Legal And Ethical Aspects Of Mental Health Care Discussion
Legal And Ethical Aspects Of Mental Health Care Discussion
Topic: Informed Consent
Considerations regarding informed consent in mental health practice are discussed in the topic. It is ethically and legally required to obtain informed consent before starting psychotherapy with a PMHNP during clinical practice Blease et al., (2020)Legal And Ethical Aspects Of Mental Health Care Discussion. The adult patient was informed through informed consent about his mental health and the suggested course of treatment. Because informed consent supports patient liberty, the patient is free to reject the proposed therapy. Guardians and parents, however, have the legal authority to refuse the advised treatment in the context of minors or teenagers.
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Summary
The papers discussed every legal and ethical consideration that goes into children’s, adolescents, and adults’ decisions about a particular style of therapy. These articles concentrate mainly on the application of informed consent in psychotherapy procedures. The articles focus on the views of the hospital personnel and nurse practitioner toward moral and legal issues related to informed consent. Before performing any medical operation, justifications and explanations are provided with evidence based on the study (Bipeta, 2019)Legal And Ethical Aspects Of Mental Health Care Discussion. Darby and Weinstock (2018) examine the boundaries of privacy and ethical problems associated with using informed consent in therapeutic contexts. Davis et al. (2016) evaluate the “Informed assent recall among adolescents in substance use disorder treatment research.” The four publications chosen for this study provide enough information about applying moral and legal requirements for informed consent in mental health psychiatric procedures. The most significant ethical and legal concerns about children, teenagers, and adults are further discussed.
Ethical Considerations of Informed Consent in Psychiatric Mental Health Practices
For better therapeutic results, adult patients require psychotherapy right away. A PMHNP is granted the legal right of consent by the mental nurse practitioner. After hearing about the therapy strategy, the patient rejects it as ineffectual. The PMHNP is faced with ethical and moral decisions in this situation. Although the doctor believes the course of therapy benefits the patient, the patient’s impaired ability to make decisions makes it challenging to carry out the plan. The ethical principle of informed consent will be violated if the therapist withholds information about all the specifics of the mental treatment (Blease et al., 2020)Legal And Ethical Aspects Of Mental Health Care Discussion.
Parents make treatment decisions for adolescents and children receiving psychotherapy. The parents forbid the children or adolescents from learning about the PMHNP’s therapeutic intervention. The opinions and consent of children and teenagers are frequently disregarded by their parents. The parents make the decisions based on their viewpoint. To guarantee the ethical concerns of informed permission, this situation presents ethical challenges for the PMHNP. Making an ill-informed judgment about therapy interventions in children’s and adolescents’ psychotherapeutic approaches is immoral.
Legal Considerations of Informed Consent in Psychiatric Mental Health Practices
A PMHNP faces a dilemma regarding psychotherapy for an adult patient with a significant mental illness. Such patients’ reactions to the suggested medication regimen can occasionally harm the doctors or the patients themselves. This is the legal consideration’s cap since it might prevent the therapy from being delivered generally in some circumstances. However, for PMHNPs in medical care, the legal ramifications of informed consent are inevitable.
In psychotherapy, adolescents and children are frequently viewed as incapable of making decisions. However, due to their legal rights, adolescents receiving psychiatric treatment can make their choices and give informed consent. It is illegal for the practitioner to persist on the same care plan, regardless of how beneficial the therapy is. Even though the doctor is aware of the patient’s history, the adolescent client cannot assess the significance of the suggested treatment. However, the choice cannot be made on behalf of the patient by the practitioner Chenneville and Schwartz-Mette, 2020)Legal And Ethical Aspects Of Mental Health Care Discussion.
Application to my Clinical Practices
I would implement the moral and legal requirements of informed consent for such treatment interventions in my clinical environment since I am a mental health nurse practitioner. Likewise, by reading these pieces, I would be better equipped to deal with the ethical questions that arise in my therapeutic practice. It is crucial to obtain the child or adolescent’s agreement for various reasons, including those related to law, morality, and the success of mental therapy.
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Major depressive disorder (MDD)
MDD, also called clinical depressive episodes, is an illness that affects several aspects of a human’s life. MDD might have an impact on one’s mood, behavioral patterns, and physical abilities, such as sleep and appetite. People suffering from major depressive disorder frequently lose interest in pleasurable activities. They also have difficulties completing everyday tasks. Major depressive disorder, according to clinical personnel and health scientists, is among the most prevalent forms of depression, negatively impacting millions of individuals living in the United States and being the worldwide leading cause of disability.
