Ethical Dilemmas In Mental Health Services: An Essay.

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1.0 The Ethical Dilemma

1.0 The Ethical Dilemma 

1.1 Scenario 1

1.1.1 Identification and description of the dilemma

The dilemma here face is that whether the mental health officer reports the behavior of the other colleagues regarding the client to the supervisor even though she has asked to keep the conversation confidential. The mental officer also faced the dilemma whether or not to file the incident in the document in order to showcase the behavioral issue of the colleagues.

1.1.2 Identification my own personal values/attitudes and where conflict may arise

According to my opinion, the colleagues possess a rude behavior towards the client of an organization as they are discussing the behavior the client possesses. In a service providing company, the employees have to deal with many kinds of the client; however, the bound to provide them services. The employees talk against the client in the office hours, which is unjustified. I think this is wrong and if not handled properly, they can misbehave with other clients as well which furthermore affects the brand reputation.

1.1.3 Identification of actual or potential conflict of interest may exist 

The behavioural issue of the employees might get worst regarding another client, whom the employees think they are annoying. The employee might have developed a good relationship with their colleagues; while they still have to offer services to their clients.

1.1.4 Identify any Unethical conduct and how/who you would report it

The unethical aspect of this scenario is that possessing a critical viewpoint about the clients that shows disrespect regarding the human dignity. Discussing the attitude of the client in the office premises and during office hour refers to lack of culturally safe and sensitive practice, which should be followed by all the employees. Lastly, the employee is breaching the data protection regulation by speaking about the issue and work-related problems raised by Jenny.

 This behavior should be reported to the client as they are liable for handling the employee's work related attributes regard their clients. This does not need any further discussion with the client. The reason is that this behavior if not report on time, it can be increased and may be occurred in case of other clients as well. In such case, the organization might lose some of their valuable clients.  

1.2 Scenario 2

1.2.1 Identification and description of the dilemma 

The dilemma here is mainly for Ray, who is a worker at Indigo Community Services and Health Hub and serves to overcome the problem of people with intellectual disabilities. The main problem that is identified in this scenario is that Ray, the worker knows about Sean's condition from Sean himself. Ray has all the right to report the situation as a mandatory reporter as he can see that a child is in a position of harm. However, Ray has breached the confidentiality of the Sean even through Sean have asked not to talk about this to others. Thus, the dilemma is whether or not to report about the situation to the supervisor as it might increase the probability to get even worse attitude from his father.

1.1 Scenario 1

1.2.2 Identify my own personal values/attitudes and where conflict may arise

I found this situation is wrong as Ray can see the evidence, which is the stain that is present on his body. Ray also has the authority to report the problem if noticed to the supervisors though he decided not to talk as Sean himself asked him not to make the discussion public. I think that Ray considered himself more like a friend to Sean rather than a responsible employee of the mental health organization. This is the reason he finally decides not to report about the case. However, Ray should discuss the case with the higher authority as there are some beaten marks on Sean's body. A primary investigation can help Ray to know the truth prior taking any action.

1.2.3 Identification of an actual or potential conflict of interest may exist

The actual conflict here occurred with the Sean if Ray reported the scenario to the supervisors. On the other hand, Ray has to report the same so that possible attributes through which family members can harm members with intellectual disabilities can be identified.

1.2.4 Identify any unethical conduct and how/who you would report it to

 The unethical conduct is to remain silent even though Ray has evidence in the form of the stain on Sean's body. The discussion might not consider as breaching the confidentiality through professional perspective as it is for the welfare of the Sean. A primary investigation can help Ray to know the truth before taking any action. Ray should also report a documented file to the supervisors and officers handling the department of client welfare.

1.3 Scenario 3

1.3.1 Identification and description of the dilemma 

The ethical dilemma that is occurred in this cases is whether or not Samuel has to be with Emily in all the problematic situations or Emily's right to leave the place on finding that Samuel is misbehaving with her. Another dilemma here is that whether or not if Samuel will decide to provide treatment to the Emily after the incident, it should not harm the human dignity and worth and also National Standards.

 On the other hand, other dilemmas are whether or not to report Samuel's behavior as I have not witnessed the situation thus it is hard for me to choose the innocent person and the person, who behaved wrong. If I report the incident to the Samuel, supervisor, whether or not it raises to the situation of back-lash and further workplace clash with Florence. Moreover, Samuel is my supervisor, so whether I should report the issue to support his decision is another ethical dilemma.  

