Describe about the Acute and Mental Health Crisis Care.
The acute and mental health crisis care is an agreement between the agencies and services who are involved in providing support and care to the people who are suffering from the mental crisis. With the help of this process, the mentally ill people get benefit in the time of their urgency (mind.org.uk/media. 2016). In the words of Bernstein (2014), the effectiveness and quality of this procedure and responses create a great impact on the way of recovery and the willingness to live the life again of those people who faced this type of crisis.
In this context, it is founded that in Wales and England, a huge number of people experiences the mental health crisis and they are forced to go to the psychiatric hospital during the time of vulnerability (Mental Health Crisis Care Concordat 2016). As per the theoretical concept of consequentiality ethics, the action of restraint may be ethical or unethical during the time of treating a mental patient. It depends on the circumstances of the situation.
The essay question is based on the critical evaluation of restraint treatment policy which is ethical or not during the times of treating the mental health patients.
With the help of theoretical concepts of ethical theories the above argument can be done along with survey result of NHS which is an alarming issue in Wales and England.
The survey report of the charity mind of mental health depicted the result that in every four people one people has faced a mental problem without consulting a proper psychiatric in Britain. A major portion of people approximately in every 1000 people, 300 people suffer from mental health diseases every year not only in Britain but also in England and Wales. Among them near about 230 numbers of people visit in GP and 102 numbers treated as a mental health issues; whereas, 24 numbers of people transferred to a specialist psychiatric center and six become admitted in a psychiatric hospitals (mind.org.uk/media. 2016). This type of action is ethical or not solely depends on the consequences and circumstances as in many situations it is beneficial for the patients.
The word count for the essay is 1500 words.
It can be explained with an example that sometimes a patient can be restrained with vulnerability and anger without any negative consequences. On the contrary, Noddings (2013) discussed that the motivation may be ethical by making the consequences unethical. Thus, the consequences cannot be considered as a root cause of ethics. The motivation needs to be discussed in this perspective as it is intangible.
Figure: Mind Map of the essay
(Source: As created by author)
The plan of the essay includes two types of ethical theories such as Situation Ethics and Utilitarianism has been used in this research analysis. With the help of these two theories and survey result of National data and NHS, the assessment of this system can be done along with the suitable suggestions of restraint treatment policy is ethical or not.
3: In this essay, two conceptual frameworks of ethical theories namely Utilitarianism and Situation Ethics have been used for the aspect of discussion. According to Niebuhr (2013), the theoretical concept of Situation Ethics depicts the principle of acting in love. As per this theory, love is the appropriate and best thing for any human being as it shortens the distance between the neighbors, friends, and enemies. In this perspective, in the words of Shafer-Landau (2012), Situation Ethics suggest to do the work practically by concerning to agape as there is no limitation. In addition, during the time of value judgment, love is the priority and morality and ethics is considered here instead of laws of the society. As a result, it is more applicable in this scenario as with the help of this policy; different situations can be taken into account along with flexibility (Andrews 2014).
On the contrary, as commented by Peters (2015), love is not considered as a universal understanding in every situation, and it is impossible to understand that the outcome of any action should be love which is appropriate for this situation. Thus, in this consequence, another consequentialist theory of Act Utilitarianism is critically assessed as it concentrated on the acts of the people of greatest number (Bernstein 2014). This ethical theory judges the consequences of appropriate or wrong decisions which solely depend on the utility. In general, it inferred the amount of happiness or pleasure they cause as it is a quantitative theory. By comparing to the Situation Ethics, it is more flexible and efficient to take the required action depending on the circumstances, and it emphasizes on the greatest number of happiness which is acquired by the largest number of people (Leff et al. 2015). On the other hand, the taken action is judged over evaluating the situation whether it is ethical or not. Sometimes the action may be ethical in one scenario; whereas, it may be considered as unethical in another situation. However, in the words of Thoits (2013), it is impractical to evaluate the morality in every consequence and it only focuses on the majority numbers which is not appropriate for all actions. Due to the problems of above-stated ethical theory, the theoretical concept of Rule Utilitarianism is applied here to judge the restraint procedure of treatment for mentally ill patients is ethical or not as this theory focuses on the quality of happiness instead of quantity. According to Noddings (2013), as per this ethical theory, happiness or pleasure over pain is measured according to the quality of happiness which ensures the more utility whether the action is good or bad for the society by following the pre-determined rules. However, this theory is irrelevant as it only concentrates on the majority portion of happiness instead of minority along with the concept of society accomplish the well-being of people first (Niebuhr 2013).
Moreover, if the people strictly follow this rule, then it would obey it; whereas, according to the weak rule, the people have the liberty to break the pre-determined rules for acquiring happiness over sorrow (LaFollette and Persson 2013). In this scenario, the Act of Mental Health in the year 2007 explored the issues and root cause of approximate thirteen numbers of deaths which are related to the restraint in the cities of Wales and England. With the help of this act, the procedure of treatment in case of acute and crisis disease is ethical or unethical can be analyzed along with the concept of above-stated ethical theories (Shafer-Landau 2012). The survey report of the Act of Mental Health of 2007 inferred the result that a huge number of inpatients are admitted in the hospitals whereas, the available number of beds has decreased. Moreover, as per this act, near about 39% of inpatients are absorbed in the mental care hospitals and the percentage is higher in mainly urban areas which are approximately 80 to 90% (Digital.nhs.uk. 2016).
This result would suggest that the psychiatric hospitals of NHS are continuously increasing to serve a better treatment and care for mentally ill patients and the patients of acute and crisis diseases. Furthermore, most of the inpatients are transferred to the custodial, and almost every acute ward is closed (Digital.nhs.uk. 2016). In this perspective, to critically evaluate the treatment process of restraint in case of acute and crisis care, the mental health of charity Mind organized an inquiry about the acute care and the mental health of crisis healthcare of 2010 which is well known as an Experience of Learning (Mental Health Crisis Care Concordat. 2016).
