Ethical practices and cultural diversity in mental healthcare clinics

Counselors in Group Homes

Analysis of Work Environment

Social and Cultural Composition of Population

Theoretical Links

Informed Consent and Acknowledgement of Patient Rights

Theoretical Links

Strategies to Ensure Confidentiality

Theoretical Links

Analysis of Ethical Dilemma

Racial Disparity

What Mental Healthcare Workers Are Doing

What Patients belonging to Minorities are Doing

Issues with Information Sharing

Required Decision Making Process

Decision Making Process

The main aim of the paper is to analyze the work environment of chosen mental clinic. How the patients are treated in the clinics, what practices are being observed, what behaviors are being observed in the clinic in dealing with the patients, what cultural practices are being observed in the clinics and what kind of ethical dilemmas are being seen in the chosen work environment. It is important that the ethical considerations being followed in the work environment as how the patients and mental health professionals behave in the mental clinics is important. Mental clinic is the place where the most sensitive and vulnerable population of the patients are present who need the best of behaviors and guidance.

An important fact that needs to be highlighted here is that based on current reports, there is an increase in evidence-based practices being followed in mental healthcare. Three main aims that are to be achieved by the help of evidence-based practices include an increase in quality, accountability, as well as effectiveness in mental healthcare.

Part 1: Analysis of Work Environment

This part of the paper will take into consideration the cultural and social composition of the mental clinic along with ethical codes that are being observed in the clinic. It is important to highlight here that the ethical codes being followed in mental clinics are the ones that directly affect incoming patients (Johnson, 2007, p. 56). Ethical codes that are important to be followed in the mental clinics are to be outlined in a theoretical manner as well. The main difference in the theoretical ethical codes and actual ethical standards being followed will be taken into account.

1. Social and Cultural Composition of Population

An important fact that needs to be highlighted here is that incoming patients in mental clinics are from different ethnicities, races, and cultures. Thereby here it can be highlighted that incoming patients have a vast cultural, ethnic, and geographical diversity. Thereby it is important that incoming patients be dealt by keeping in mind the fact that the patients are to be dealt by considering their cultural limits and requirements.

The observations have shown that the population of metal healthcare workplace is a culturally diverse one. There are a great number of patients who are from local areas along with a small proportion that belongs to different regions and countries. Based on a great geographical distribution of the mental patients, it can be seen that the culturally diverse populations are more of a challenge to the metal healthcare workforce. It is observed that among these patients, a great proportion is that of Hispanics as well as African-Americans.

Most importantly, it was observed that the assessments and treatments being given to the general whites were not being offered to the Hispanics and the African-Americans. Thereby racial disparity was seen in the clinic. The kind of beds and facilities that were being allotted to the Whites were not available for the Hispanics and the African-Americans. Although all the mental healthcare workers are aware of the fact that healthcare disparities are not to be followed or observed in the mental healthcare or any healthcare professions. Still prejudices based on races and ethnicities are seen in the clinic.

2. Informed Consent and Acknowledgement of Patient Rights

Within the observed metal healthcare environment, it is seen that the workforce makes sure that the treatment plans as well as mental healthcare assessments that are being carried out are carried out based on an informed consent on the family members of the patent. It is understood in the workplace that the patient rights are understood at the bets level. One of the main facts that has been realized by the workforce is that as the patients belong to the more diverse cultural backgrounds and the mental states of the patients is very vulnerable thereby it is important that all rights of the patients are taken care of. Being a mental healthcare worker, it has been realized at the clinic that some of the main rights that the patients have include being treated nicely, being assessed in a detailed manner whereas the assessments are more based on the culturally sensitive patterns.

Theoretical Links

It is important that the mental healthcare workforce properly acknowledge the patients' cultural backgrounds. Cultural values and beliefs are very important to be acknowledged (Helmchen, and Sartorius, 2010, p. 76). It is important that the mental healthcare workers are aware of the impacts that the patients" social, cultural and linguistic backgrounds have on the communication that take place between the patients' and the mental healthcare workers.

It is important that the rights of the individuals who are mentally ill should be promoted and these rights should be made aware to all mental healthcare workers within the mental healthcare facility. Within the rights of the mentally ill patients, the cultural, linguistic, spiritual, age and gender differences and religious diversity should be included. For the mental healthcare workers, it is important that they should increase awareness of mental patients, family, and friends in regards to the rights that they have. Within the mental healthcare facility, when there are children who are facing mental illnesses should be treated well and they should be made aware of the rights that they have. Mental healthcare professionals have some limitations in their expertise and knowledge, as they are not fully developed in their professions. Thereby it is important that the professionals in the field must ask for additional advice.