1.1.1 Identification and description of the dilemma

1.3.2 Identify my own personal values/attitudes and where conflict may arise

I found the behavior of Samuel wrong as he is liable for having patient while handling people like Emily. They need more support and good behavior for gaining confidence. If Emily falls and Samuel misbehaves with her in the public is a real incident, it should be reported to management officials.  

1.3.3 Identification of the actual or potential conflict of interest may exist

The conflict of interest in this case is to support the well being of the clients under the service of Samuel, who is a position of supervisor. The conflict arises because, he holds a position, where he can misbehave with me also or I might lose my job as I complain against him. However, Emily's safety should be the priority as she is the service user and her actions and progress depends on the service provider.

1.3.4 Identify any Unethical conduct and how/who you would report it to

 I think, Florence should initially talk to a trustable friend about the dilemma that she did, but she should also report to the human resource manager and the officials, liable for the safety of the clients and employees so that they can check for the safety of their service user and also monitor the working procedure of the worker Samuel.  This is the correct approach as Samuel breaches the discipline-specific practice standards of the nursing, occupational therapy, psychology and psychiatry (Health.gov.au 2018).  Samuel also overrules the Quality Management principles of the National Standards for Disability Services where he was supposed to provide leadership, encourage continuous improvement and make evidence-informed decisions (Dss.gov.au 2018).

2.0 Policy, procedure, codes and role

2.1 Scenario 1

2.1.1 Relevant components of Indigo policy and procedures, Code of Conduct, Industry Codes of Ethics that might inform how to best address the situation 

• Indigo Privacy and Confidentiality Policy
• Indigo Code Of Conduct
• Indigo Codes of Ethics
• Indigo Ethical Violation of Policy or Law Procedure (google.com 2018)
• Indigo Complaints Policy and Procedures
• National Practice Standards for the Mental Health Workforce

2.1.2 Responsibilities in the scope of your role contained in your position description 

As a new member of the organization, I will go to the supervisor to know the action that can be taken to protect the dignity of the clients as long as they take service from the organization. I will also try to give suggestions to the colleges in an informal way so that they can realize they have not done right.

2.1.3 List any legal implications and describe how you would report it or manage this

The Health and Human Services Department can take an immediate step when an employee of the health service reports a case as they know about the policies. Moreover, the Human Health Services and the Human Resources Department will handle the case at the workplace once the report has been filed. I must ensure that legislation like Fair Work Amendment Act 2013, Sex Discrimination Act 1984, Racial Discrimination Act 1975 and Equal Opportunity Act 2010 are properly maintained (Humanrights.gov.au 2018).

1.1.2 Identification my own personal values/attitudes and where conflict may arise

2.2 Scenario 2

2.2.1 Relevant components of Indigo policy and procedures, Code of Conduct, Industry Codes of Ethics that might inform how to best address the situation 

• Indigo Child Protection Policy
• Indigo Child Protection Reporting Procedure
• Indigo Duty Care Dignity Risk Policy
• Indigo Code of Conduct
• National Standards for Disability Services
• National Association of Social Workers
• Standards for the Practice of Social Work with Adolescents
• Indigo Codes of Ethics for client’s interests

2.2.2 Responsibilities in the scope of your role contained in your position description 

I will suggest him to share the incident with the HR and management of the health organization. I should also help Ray in finding out aspects that are harmful to Sean to convince the supervisor to initiate a primary investigation.

2.2.3 List any Legal implications and describe how you would report it or manage this

The NSW mandatory reporting guidelines of suspects on reasonable grounds should be followed (Child Family Community Australia 2018).

2.3 Scenario 3

2.3.1 Relevant components of Indigo policy and procedures, Code of Conduct, Industry Codes of Ethics that might inform how to best address the situation 

• Indigo Ethical Violation Procedure
• Indigo Duty Care Dignity Risk Policy
• Indigo Code of Conduct

 The policies descry that any employee cannot violate the general working ethics and the employees must care about their client's safety. According to the codes of conduct Employees and Management Committee, members should emphasize on their integrity and professionalism. They are also liable for the staff wellbeing and professional development.

2.3.2 Responsibilities in the scope of your role contained in your position description 

 Being an employee, I should report to my management regarding the attitude of the Samuel and how Emily had to suffer for his behavior. I will also ask Florence to be the witness so that the report can be filed. I should also assist Emily if she need help and know her concern so that I can convey the message to the higher authority.  

2.3.3 List any Legal implications and describe how you would report it or manage this

• Breach of Duty of Care

I will place the complaints based on the Incident reporting about the behavior of the Samuel towards Emily (Health.gov.au 2018). This is because; Samuel’s behavior was witnessed by many along with Florence. This is enough to file a report.