FDA-approved drug: according to Rothschild (2021), Escitalopram and fluoxetine are the approved drug by FDA, whereby Escitalopram is for ages between 12 to 17 years while fluoxetine is for children from ages 8 to 17 years.
Off-label drug: Off-label drug use is the technique of recommending a prescription medication for an intent besides what the FDA has endorsed. This is known as “off-label” use since the drug is being utilized in a manner not mentioned in the product description. According to Urits et al. (2019)Legal And Ethical Aspects Of Mental Health Care Discussion, Fluvoxamine is the preferred off-label drug for children and adolescents.
Nonpharmacological intervention: Nonpharmacological intervention is any form of health treatment that does not depend exclusively on drug therapy. Examples of such interventions for children and adolescents with major depressive disorders are family therapy, interpersonal therapy, and cognitive-behavioral therapy (Krause et al., 2019).
Risk assessment to inform treatment decision making
The risks and advantages of the FDA-approved medication include that it is beneficial in combating major depressive disorder in kids and teenagers and has few side effects. According to Rothschild (2021), Escitalopram raises serotonin levels in the brain, which lessens the signs of anxiety and despair. Despite the benefits associated with the drug, there are some risks associated with it. Escitalopram might cause agitation, irritability, or other unusual behavior in some children and adolescents. It may also result in suicidal thoughts, inclinations in some individuals, and an increase in depression. Rothschild (2021) also indicates that one may start experiencing some headaches, weakness, and long-lasting confusion with frequent muscle cramps. Urits et al. (2019) indicate Fluvoxamine is essential when prescribed as off-label for major depressive disorder (MDD)Legal And Ethical Aspects Of Mental Health Care Discussion. Fluvoxamine helps to reduce unwanted thoughts and has no risk associated with its use.
Clinical practice guidelines for major depressive disorder
Detailed assessment and accurate diagnosis are necessary for managing the major depressive disorder. The evaluation should be formulated based on a physical exam, history, and mental state assessment. All sources should be utilized to gather history, particularly the family. The diagnosis should be documented using the most recent diagnostic standards. Clinical practice guidelines identify the phases of sickness or therapy. A psychiatrist may select from a variety of first alternative treatments during the acute phase, such as psychotherapy combination, psychotherapy, pharmacotherapy, a drug, or Electroconvulsive therapy (ECT). Clinical and non-clinical considerations typically impact the choice of an initial therapy technique. Most of the clinics have incorporated the FDA- approved medication, off-label treatments, and nonpharmacological interventions into their guidelines for treating major depressive disorder. Clinical practice guidelines recommend treating severe depression disorders in children and adolescents with FDA-approved medications, off-label treatments, or nonpharmacological interventions since all three are efficient and have few adverse effects (Fabi et al., 2020)Legal And Ethical Aspects Of Mental Health Care Discussion.
Study plan
Content-area strengths and opportunities for improvement
My strengths are in the domains of therapeutic interventions, the therapeutic connection, and the therapeutic procedure, according to the findings of my practice tests. I exceeded the cutoff in each of these categories, demonstrating that I am comfortable with the ideas in overall and that I have a strong basis for future learning. In terms of diversity, ethics, and lifetime maturation, I also did reasonably well, though I could still improve my understanding in these areas with additional studying and practical sessions.
My most significant area for improvement is in diagnosis and evaluation. While I understand the fundamentals and can correctly respond to questions, I could gain from additional practice and study in this area to become much more competent and self – assured. In addition, I need to improve my test-taking skills, as I ran out of time on a few questions all throughout exam. I really do have to learn how to pace myself and how to better regulate my time Legal And Ethical Aspects Of Mental Health Care Discussion.
SMART Goal
- After finishing any reading or tasks for the next class, I will analyze and revisit the chapter we just finished.
- When I finish all of the tasks for the following class, each day, I will spend a minimum of an hour or so revisiting my notes from the initial course.
- To complete multiple assignments simultaneously, I will use a calendar to generate study schedules and enter all of my individual dates and appointments. Every week, I would review my plans and revise my study schedule and extracurricular activities.
