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Recommended: Ethical standards for the treatment of mental health
Individuals with mental illnesses have been successfully treated in the past through different methods including psychotherapy and medication. However, an ethical dilemma presents itself when individuals with severe mental illness refuse to receive treatment for their disorders. In recent decades, the use of forced medication has emerged as “one of the most controversial issues in mental health policy in recent decades” (Swartz, Swanson, & Hannon, 2003, p. 406). The medical community is torn between whether it is appropriate to grant these patients’ wishes or if it’s best to continue on with the treatment they recommend. Despite frequently being faced with this ethical dilemma, society still has not reached an agreement regarding how to proceed.
Some believe that involuntary treatment for those with mental illnesses is sometimes necessary and in the best interest of the patients. Due to their specific illness, some individuals are unable to make proper judgment about their need for treatment. People with schizophrenia, for example, may have anosognosia, a lack of awareness of their mental illness, or have delusional beliefs and suspicions towards medication. Those with depression or bipolar disorder might also have impaired insight of the severity of their mental illness. Studies have shown a strong association between lack of awareness and medical nonadherence (Nose, Barbui, & Tansella, 2003). Furthermore, disorders that are ego-syntonic, or those in which the patient believes the disorder is part of their identity, impair insight into the extent of the disorder. Individuals with anorexia nervosa might resist receiving treatment because they are proud of their slight physiques and fear the weight gain involved in treatment.
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...cision behind the use of forced treatment should be on a patient-by-patient basis. Although it does infringe on the fundamental civil liberties of individuals, those with severe mental illnesses that threaten their lives could be treated and consequently saved from the deleterious symptoms of their disorders. Medication could effectively free patients of their symptoms and give them back the autonomy to make rational decisions regarding their personal health. Still, the ambiguous line in determining whether or not a patient has this ability will continue to exist. Medical practitioners must carefully consider each individual case before prescribing treatment without consent. Even though there may be some cases in which patients have their rights unjustly infringed upon, in the end the employment of forced treatment may benefit more mental illness patients than not.
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.
How do the issues facing those doing strategic planning differ from those doing tactical planning? Can the two really be
Gupta, M. (2001): Treatment refusal in the involuntarily hospitalized psychiatric population: Canadian policy and practice. In: Medicine and Law, Vol. 20, Issue 2, pp. 245-265.
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.
Forcing someone to take medication or be hospitalized against their will seems contrary to an individual’s right to refuse medical treatment, however, the issue becomes complicated when it involves individuals suffering from a mental illness. What should be done when a person has lost their grasp on reality, or if they are at a risk of harming themselves or others? Would that justify denying individuals the right to refuse treatment and issuing involuntary treatment? Numerous books and articles have been written which debates this issue and presents the recommendations of assorted experts.
As science has evolved, so have treatments for mental illnesses have over time. The medical model is described as the view that psychological disorders are medical diseases with a biological origin (King, 2010, pg. 413). Abnormal behavior that categorizes some disorders can be impacted by biological factors such as genes, psychological factors such as childhood experiences, and even sociocultural factors such as gender and race (King, 2010). Treatments such as psychosurgery (lobotomy) , drug therapy (pharmaceuticals), electroconclusive therapy, and psychoanalysis are used to treat a wide range of psychological disorders. Back then, the public’s negative views on mental illnesses also went as far to associate with the people who treated it; psychiatrists. “Nunnally (1961) found that the public evaluated professionals who treated mental disorders significantly more negatively than those who treat physical disorders,” (Phelan, Link, Stueve, & Pescosolido, 2000, pg. 189). People back then didn’t see the point in “paying to be told that they were crazy”. However, in today’s society, it is now acceptable to seek help from psychiatric professionals; we are seeing more and more people seek mental health treatment. “In terms of facility-based records of utilization (Manderscheid and Henderson 1998), the data suggest that the rate of utilization of professional mental health services has at least doubled and maybe tripled, between the 1950’s and today,” (Phelan, Link, Stueve, & Pescosolido, 2000, pg. 189). In the 1950’s, neuroleptic drugs like Thorazine were introduced to treat the symptoms of schizophrenia. These drugs block a neurotransmitter called dopamine from getting to the brain, which in turn reduce schizophrenic symptoms, however there are some side effects such as substantial twitching of the neck, arms, and legs, and even dysphoria or lack of pleasure. (King, 2010, pg.
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...
