Mental Health: Legal Issues, Informed Consent, Confidentiality - Essay.

Module 1 Module one looked at the specific rights and responsibilities of the registered nurse in a specialty clinical area(mental health), from the perspective of keeping the nurse and her/his patients/clients physically and emotionally safe. It also raised the issue of legal responsibilities and identified issues specific to the specialty area.

For your assessment: Write an issue of safety or of legal responsibility that you explored in some depth, ensuring it is specifically related to the specialty area.

speciality area is mental health

This looks specifically at the rights of clients and in more depth the rights of carers in the process of treatment and recovery. It raises some questions about how the nursing profession views and deals with the rights of the carers and their need for information, particularly in the context of patients/clients who may lack insight in their care needs.

For your assessment: Write your understanding of the dilemma of providing information to carers while considering the confidentiality concerns relating to the patient/client. Don't forget to consider the ethical implications in your consideration of the issues.

Article(s): You MUST select or use one of the articles you sourced from the activity or that you have identified 

Articles:

https://www.youtube.com/watch?time_continue=5&v=PWbO6EgFpzg

https://www.youtube.com/watch?time_continue=2&v=fb0FwrZH2q4

Plank, A., Mazzoni, V., & Cavada, L. (2012). Becoming a caregiver: new family carers' experience during the transition from hospital to home. Journal Of Clinical Nursing, 21(13/14), 2072-2082. doi:10.1111/j.1365-2702.2011.04025.x

You are asked to explore some of the writings in the public domain on how people have made meaning of their health-related issues. In the module activity, you are asked to choose one of your readings (from one of the three perspectives listed) and write a reflection on how that has changed yourFor this module, you are asked to explore some of the writings in the public domain on how people have made meaning of their health-related issues. In the module activity, you are asked to choose one of your readings (from one of the three perspectives listed) and write a reflection on how that has changed your

For your assessment: Review and refine your reflection from the activity (on ONE of the readings) for this module to a 500 word submission using the 5 R’s of reflection (Bain, Ballantyne, Packer & Mills, 1999). Your reflection should consider: • How that has changed your perspective or given you some insight into the meaning illness has for that person; • How you relate to this and make meaning of your own experiences; • Your own perceptions, morals and ethics.

Legal Issues in Mental Health

Good mental health entails a sense of self-worth, confidence and wellbeing. It enables to comprehend and appreciate our daily lives, our environment and other people around us. Loss of the sense of one’s welfare describes being mentally unwell (Roberts, 2018). Sometimes, mentally unwell people need to be treated without their consent in cases where their well-being or those of others are at risk. These are known as involuntary patients. On the other hand, a voluntary patient is one who remains at a mental health care institution voluntarily for observation or treatment or one who has been admitted by his or her guardian as a voluntary patient (Watson et al., 2014).

Mental health laws relates to matters such as when an individual can be offered mental health treatment, the operations of community treatment and inpatient treatment orders and the rights of people with mental illnesses.The laws also identifies the key groups in mental health care which include mental health professionals, mental health patients, mental health services referrers, private psychiatric hospitals, non-governmental organizations as well as the persons supporting mental health patients (Bellesheim, 2016).

People with mental health problems have a right to participate meaningfully in individual and community activities without discrimination, social exclusion or stigma. Just like all other Australians, they should be allowed access to literature and advocacy amenities to ensure that they apprehend and are able to exercise the rights and responsibilities without prejudice. They should have access to a wide range of mental and other general health services they require as well as other facilities such as accommodation (Battams & Henderson, 2010). They should have the ability to expect that their service providers will honor and uphold their rights and deliver the proper standards of care fairly. Additionally, people with mental illnesses and mental health problems have a right to be involved in decisions concerning their own individual treatment as well as in the formulation, implementation and evaluation of mental health policies (Battams, 2016).

Mental health nurses have a responsibility to plan and provide medical and nursing care to individuals with a range of mental health issues. According to the law adults with mental health problems have a right to be included in decision making about their care. However, there is a dilemma on how to safeguard this ethical principle for these people. By definition, individuals with mental illnesses are not certainly impaired for consent as they do not always seem to have poor judgment and diminished cognizance (Amer, 2013). Informed consent is one of the most fundamental aspects of best medical practice. Health professionals are thus required to obtain informed consent from the patient before onset of intervention.