Patient rights also include a freedom towards observing their lives in the clinics in accordance to their cultures and ethnic backgrounds. It has been mentioned that racial disparity is one of the main issues in the clinic so the freedom being given to the already mentally vulnerable patients is lesser that is having a negative impact on their well-being (Lloyd, King, and Deane, 2008, p. 38).

3. Strategies to Ensure Confidentiality

One of the main facts that need to be highlighted here is that the mental healthcare professionals should be aware of the rights of the mentally ill people. One of the main responsibilities that the mental healthcare professionals should have is to make improvements in the mental health of the patients. Patient recovery is the main aim in these cases.

In the mental clinic, it was observed that any treatments and assessments that are to be designed and decided upon are being shared with only the family members. To make sure that the confidentiality is achieved, the information shared with the patients or the family members are not shared with anyone outside the office of the healthcare provider. On the other hand, the second main fact that was observed in the mental health clinic was that file maintenance was being ensured in the case of the patients who belonged to the White backgrounds and the level of secrecy was lesser in the case of the patients who belonged to more culturally diverse backgrounds. The racial and ethnic disparity is one of the greatest issues being seen in the mental clinic. Caretakers that are being assigned to the Hispanics and African-Americans are also Hispanics or African-Americans. Although this is the example of racial disparity being observed in the clinic but there is one underlying advantage. It is seen that the cultural practices of the caretakers are the same as that of the patients based on which the development of understanding between the caretakers and the patients is higher. The disadvantage in this case is that the knowledge and awareness of caretaking sensitivities is lesser in Hispanics and African-Americans based on which the quality of the care in racially different patients is lower. White caretakers are more educated and privileged based on which the quality of care is better in White patients. Information that is being shared with the Hispanics or African-American caretakers is seldom kept confidential based on lesser awareness in lesser privileged caretakers. Opposite is the case with the White and more privileged caretakers in the mental clinic. The sharing of important information thereby is under a great racial and ethnic influence.

Theoretical Links

Sharing of information and confidentiality include the issues that are most important to the career of the mental healthcare professionals as well as the patients. For the medical healthcare professionals, it is important that the healthcare providers or caretakers are kept in mind in all the discussions that involve confidential information sharing between the patients and healthcare providers (Nelson, 2003, p. 28). It has been reported by many authors that if healthcare providers or caretakers are excluded from the discussions of confidential levels, there can be serious financial, medical, practical, as well as personal consequences for the mental healthcare professionals.

There is no doubt about the fact that mental illnesses are the kind of illnesses that require a full time caretaker with a patient. In mental healthcare, it is important that all patient related information is shared with the caretaker. It is to be seen that the mental healthcare providers and the staff must be aware of the fact that the caretakers are the ones who know the patients best as they are with the patients all the time. Thereby it is important that the caretakers are kept in the loop. On the other hand, in regards to the need of confidentiality required in the mental healthcare professions, it is important to realize that mental illnesses can cause sudden changes in the situations and to these situations, all caretakers are supposed to respond. One of the main facts that has been highlighted by the authors is that mental healthcare is represented by an increased partnership between patients and healthcare providers (den Exter, 2009, p. 49). Difference of opinion is the main subject of mental healthcare and these are to be shared with the caretakers.

Part 2: Analysis of Ethical Dilemma

The ethical situation being observed in the mental clinic has been observed with all its details in the section above. More importantly, the actual situation has been compared with the required theoretical ethical consideration by the help of creating theoretical links. Following are some of the main ethical dilemmas that are observed in the work environment.

1. Racial Disparity

Reports that have been recently published have shown that between 1990 and 2000, 25% of the population increase in U.S. was based on racially diverse people. More than 43% of the people in U.S. belong to ethnicities that are non-English language speakers. One in ten Americans is foreigners now. Based on these facts, it is important to see the great diversity in ethnicities and races of people and population of U.S. (Valfre, 2004, p. 55). This is the same ethnic and racial disparity being seen inside the mental healthcare facilities in the modern days. On the other hand, it is important that the mental healthcare professionals realize the fact that the culture of patients as well as the caretakers has an important influence and impact on healthcare provision in mental clinics.

What Mental Healthcare Workers Are Doing

One of the main ethical dilemmas that has been seen in the chosen mental clinic relates to the ethical and racial disparity faced by the Hispanics and the African-Americans. Racial and ethnic minority populations in the mental clinic are based on the following facts.

1. The patients belonging to different races and ethnicities are the ones that do not get an easy and equal access to healthcare in mental services (Bhugra, and Malik, 2010, p. 78).

2. Necessary mental health services that are required by the mentally ill patients are not provided to the patients based on races and ethnicities.

3. It has been seen that the patients receive poor treatments and assessments as compared to the patients who belong to a majority of White population.