3.0 Consultation 

3.1 Scenario 1

3.1.1 Person to consult to gather information about the situation

I would choose the mental health worker to convey the message to the workplace supervisor regarding the behavior of the employees. I will also talk about the incident to my supervisor and Jenny’s attitude after facing the incident.

3.1.2 People to discuss or brainstorm with in regard to possible action that could be taken

I will suggest some valuable propositions to the supervisors like on making the employees aware of the legislation followed in the company and the ways through which these regulations can be followed.

1.1.3 Identification of actual or potential conflict of interest may exist

3.1.3 Techniques to employ to ensure non judgmental practice while problem-solving

I will assess whether or not my action have breached any of the legal obligations or whether or not I have some hidden motives other than client’s wellbeing on reporting the incident to the supervisor.

3.2 Scenario 2

3.2.1 Person to consult to gather information about the situation

I will consult to the supervisors of the agency as talking to the Sean’s parent might create more adverse effect on him. The supervisors should be approached with the incidence and showing them the stains Sean have on his body.

3.3.2 People to discuss or brainstorm with in regard to possible action that could be taken

This problem can be solved if Sean will be treated with love and get regular assistance. I will suggest keeping Sean under agency’s care system or invigilation until the problem of the Sean’s family will resolve. This needs permission from the management officials or local governing bodies.  

3.2.3 Techniques to employ to ensure non judgmental practice while problem-solving

Filing a formal complaints based on the evidence, which is the stain marks on Sean’s body is enough to highlight the issue of child harm in case of Sean. Thus, I would talk about the legal obligations present or applicable in this situation with the supervisor.

3.3 Scenario 3

3.3.1 Person to consult to gather information about the situation

Emily’s case is critical as she is a service user and has difficulty in assisting herself. The law officials from Fair Work Ombudsman and senior authority are the people with whom the situation can be consulted.  

3.3.2 People to discuss or brainstorm with in regard to possible action that could be taken

 I will prepare a report and ask Florence to support me in explaining the issue that she had witnessed. This will be more effective to make the officials think about the situation.

3.3.3 Techniques to employ to ensure non-judgmental practice while problem-solving

Samuel did not represent his leadership skills and behaved unethically with Emily. This matter should be directly reported to the senior authority with the proposal to raise concern against Fair Work Ombudsman for Samuel.

4.0 Possible Actions 

4.1 Scenario 1

4.1.1 Options (for action) and the Consequence of the identified actions for all relevant parties (self, service, users, colleagues, organization, the profession, and the broader community

 The decision of conducting the meeting among the staffs and Jenny may work as the discussion can reveal the problem that Jenny was facing due to which she raised trouble in the past. The meeting can also result in making Jenny know that she should change her behavior. The negative impact of this solution is that the workers might not give her proper assistance after the issue has been raised.

1.1.4 Identify any Unethical conduct and how/who you would report it

4.1.2 Consideration of the rights and responsibilities of all people involved by identifying and discussing the balance rights and responsibilities of workers and service users

 Jenny has the right to raise a concern to the official regarding the behavior of their staffs and the staffs also have the right to explain the reason behind their behavior. Though the rule is same for all the employees that are they all have to respect their colleagues under any circumstances.  

4.2 Scenario 2

4.2.1 Options (for action) and the consequence of the identified actions for all relevant parties (self, service, users, colleagues, organization, the profession, and the broader community

 The meeting with the Sean's Family might get successful if the allegation that Sean has told to Ray was vague and the officials can take decisions for better treatment of Sean. On the other hand, the situation can get worse if the body marks are due to his father and the official take decisions against his father. This action might leave Sean in further shock and further impacted his intellectual ability. Sean on the other hand also gets hut due to beaching his confidentiality which can be raised by the Sean that furthermore hampers the brand reputation.

4.2.2 Consideration of the rights and responsibilities of all people involved by identifying and discussing the balance rights and responsibilities of workers and service users

Sean can raise the incident directly to the officials or have answered to Ray for raining the concern to the officials. He could have helped Ray in getting more evidence so that actions for safeguarding him can be assessed.

4.3 Scenario 3

4.3.1 Options (for action) and the Consequence of the identified actions for all relevant parties (self, service, users, colleagues, organization, the profession, and the broader community 

 The pro is that Emily will get justice and also receive proper treatment after the successful execution of the meeting with different authorities. However, con of this approach is a conflict of interest for Samuel with the officials and the poor reputation of the organization that was occurred after this incident. Samuel can also start misbehaving with me as I filed the complaints against him.