Informed consent is acquired after explicit explanation to the patient about the risks of and the factors involved in treatment including the benefits and alternative options. This information should be relevant to the patient and help him or her decide whether to undergo a particular treatment or experiment. The health care provider therefore has a responsibility to inform the patient of every single feature of the treatment no matter how sensitive it may seem. The elements of informed consent include:

Informed Consent in Adult Psychiatry

Voluntarism: the client or patient should be able to act voluntarily without being influenced by another through coercion, manipulation or persuasion.

Competency: unless proved otherwise, adults with mental health issues should be considered capable of understanding and acting reasonably in their judgment.

The other elements in informed consent are disclosure of all relevant info, sufficient understanding and decision making.

Lack of informed consent can strengthen a claim of medical malpractice or be used as an alternative point of attack where the case is weak elsewhere.

Rights of Clients in the Process of Treatment and Recovery

Treatment and care should be provided in a way that least limits the patient’s liberties and rights, safeguards their rights and enhances their recovery and ability to live in the society without requiring involuntary care or treatment.Care should only be provided to a mentally ill person if it is suitablefor the promotion of the individual’s health and wellbeing. The provision of treatment and care to patients must assimilate quality practices and principles, be offered in accordance with the contemporary medical practices having regard to the patient’s welfare and safety as well as the safety of others. Care must also be delivered under governance engagements that are clinically appropriate.

Recovery-oriented services should be provided for the clients. These amenities should be tailored to each individual patient’s needs and recognize patient’s rights to have family and other support persons involved in all aspects of their care. Services directed towards quick recovery helps people to be aware of the importance of taking accountability for their own recovery and wellbeing by outlining their goals, aims and aspirations.

A carer is a person recognized by the law as primarily involved in provision of care for the mental ill individual on a daily basis. A person with mental illness or mental health problems has a say over who their carer is unless they are lacking in mental capacity. Hence they can dismiss people from being considered as their carer. An individual who has mental capacity is considered to have a general understanding of the advice, support and information provided to them about their situation as well as a broad cognition of the probable consequences of their decisions.

The laws on carer rightsenable sensitive patient data to be shared between all mental health care providers, the carers and the recipient of the services offered to enable all groups to work together for effective service provision.Keeping this information confidential is expected of all the groups of people involved (Price, 2015). Making available delicate patient material to carers is meant to aid them to carry out their caring role in the best way possible. Service providers also have a right to be heard, that is, their inputs concerning patient care should be put into account when making decisions. This means that carers should also be involved in making resolutionsabout their patient’s health (Wray & Braine, 2016). Not being involved enhances the feelings of isolation, loss and grief for the carers (Henderson &Battams, 2011).

The responsibilities of service providers are to ensure that patients obtain the superlative professional care available and that their dignity is esteemed. In addition, it is their duty to convince the person they care for to cooperate as far as possible with the care and treatment that will help them in their journey of recovering (Kara, 2016).

Confidentiality Concerns

Generally healthcare is viewed as a partnership between the professionals, patients and families. However, in mental health there are diverse opinions about what can be shared with the carer. The issues in sharing of info relates to:

• Legal and ethical Obligations: mental health workers are bound by law and professional codes of conduct to confidentiality. A breach of confidentiality can lead to lawsuits. However, the professionals also have an obligation of confidentiality to service providers (Wilson et al., 2015).
• Consent: agreement of the patient to disclose his/her information to the carer must be sought. Complexity of the matter is increased if the patient is not able to give informed consent, for instance due to dementia.

Maggie had an accident when she was 17 years old. She was having a rough day and thus was not very intent on the road while driving. This led to her car sliding off the road causing the mishap. Luckily for her, the very first person to arrive on the scene was a volunteer firefighter who had some knowledge on first aid. Maggie was unconscious at this point and still cannot remember what happened immediately after the accident.She was flown to the general hospital where she immediately started receiving treatment. Maggie was in a comma when she got to the hospital with fractures on her hips and pelvis and even a swelling on the frontal left lobe of her brain.

