the facility workers can face legal consequences such as facing prison time, fines, lawsuits, and etc. Society has a better understanding of why certain people act the way that they do and being more knowledgeable about psychology and mental diseases allows us to have a different approach when dealing with these topics or these individuals. In today’s era, there are many normal individuals who are willing to stand up for those who do not have a voice of their own. I believe that this change in one’s ability to stand up for another individual or group of individuals is what brought about change to the medical environment of those who are mentally
...ments. In psychotherapy the psychologist must ensure that there is a high level of trust between him and the patient. There must also be high confidentiality rate between both parties. Only at necessary times should a patient’s record be disclosed to third parties. There must also be set boundaries between the patient and his or her psychologists and there must be no form of sexual interaction between both parties. In terms of pharmacological treatments with patients who suffer from ADHD, the over prescription of Ritalin must be revised as more and more young children are forced to take the drug which often times leads the child to lose his or her freedom of personality. These ethical issues must be looked into as these drugs are given to children so that they can fit into a socially normal behavioural society which in turns makes them be subject of discrimination.
The BBC documentary, Mental: A History of the Madhouse, delves into Britain’s mental asylums and explores not only the life of the patients in these asylums, but also explains some of the treatments used on such patients (from the early 1950s to the late 1990s). The attitudes held against mental illness and those afflicted by it during the time were those of good intentions, although the vast majority of treatments and aid being carried out against the patients were anything but “good”. In 1948, mental health began to be included in the NHS (National Health Service) as an actual medical condition, this helped to bring mental disabilities under the umbrella of equality with all other medical conditions; however, asylums not only housed people
Some of the disorders listed in the DSM-5 contain clusters of symptoms, however many disorders are now on a spectrum with other closely related disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). It is important to remember that clients frequently do not meet all of the criteria for a given disorder, and there may be overlapping symptoms across multiple disorders that warrant clinical attention. Thus, the boundaries between various disorders can easily become blurred. Clinicians often have to give a diagnosis fairly quickly, particularly when seeking third party reimbursement. And, while a diagnosis should not be given solely for reimbursement purposes, giving a diagnosis is often a time-sensitive process. INSERT CODE OF ETHICS. Helping professionals can do harm to clients when an inaccurate diagnosis is given, particularly because the diagnosis is a key element when making treatment decisions....
A counselor should always keep their thoughts to themselves and remain open-minded about the situation. The only time a counselor should share their thoughts is if it helps the client with their situation that they are dealing with. “Counselors must practice only within the boundaries of their competence (Standard C.2.a.), and, if they “determine an inability to be of professional assistance to clients” (Standard A.11.b.), they should facilitate a referral to another provider. (Kocet, M. M., & Herlihy, B. J. (2014). Addressing Value-Based Conflicts Within the Counseling Relationship: A Decision-Making Model. Journal Of Counseling & Development, 92(2), 180-186 7p. doi: 10.1002/j.1556-6676.2014.00146.x).” Keeping your thoughts to yourself is
The counselor accomplishes the above by expressing empathy, developing discrepancies, going along with resistance and supporting self-efficacy. Moreover, the counselor guides the client toward a solution that will lead to permanent posi...
People deal with different life situation’s every day and counseling is a great way to cope with situations that are hard to cope by oneself. Counselors are faced with these situations and it is extremely important to be prepared and have the proper training to be able to handle a client’s situation to the best of their ability. There are rules and regulations to help keep counselors on a professional level to help guide with situations such as confidentiality, supervisor and trainee relationships, and diversity and clinical experience.
When it comes to mental illnesses people tend to assume the worst of the patients, what they don’t think about is the people who care for them. They don’t care what really goes on behind the walls of the facilities. The patients were treated like animals, and horrendous punishments were appointed whenever someone missbehaved. Instead of helping the patients with their mental health, the doctors and nurses were making the patients feel worse. Recovery was on the low percentage and thirty-eight percent of the patients in mental hospitals in the 1800s were reported dead. If we were to compare the time periods of 1600s-1800s and 2000s the differentiality would be beyond extremity.
Corey, G. (2011). Theory and practice of counseling and psychotherapy. (ninth ed., pp. 291-301). Belmont, CA: Brooks/Cole.
According to the Facts and Numbers page on the National Alliance of Mental Illness website, "One in four adults--approximately 61.5 million Americans-- experience mental illness in a given year. One in fo17-- about 13.6 million-- live with a serious mental illness such as schizophrenia, major depression or bipolar disorder." (Facts and Numbers). Throughout history people with mental illness have been perceived as lesser than those without mental illness, and thus these people have an innumerable amount of difficulties and challenges to overcome compared to their counterparts with the benefits of pristine mental health. In The Mad Among Us by Gerald N. Grob, he describes the change of the ways of caring for the mentally ill starting from the beginning of institutionalization in the early eighteenth century (Grob 17) to the idea that serious disorders cannot be cured, but alleviating the symptoms "should be able to remove the obstacles that stand in the way of natural self-healing processes." (Grob 311). The lies of people with mental illness are as diverse as the disorders they live with. Unimaginable obstacles are waiting around every corner for people with mental illness.
Koocher, G.P., & Keith-Spiegel, P. (2008). Ethics in psychology and the mental health professions. New York, NY: Oxford University Press.