LEGAL AND ETHICAL

appletree-erykah badu

milieu therapy

treatment focused on modifying or controlling the immediate environment in which a client is living in order to promote health and healing. enhances a client’s recovery process by organizing daily living in a safe, therapeutic, social environment. basic idea is to assist the client in developing life and social skills that may have been disrupted by their mental health disorder.

ethics

provides a basis for determining intentions, motives, and actions by a particular group or within society. also involves the consideration of cultural norms, personal morals or values, and values of the profession. principles of autonomy, nonmaleficence, beneficence, fidelity, veracity, justice, and the rights to confidentiality, informed consent, and involuntary admission are all apart of the fundamental rights of clients.

bioethics

the study, research, and moral inquiry of issues raised by advances in medicine and life sciences specifically focused on their effects on humans.

parity

equal coverage for mental and physical health in accessibility to health insurance

mental health laws

laws addressed by the federal and state governments for addressing mental health concerns and laws. establishes that the right of mentally ill clients are the same for all individuals while also ensuring parity in services for client who have a mental illness.

federal government

regulates health systems and providers, protects the rights of the individual, provides funding for services, supports research and innovation, and establishes and enforces a minimum standard of mental health care.

state government

establishes specific standards and regulations for mental health treatment, provides oversight of mental health care within the state; addresses issues related to treatment facilities, medical records, and standards, including involuntary treatment; expands on federal government programs, funding, research, and protection standards

involuntary admission

initiated for a client who is experiencing severe manifestations of mental illness and is deemed a danger to themselves or others, is unable to meet basic self-care needs, and their illness prevents them from recognizing the need for seeking care.

voluntary admission

admission whereby a client recognizes the need for and often requests treatment. generally occurs when a client is experiencing an exacerbation of manifestations or a mental health crisis, recognizes the need for inpatient treatment, and consents to inpatient hospitalization.client can submit a request for discharge in writing; provider must assess client within 72 hours following request to determine if client condition is stable enough for discharge.

emergency admission

occurs when a client is an imminent danger to themselves or others and in some cases is detained by law enforcement. client can be offered voluntary admission if it is determined that they are competent and have the capacity to make treatment decisions.

informed consent

provider administering treatment should provide the client or the client’s legal representative with an understandable explanation of the treatment. explanation should include a description of the treatment, a statement of possible benefits and adverse effects, a statement of risks involved in receiving treatment, possible consequences of not receiving the treatment, and alternative treatments available.

implied consent

occurs in an emergency situation when a client is unconscious or otherwise unable to give informed consent for a treatment or procedure. also assumed when a client’s actions demonstrate their willingness to accept treatment, such as when they roll up their shirt sleeve to have their blood taken. can never be used when a client or the client’s legal representative refuses medical treatment.

tort

a violation of a client’s protected rights and represent a breach of the duty of the nurse. can be intentional or unintentional.

unintentional tort

implies that the nurse did not use forethought in the action or omission of action, but harm still occurred. includes negligence and malpractice.

intentional tort

an action in which an individual deliberately acts in a way that causes harm to another. includes assault, battery (contact with another person without their consent that is unwanted and considered offensive), and false imprisonment. assault does not require actual physical harm to be done to the client (can be verbal) and battery does not need to include a threat nor does the client need to be aware of the physical contact, the contact must simply be considered offensive or unwanted by the client.

restraints and seclusion

occurs in response to a behavioral emergency, in which the client poses an immediate danger to themselves or another person. intention must be based on client safety, not on simply making milieu management more convenient for the nurse. client should never be secluded or left alone in a locked room, unsupervised, or left in a prone or supine position. client should be checked at regular intervals, at least every 15 min. utilize time out first, restraints are last resort.

interprofessional teams

teams that are made up of several disciplines; can be compromised of psychiatrists (diagnose both medical and psychiatric illnesses, prescribe meds), psychologists, occupational therapists, medical secretaries, art therapists (use media like painting to express feelings), drama therapists (act out feelings), advocacy workers, social workers, and nurses