Maggie feels very grateful towards Adams, the firefighter who helped her out as she says she definitely owes a lot to him.Maggie also feels very grateful for her family’s support especially her mother who practically never left the hospital. Fortunately, all the care she needed was available at that hospital where she was. She was in a comma for about a month and stayed in the hospital for much longer after that. She had a good experience in the hospital as the nurses, doctors and all other service providers were compassionate and understanding of the patient’s situation (Jason, 2014).

In my understanding, Maggie’s accident was a serious oneand she was very fortunate that the first person at the scene knew how to provide primary care for her. The help she obtained before getting to the hospital was vital in her treatment process. It prevented a furtherance of her medical conditionwhich then increased the effectiveness of the treatment she received after getting to the hospital.

During the month she was in comma, Maggie was constantly in pain and could not move at all. She almost lost her mobility. In this situation, the hospital personnel are observant of ethics in medical care (Gillon, 2015). They are empathetic and compassionate to Maggie to help her have the best hospital experience. Ethical aspects of non-maleficence and beneficence are especially portrayed in that the medical staff and all other service providers are helpful and friendly to Maggie. They serve in her best interests and without any motive of harming the girl. The nurses get Dr. Henry when he is most required just to ensure that Maggie gets the best medical care she deserves as their patient.

Maggie’s scenario brings to light the importance of observing medical ethics and being sympathetic and caring towards the patients (McColl-Kennedy et al., 2017). It is also important to provide quality care by serving in the best interests of the patients. Maggie was satisfied with the care she received at the Kingston Foundation as it has led to her successful recovery. She still sees Dr. Henry but she is almost making a full recovery as she can even run. Dr. Henry indicates the importance of continuing care and support for patients even after they are doing way better.

References

Amer, A. B. (2013). Informed consent in adult psychiatry. Oman medical journal, 28(4), 228.

Battams, S. (2016). Public Mental Health Policy, Mental Health Promotion, and interventions which Focus on the Social determinants of Mental Health. Frontiers in Public Health, 4, 285.

Battams, S., & Henderson, J. (2010). The physical health of people with mental illness and ‘the right to health’. Advances in Mental Health, 9(2), 116-129.

Bellesheim, K. R. (2016). Ethical challenges and legal issues for mental health professionals working with family caregivers of individuals with serious mental illness. Ethics & Behavior, 26(7), 607-620.

Gillon, R. (2015). Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics. Journal of medical ethics, 41(1), 111-116.

Henderson, J., & Battams, S. (2011). Mental health and barriers to the achievement of the ‘right to health’. Australian Journal of Primary Health, 17(3), 220-226.

Jason, A. (2014). Defining patient experience. Patient experience journal, 1(1), 7-19.

Kara, H. (2016). The value of carers in mental health research. Journal of Public Mental Health, 15(2), 83-92.

McColl-Kennedy, J. R., Danaher, T. S., Gallan, A. S., Orsingher, C., Lervik-Olsen, L., & Verma, R. (2017). How do you feel today? Managing patient emotions during health care experiences to enhance well-being. Journal of Business Research, 79, 247-259.

Price, B. (2015). Respecting patient confidentiality. Nursing Standard, 29(22).

Roberts, M. (2018). Understanding Mental Health Care: Critical Issues in Practice. SAGE.

Watson, S., Thorburn, K., Everett, M., & Fisher, K. R. (2014). Care without coercion–mental health rights, personal recovery and trauma?informed care. Australian Journal of Social Issues, 49(4), 529-549.

Wilson, L. S., Pillay, D., Kelly, B. D., & Casey, P. (2015). Mental health professionals and information sharing: carer perspectives. Irish Journal of Medical Science (1971-), 184(4), 781-790.

Wray, J., & Braine, M. E. (2016). Supporting families and carers. British journal of nursing (Mark Allen Publishing), 25(9), 474-474.’

https://www.youtube.com/watch?time_continue=2&v=fb0FwrZH2q4