There were patients who had chronic illnesses and were subdued by restraints and sedation up to 1950s. Moving forward towards the 60’s, the criteria of hospitalization started to change when questions on how well asylums worked and the ethical problems with patient care was raised (West, 2010). Due to the Community Mental Health Centers Act of 1963 these institutions started to close all around the states and shifted away from rural to urban areas. Psychiatric hospitalization had a new criterion stating that an individual had to pose a threat to themselves or others and or show evidence of severe psychiatric illness that renders him or her gravely disabled (Caple,
Mental healthcare has a long and murky past in the United States. In the early 1900s, patients could live in institutions for many years. The treatments and conditions were, at times, inhumane. Legislation in the 1980s and 1990s created programs to protect this vulnerable population from abuse and discrimination. In the last 20 years, mental health advocacy groups and legislators have made gains in bringing attention to the disparity between physical and mental health programs. However, diagnosis and treatment of mental illnesses continues to be less than optimal. Mental health disparities continue to exist in all areas of the world.
Moral treatment is a treatment that uses “psychological methods” to treat mental diseases (Packet Two, 26). In general, moral treatment was a relatively benevolent and humane approach to treat mental disorders. Before the introduction of moral treatment, insane people were regarded by the general public as wild animals whose brains were physically impaired and usually incurable (Packet One, 11). Therefore, regardless of patients’ specific symptoms, physicians generally labeled patients as lunatics and treated them with the same method (Packet One, 11). Because of the perceived impossibility of curing mental illness, physicians put far greater emphasis on restraining patients’ potential danger behaviors than striving to bring them back to sanity. Cruel methods such as bloodletting were widely used, but their effectiveness was really poor. Moral treatment was a response to this ineffective and brutal traditional treatment. The advocates of moral treatment insisted that mental diseases were curable. By providing a friendly environment that contributed to reviving, moral treatment could help patients to...
Continuing budget cuts on mental health care create negative and detrimental impacts on society due to increased improper care for mentally ill, public violence, and overcrowding in jails and emergency rooms. Origins, of mental health as people know it today, began in 1908. The movement initiated was known as “mental hygiene”, which was defined as referring to all things preserving mental health, including maintaining harmonious relation with others, and to participate in constructive changes in one’s social and physical environment (Bertolote 1). As a result of the current spending cuts approaching mental health care, proper treatment has declined drastically. The expanse of improper care to mentally ill peoples has elevated harmful threats of heightened public violence to society.
Involuntary hospitalization is a legal procedure used to require individuals with mental health disorders to receive treatment withoaut their care. I am addressing this topic because there is an enormous problem in the medical field with treatment care. Involuntary health care treatment should not be forced upon because it can cause more harm than damage.
Torture, for weeks, for months, for years, but it is somehow plausible to consider it help. The sane being shoved into a psych ward, drugged, and forced with erroneous treatments, yet this is regarded as the panacea? Mental institutes do not solve everyone’s problems. Forced treatment on the resistive or illegitimate mentally ill exemplifies the need to regain civil rights for patients. The current laws applied to the topic remain not enough to withhold these patients’ civil rights. Also, patients bias court cases while influenced by prescribed drugs. The stories and results of these foul acts are tremendously horrifying. As Americans we are born with our civil rights therefore these persons deserve justice.
“Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior” (Mayo Clinic). Mental disorders can happen many times through one’s life, but mental illness is classified as an ongoing problem with the symptoms that can affect the ability to perform normal day to day tasks (Mayo Clinic). Many people look at those afflicted with mental disorders as being crazy or clinically insane, while the reality is a problem many people live with on a daily basis with help from medications, psychologist visits, family, friends, help groups, and many other support systems. The lack of support available to mentally ill patients, the more that will refuse treatment and refuse to find help for their disorders. Many people who were born with mental disorders grow up knowing they have a problem, but people who develop them later in age don’t understand how to cope with it.
When patients are labeled with a mental illness they start to believe they actually have that illness. In more severe cases, misdiagnosis can result in the patient’s death or simply taking their own life. According to Dr. Mercola “Diagnostic errors are just one type of error that occurs in the medical field, and you might be surprised at just how common errors occur. While the 1999 IOM report blamed 98,000 deaths a year on hospital errors, a 2013 study in the Journal of Patient Safety projected that medical errors now account for 210,000 to 440,000 US deaths annually”. To better understand the severity of misdiagnosis, imagine a close family member getting diagnosed with a mental disorder that he or she doesn’t have and from that they decide to take their own life due to unnecessary treatment that is harmful to their