Study Plan and Tasks Needed to Complete Each SMART Goal
My certification exam preparation is crucial because it will determine my success. The approach I use for practice consists of six phases that I believe are authentic and necessary for my study journey (Guzzetta et al., 2018). The first step is to determine how I best study. Each plan should be tailored to the person’s learning needs and timeframe. Rather than one long cramming session, I will read for more than an hour at a time. I will reserve approximately four to five hours of reading time to ensure appropriateness. The very next step involves picking suitable learning material. To ensure that the information is current, I have to look online for up-to-date and peer-reviewed documents. To complete my first and second SMART goals, I will need to create time to analyze and reread the previous chapters that I might not have understood well (Harber, 2021)Legal And Ethical Aspects Of Mental Health Care Discussion. This will help in developing an understanding of the earlier chapters. I would not want to get through the insignificant practice tests only to perform poorly on exams. Third, assessing my knowledge is a starting point toward evaluating whether or not my goals are attainable.
The next stage is to give the plan a deadline to be bound to a specific time. For my third SMART goal, I will draft a wall timetable that shall act as a reminder to know the subjects I will need to cover in a day and the times for a break. I will measure my progress by trying some texts or question-and-answer sessions with my colleague to identify if I have developed an understanding (Kaushik & Lipton, 2018).
Measuring Progress:
I will track my progress by keeping a log of the practice questions I complete and the amount of time I spend reading and studying. Additionally, I will take a practice test at the end of April to gauge my progress and make sure I am on track to meet my goal.
Timetable:
- Read one book on assessment and diagnosis by the end of February.
- Complete assessment and diagnosis practice questions at least 2 times a week in February – April.
- Participate in a study group or review course in March or April. Legal And Ethical Aspects Of Mental Health Care Discussion
Weekly Timetable
Sunday | Monday | Tuesday | Wednesday | Thursday | Friday | Saturday |
Ethical and Legal Foundations of PMHNP Care
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Practice questions | Mental Health and Psychiatric Nursing | Schizophrenia | Essentials of Evidence-Based Practice | Policy and Advocacy for Improving Population Health |
Resources Used to Accomplish Goals and Tasks
I will use practical and case-based questions from the National Council Licensure Examination (NCLEX, 2020) to discourage memorization and encourage thinking critically.
- Study group or review course: I will look for local study groups or review courses that I can join or attend in person. Alternatively, I can look for online study groups or review courses that I can join from home.
- Mnemonics and other mental strategies: I will use mnemonics and other mental strategies to help me remember key concepts related to assessment and diagnosis.
- Print or online resources: I will use print and online resources, such as textbooks, journal articles, and practice questions, to supplement my learning.
- Flashcards: I will create flashcards to help me study key concepts related to assessment and diagnosis.
- Quizzes: I will take online quizzes to test my knowledge and help me identify areas I need to focus on.
Moreover, when members discuss, they might have the opportunity to learn from one another’s experiences (Troussas et al., 2020)Legal And Ethical Aspects Of Mental Health Care Discussion. Lastly, although not every aspect of the NCLEX is contained, I will concentrate on it while employing a wide range of methods and resources. Rather than postponing the test until after graduation, I must incorporate it into my certification exam preparation.
References
Bipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care. Indian Journal of psychological Medicine, 41(2), 108–112. doi:10.4103/ijpsym.ijpsym_59_19
Blease, C. R., Arnott, T., Kelley, J. M., Proctor, G., Kube, T., Gaab, J., &Locher, C. (2020). Attitudes About Informed Consent: An Exploratory Qualitative Analysis of UK Psychotherapy Trainees. Frontiers in Psychiatry, 11. doi:10.3389/fpsyt.2020.00183
Chenneville, T., & Schwartz-Mette, R. (2020). Ethical considerations for psychologists in the time of COVID-19. American Psychologist, 75(5), 644.
Darby, W. C., & Weinstock, R. (2018). The Limits of Confidentiality: Informed Consent and psychotherapy. FOCUS, 16(4), 395–401. doi:10.1176/appi.focus.20180020
Davis, J. P., Lux, E. A., Smith, D. C., & Cleeland, L. (2016). Informed assent recall among adolescents in substance use disorder treatment research. Journal of child & adolescent substance abuse, 25(5), 417-427.
Fabi, A., Bhargava, R., Fatigoni, S., Guglielmo, M., Horneber, M., Roila, F., … & Ripamonti, C. I. (2020). Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment. Annals of Oncology, 31(6), 713-723.
Guzzetta, A. A., Weis, J. J., Hennessy, S. A., Willis, R. E., Wilcox, V., Dunkin, B. J., … & Scott, D. J. (2018). Proficiency-based preparation significantly improves FES certification performance. Surgical endoscopy, 32(11), 4451-4457.
Harber, C. (2021). Examinations and Testing. In Post-Covid Schooling (pp. 121-137). Palgrave Macmillan, Cham.