4.3.2 Consideration of the rights and responsibilities of all people involved by identifying and discussing the balance rights and responsibilities of workers and service users

 The organizational officials are also liable for treating and give training to Samuel in a professional way. The Samuel is also responsible for following all the code of ethics and code of conduct ethically. He should read about the norms and action taken for maintaining the client’s dignity.

1.2 Scenario 2

5.0 Selecting a course of action

5.1 Scenario 1

5.1.1 Determine the best course of action, listing 2 reasons for taking this specific action 

Jenny has asked an employee not to tell anything about her concern and the employee decided not to tell about this thing according to Privacy and Confidentiality Policy. The employee should also focus Data Protection Act (1998). The employee should adhere to Duty Care Dignity Risk Policy and Equity and Workplace Harassment Policy to protect the dignity of the employees.

Another action is that to conduct meeting with the employees regarding the code of ethics and conducts followed by the organization. This will raise the awareness among the employees.

5.2 Scenario 2

5.2.1 Determine the best Course of Action, listing 2 reasons for taking this specific action

The Indigo Child Protection Policy highlights the regulation through which the parents or another person cannot harm a child based on their disability. Thus, the Indigo Child Protection Reporting Procedure help Ray to file a report to the JIRT team, who will them investigate against Sean's father if found guilty in the investigation.  

5.3 Scenario 3

5.3.1 Determine the best Course of Action, listing 2 reasons for taking this specific action

I can report a file according to Indigo Ethical Violation Procedure and highlight Indigo Duty Care Dignity Risk Policy; I need Florence to describe the scenario as she is the witness for the incident. The Indigo Code of Conduct is applicable to both me and Samuel, where Florence should help me to report misbehave with the service user and Samuel should also follow ethical behavior.

6.0 Further Improvements 

6.1 Scenario 1

6.1.1 One way that works practices could be improved to meet legal and ethical responsibilities

 In order to make the workplace environment safer, the policy should be strict and flexible. HR should be more alert on the way employee behave with each other. The employees are allowed to file against the bad behavior and attitude that other employees possess. People from government can be contacted for providing training for giving respect to the clients and the possible action that they can take if any of the regulation is breached. Presentation with proper animations and action should be represented so that every employee can get the motive behind the training.

6.1.2 Identify which Indigo policies need to be updated (or developed) to reflect the improved work practices (identified above)

1.2.1 Identification and description of the dilemma

The code of conduct policy should be improved and taken an immediate step against the bullying people at the workplace. There should be strict action taken for the people, who spread unsatisfied things about colleagues without getting into the conversation with that person. However, the policy for privacy and confidentiality is enough to protect the data and evidence collected. A third person should also have right to report the poor mental condition of a colleague if they found some unusual change in behavior and working process of the victim.  

6.1.3 Two ways to communicate the changes (to work practices and policies) to other staff (both colleagues and supervisors)

 In this case, both ways can be taken into consideration- the traditional way to communicate and contemporary way to communicate. Official meetings, billboards notice and magazines on amendments of the policies can be considered. Moreover, these notices should compare the old and new regulation so that the employees know the changes made in the policies.  

 Another way to communicate with the staffs is the contemporary media like official e-mails, personalized message to make them aware that there are some amendments made in the organizational policies with the link provided in it. The organization can also update the information on the social media that the company is using so that not staffs can miss out form the information.  

6.2 Scenario 2 and Scenario 3

6.2.1 One way that works practices could be improved to meet legal and ethical responsibilities 

However, in case of Sean and Emily, the Human Rights Commission’s members have to be more flexible. The professional for mental health should also have commitments with necessary medical institutes to provide necessary treatment to the people with intellectual disabilities so that they can help them to overcome their trauma.

6.2.2 Identify which Indigo policies need to be updated (or developed) to reflect the improved work practices (identified above) 

A primary investigation could be incorporated without the permission of the victim so that few pieces of evidence can be collected regarding their abuse. The policy can further take the consent of the victim whether or not to proceed with disciplinary action against the abusers.

6.2.3 Two ways to communicate the changes (to work practices and policies) to other staff (both colleagues and supervisors) 

The changes can be informed to the staffs through conventional way of meetings, official gatherings and office billboard notice. This information can also be shared through personalized mails. In case of the abusers, the policies that they have breached will be separately highlighted along with the possible actions that will be taken against them.  

1.2.2 Identify my own personal values/attitudes and where conflict may arise

Another method is to organize a meeting with the abusers, their service users and officials of the organization could be conducted especially for the case that the staffs obtained against the policy. This meeting is also assisted by mental health officers for the victims to know about the problem that they have faced. Family members of the victim can be included if the victim is unable to present any defending statements for themselves.

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