The survey report of the inquiry showcases the information that most of the hospitals are inefficient and lack of proper treatment and care in Wales and England in which the data is collected from the family and friends of the patients and associated staffs and advocates. In this context, the result would highlight more information regarding this issue that sometimes the life in the ward is terrible and become violent to exist and the associated nurses do not bother about the patients. In addition, due to the lack of wards and relevant nurses, the staffs and members has faced a stress and over-worked (mind.org.uk/media. 2016). Furthermore, the atmosphere of these types of hospitals provides a relaxing and homely environment which is supportive and effective during the time of treatment the mentally ill patients.
In this scenario, in the words of LaFollette and Persson (2013), the Nursing department of Royal College (2008) stated the different types treatment related to restraint which is sometimes ethical or unethical depending on the consequences. According to Andrews (2014), the physical restraint treatment procedure is generally used in the psychiatric hospitals to control the abusive, violent and aggressive patients by blocking, holding or moving the patients by the staffs. Thus, it may be considered that the ethics and morality of physical treatment related to the mentally ill patients are not maintained properly and become violated. Since the statement is partially true as this process is used concerning the importance of the situation and the aggressiveness of the patients (Peters 2015).
However, as stated by Bernstein (2014), in the chemical restraint process treatment can be done by using medicine; whereas, in the mechanical restraint procedure, the aggressive patients can be controlled by using equipment such as belts or ties to tie up the patient in the chair or bed. In addition, the staffs of the hospitals lock the doors and keypads to stop the patients leave from the rooms which do not bother about their freedom (Niebuhr 2013).
On the contrary, the psychological and technological surveillance is not so strict types of restraint as in this process the patients would guide by the doctor about what and when to do in a great care (Leff et al. 2015). The patients are observed through the CCTV by which the required action should be taken against any violent patient, but their personal things are detached from them.
By concerning the above research analysis, it can be inferred that Utilitarianism theory specifically Rule Utilitarianism theory is more applicable to prove the statement that restraint policy of treatment to the mentally ill patients is partially ethical as it considers the current situations of the patients (Thoits 2013). Furthermore, the physical restraint process may be considered as an unethical as the patients are controlled physically during the times of their anger and agitation. On the contrary, the other process of restraint treatment can be applied on the inpatients in an ethical manner (Andrews 2014).
From the above discussions, it can be concluded that the restraint policy of treatment to the mentally ill patients is considered as partially ethical and unethical which depends on the current circumstances. In this perspective, the ethical theory of Utilitarianism is more appropriate than Situation Ethics to critically analyze the ethical and morality of the treatment restraint policy. As per the Utilitarianism theory, the main emphasize is given to the highest utility of happiness of the people over pain with or without Obeying and breaking the pre-determined rules. This ethical theory is more flexible and relevant compare to the Situation Ethics.
Moreover, the survey report of the mental health of charity Mind showcases the information that most of the hospitals are running out of order along with the lack of proper facility of staffs, separate rooms, care and food which indicates the inefficient structure and ineffective treatment environment to the mental patients suffered from acute and crisis. On the other hand, while the chemical, psychological and technological surveillance of restraint treatment can be done in an ethical manner; the physical and mechanical treatment procedures are considered as an unethical restraint treatment procedure. Thus, the overall restraint policy of treatment to the mental ill patients are accomplished as an partially ethical and unethical measures as sometimes the policy is very tough for the acute and crisis care inpatients whereas, the another part of policy is suitable towards them.
Andrews, K., 2014. Personhood, Ethics, and Animal Cognition: Situating Animals in Hare’s Two-Level Utilitarianism, by Gary E. VarnerThe Philosophy of Animal Minds, edited by Robert W. Lurz. Mind, p.fzu128.
Bernstein, J.M., 2014. Recovering ethical life: Jurgen Habermas and the future of critical theory. Routledge.
Digital.nhs.uk. (2016). Mental Health Services Data Set - NHS Digital. [online] Available at: https://digital.nhs.uk/mhsds [Accessed 5 Sep. 2016].
LaFollette, H. and Persson, I. eds., 2013. The Blackwell guide to ethical theory. John Wiley & Sons.
Leff, H.S., Chow, C.M., Pepin, R., Conley, J., Ph, B., Allen, I.E. and Seaman, C.A., 2015. Does one size fit all? What we can and can't learn from a meta-analysis of housing models for persons with mental illness.Psychiatric Services.
Mental Health Crisis Care Concordat. (2016). About - Mental Health Crisis Care Concordat. [online] Available at: https://www.crisiscareconcordat.org.uk/about/ [Accessed 2 Sep. 2016].
mind.org.uk/media. (2016). listening_to_experience_web.pdf. [online] Available at: https://www.mind.org.uk/media/211306/listening_to_experience_web.pdf [Accessed 2 Sep. 2016].
Niebuhr, R., 2013. Moral man and immoral society: A study in ethics and politics. Westminster John Knox Press.
Noddings, N., 2013. Caring: A relational approach to ethics and moral education. Univ of California Press.
Peters, R.S., 2015. Psychology and Ethical Development (Routledge Revivals): A Collection of Articles on Psychological Theories, Ethical Development and Human Understanding. Routledge.
Shafer-Landau, R. ed., 2012. Ethical theory: an anthology (Vol. 13). John Wiley & Sons.
Thoits, P.A., 2013. Self, identity, stress, and mental health. In Handbook of the sociology of mental health (pp. 357-377). Springer Netherlands.