4. The patients in the mental clinic settings are underrepresented and are not treated well.

5. The most important fact that has been seen in the setting is that related to the caretakers assigned to the patients. It has been seen that caretakers are from the same ethnic background as that of the patient based on which although understanding between the patient and healthcare provider is better but confidentiality is at stake. Caretakers from different ethnic backgrounds are the ones who are less privileged and have lesser knowledge about information sharing based on which information sharing is less confidential. Any knowledge that is shared between the caretaker and patient is lesser confidential.

What Patients belonging to Minorities are Doing

The ethical dilemmas are not only seen at the end of the mental healthcare service providers but the responsibility lies at the end of the patients as well. The patients, same as in the case of the caretakers, are less privileged and have lesser information in relation to the use and access to the health services. Within the mental healthcare setting it is seen that the patients who belong to the minorities are lesser aware of the ways in which the healthcare services are to be used. In the mental clinic setting, it has been seen that the patients belonging to the minority often misuse the healthcare services or often do not take the required assessments and treatments. A great delay in seeking the treatment has been seen at the end of patients who belong to the minorities as Latinos, Hispanics, and African-Americans (Elder, Evans, and Nizette, 2009, p. 38).

2. Issues with Information Sharing

The second main issue that has been seen in the selected mental clinic is that there is a great risk being taken in the confidentiality needed between the patients and caretakers or mental healthcare workers. It has been seen that the information and knowledge as well as the awareness of the caretakers belonging to ethnic and racial minorities is lesser especially in the case where increased confidentiality is needed. Information sharing in the patients, patients' families, and caretakers of the patients is very important (Johnson, 2007, p. 55). Complete secrecy is to be ensured and it should be ensured that all information must be kept between the patients, families and their caretakers. But in the mental clinic setting it has been seen that the caretakers are lesser informed based on which information is at a risk of being shared outside the clinics.

One of the main facts that need to be highlighted here is that there is no highlight and focus of the medical course works on the cultural settings that are required in the mental clinic setting. Based on ethical and racial disparities, the main knowledge of information sharing should not be kept inaccessible and it should be made open to all. Here the main changes that can be made by the authorities at the mental clinic include knowledge sharing about the necessary requirements of mental health clinics. If issues of racial disparities are kept on the minimal levels, only than the mental healthcare providers can think over the strategies that are important for information sharing and knowledge provision. If proper information-sharing mechanisms are not designed in the clinic, than information secrecy that is required in the patients and caretakers can be in a great risk (Helmchen, and Sartorius, 2010, p. 89).

Required Decision Making Process

Based on the ethical dilemmas that are seen in the chosen mental clinic, it is important that the higher authorities in the clinic make important decisions. Some of the main decisions that are to be made by the clinic include the following;

1. Make changes in ethical disparities seen in the clinics. For this, the mental clinic authorities need to be aware of the changes that are required. Changes that may be required in the mental clinic include changes in information sharing, knowledge sharing, and secrecy in patient-caretaker relationship.

2. The mental healthcare providers should provide assessments and treatments that are required by the patients in an equal manner. For this, it is important that the assessments and treatments should be in accordance to the cultural backgrounds and religious sensitivities of the patients. Changes should be decided on the level of the staff hired in the mental clinic. It is important that the staff should be aware of the cultural backgrounds of the patients and it is important that proper respect should be shown to the cultural and religious sensitivities.

3. Social as well as the cultural composition of the clinic should be kept in mind by the higher authorities and decisions should be made accordingly. The information and knowledge sharing is important in the clinic. It is important that proper information is disseminated in the staff by the help of which the staff can help incoming patients can be informed about the treatments and assessments that are to be made and chosen. It is important that the patients be informed about the best available assessments and treatments.

Decision Making Process

One of the main steps that are needed in the decision making process in the mental clinic is an implementation of the decisions. The decisions should be shared with the staff, in particular with racially diverse staff. It is important to be understood that cultural and religious sensitivities of the patients is important (Nelson, 2003, p. 55).

Conclusion

It has been learned that the setting in the clinic is such that racial and cultural disparity is higher in the clinic based on which it is important that the authorities should be more learned about cultural as well as religious sensitivities of the patients. On the other hand, at the level of the patients, it is important that the patients should be aware of the treatments and assessments that are important. These assessments and treatments should be in accordance to the cultural and religious backgrounds of the patients. Important information should be shared with the clients or the patients in a manner that the information should be kept secret in all cases. Ignoring all racial disparities, it is important that the information is shared with the caretakers as well. Keeping the caretakers out of the information sharing mechanism is an unethical practice. Thereby the mental healthcare providers should be aware of any racial and ethnic disparities that are being observed.