Kaushik, D., & Lipton, Z. C. (2018). How much reading does reading comprehension require? a critical investigation of popular benchmarks. arXiv preprint arXiv:1808.04926.
National Council of State Boards of Nursing. (2020). NCLEX examination statistics. Legal And Ethical Aspects Of Mental Health Care Discussion
Rothschild, A. J. (2021). Why Is There No Food and Drug Administration–Approved Medication for Major Depression With Psychotic Features?. Journal of Clinical Psychopharmacology, 41(4), 359-361.
Troussas, C., Giannakas, F., Sgouropoulou, C., & Voyiatzis, I. (2020). Collaborative activities recommendation based on students’ collaborative learning styles using ANN and WSM. Interactive Learning Environments, 1-14.
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Urits, I., Peck, J., Orhurhu, M. S., Wolf, J., Patel, R., Orhurhu, V., … & Viswanath, O. (2019). Off-label antidepressant use for treatment and management of chronic pain: evolving understanding and comprehensive review. Current pain and headache reports, 23(9), 1-10.
Krause, M., Gutsmiedl, K., Bighelli, I., Schneider-Thoma, J., Chaimani, A., & Leucht, S. (2019). Efficacy and tolerability of pharmacological and nonpharmacological interventions in older patients with major depressive disorder: A systematic review, pairwise and network meta-analysis. European Neuropsychopharmacology, 29(9), 1003-1022 Legal And Ethical Aspects Of Mental Health Care Discussion
245210__wk_2_adult_legal_ethical__2pdf_638b64c7ca38e.pdf
# 2 —2 pages. 4 articles will be sent via attachment. Writer may add their own articles as well.
Advanced practice nursing in all specialties is guided by codes of ethics that put the care, rights, duty, health, and safety of the patient first and foremost. PMHNP practice is also guided by ethical codes specifically for psychiatry. These ethical codes are frameworks to guide clinical decision making; they are generally not prescriptive. They also represent the aspirational ideals for the profession. Laws, on the other hand, dictate the requirements that must be followed. In this way, legal codes may be thought to represent the minimum standards of care, and ethics represent the highest goals for care.
For this Discussion, you select a topic that has both legal and ethical implications for PMHNP practice and then perform a literature review on the topic. Your goal will be to identify the most salient legal and ethical facets of the issue for PMHNP practice, and also how these facets differ in the care of adult patients versus children. Keep in mind as you research your issue, that laws differ by state and your clinical practice will be dictated by the laws that govern your state.
Select one of the following ethical/legal topics:
Autonomy
Beneficence
Justice
Fidelity
Veracity
Involuntary hospitalization and due process of civil commitment
Informed assent/consent and capacity
Duty to warn
Restraints
HIPPA
Child and elder abuse reporting
Tort law
Negligence/malpractice
In the Walden library, locate a total of four scholarly, professional, or legal resources related to this topic. One should address ethical considerations related to this topic for adults, one should be on ethical considerations related to this topic for children/adolescents, one should be on legal considerations related to this topic for adults, and one should be on legal considerations related to this topic for children/adolescents.
Briefly identify the topic you selected. Then, summarize the articles you selected, explaining the most salient ethical and legal issues related to the topic as they concern psychiatric-mental health practice for children/adolescents and for adults. Explain how this information could apply to your clinical practice, including specific implications for practice within your state. Attach the PDFs of your articles.
# 3A 2 pages —- 3 articles sent via attachment. Writer please add extra articles
Use major depressive order to research for this Assignment.
Use the Walden library to research evidence-based treatments for your assigned disorder in children and adolescents. You will need to recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating this disorder in children and adolescents.
Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.
# 3 B : Study plan Assignment 2 pages – at least 5 references. Please provide your own.
Based on your completed practice exam results from previous week , identify strengths and areas of opportunity and create a tailored study plan to use throughout this course to help you prepare for the national certification exam. This will serve as an action plan to help you track your goals, tasks, and progress. You will revisit and update your study plan in NRNP 6675, and you may continue to refine and use it until you take the exam.
Reflect on your practice exam question results. Identify content-area strengths and opportunities for improvement.
Also reflect on your overall test taking. Was the length of time allotted comfortable, or did you run out of time? Did a particular question format prove difficult
Based on your practice test question results, and considering the national certification exam, summarize your strengths and opportunities for improvement. Note: Your grade for this Assignment will not be derived from your test results but from your self-reflection and study plan.
Create a study plan for this quarter to prepare for the certification exam, including three or four SMART goals and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress.
Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study