NUR1 424 - Mental Health Ethics Class 9

Mental Health Ethics

• NUR1 424 - Class 9 notes by Marianne Sofronas & Catherine-Anne Miller
• Course content includes coercion, stigma, trauma & violence informed care, moral practice in mental health nursing.

Class 9 - Mental Health Ethics - Learning Objectives

• Discuss main ethical dimensions of mental health nursing practice
• Identify risks to autonomy and beneficence related to paternalism, coercion, and power in mental health nursing
• Discuss implications of mental health stigma for ethical nursing practice
• Describe how a trauma and violence informed approach is part of ethical nursing practice
• Analyze mental health ethical cases

Class 9 - Mental Health Ethics - Class Content

• Mental Health Ethics and Nursing
• Coercion and Stigma in mental illness
• Trauma and Violence Informed Care (TVIC)
• Nursing Ethics in mental health cases
• AI ethics - Online Content

Mental Health Ethics - The Student Will Be Able To

• Explore contextual factors in mental health in Canada
• Discuss main ethical dimensions of mental health nursing practice
• Reflect on paternalism, coercion, & power in mental health nursing
• Discuss implications of mental health stigma & link it to ethical nursing practice
• Reflect on trauma & violence informed care (TVIC) in ethical nursing practice
• Analyze mental health cases through the lens of ethical theories

Content Summary

• 01 Context in Canada: Background information about mental health in Canada
• 02 Introduction to Mental Health Ethics: General overview of the topic
• 03 Paternalism, Coercion, & Power in Mental Health: Understanding these concepts within a mental health setting
• 04 Stigma and Nursing – Ethical Implications: How stigma affects ethical nursing practice
• 05 Trauma and Violence Informed Care – Ethical Care: Incorporating trauma informed care into ethical nursing practice

Reflections

• Short reflection activity about mental health.

1- Context

• Posters: "Don't give up", "You are not alone", "You matter"

Some Ethical Questions in Mental Health

• Resource allocation/social justice (Clinical issues vs. psychosocial needs)
• Treatments are often relational and without quick fixes
• Deinstitutionalization movement (1960-70s)
• Competence/capacity and consent (Autonomy)
• OMH diagnosis
• Implications of incompetence
• Forced treatment & confinement, restraints (coercion)
• Confidentiality and privacy
• Patients with mental illness (MI) and expectations of privacy and confidentiality

Stigma

• Notes on the management of spoiled identity by Erving Goffman

Perceptions of Mental Illness

• Canadian News Media regularly stigmatize people with mental illnesses.
• Symposium targets journalism students.

Mental Disorders in Canada, 2022

• Prevalence of mood and anxiety disorders increased from 2012 to 2022.
• Highest prevalence among young women
• Despite recent rises in substance-related deaths, the prevalence of substance use disorders did not increase from 2012 to 2022.
• Over 5 million Canadians (18%) aged 15 and older met criteria for a mood, anxiety, or substance use disorder in the previous 12 months.

Mental Illness in Canada

• 1 in 5 Canadians experience mental illness in their lifetime
• 20% of those have a substance abuse problem
• 70% of mental health problems begin in childhood or adolescence
• Mental illness affects anyone, but some groups are at higher risk (lower income, underemployed, single mothers, children exposed to violence, workers with little decision-making power, victims of violence or abuse).
• Indigenous populations are at higher risk (30% show symptoms of depression, suicide and self-inflicted injuries are the #1 cause of death in adults under 44, suicide rates in Indigenous communities are 5-7 times the national average, suicide rate in Inuit communities is 11 times the national average).

Unmet Health Care Needs (2022)

• More than 1 in 3 (36.6%) of those with a mood, anxiety, or substance use disorder reported unmet or partially met health and mental health care needs.

Mental Illness in Canada - Additional Factors

• Only 1/3 of those who need mental health services in Canada actually receive them
• 15% of burden of disease, 5% of health care $
• People with serious mental illness are disproportionately affected by homelessness
• 3 people commit suicide and 8 hospitalized for attempted suicide in Quebec each day
• 90% of suicide attempts preceded by history of mental illness

Mental Illness & Violence

• Belief that people with mental illness are dangerous increases stigma & fear
• People with mental illness are a small proportion of perpetrators of violence
• Most people who are violent do not have a mental illness
• People with mental illness are far more likely to be victims of crime

Diagnostic and Statistical Manual-V

• DSM-V Proposal for the definition of Mental/Psychiatric Disorder

Technology

• Specifics on Technology not detailed

Mental Health Prevention & AI

• David, a 35-year-old man, uses the app Sovie to monitor his mental health.
• The app collects various information (medication, diagnoses, routines) and provides a mood level and depression tendency rating.

Additional Mental Health Resources and Topics

• La Déclaration de Montréal (2018): Focuses on well-being, autonomy, equity, inclusion, participation, prudence, and responsibility.
• Virtual AI girlfriend app, social connection, loneliness epidemic, and technology; AI in healthcare, ethics considerations, implications.
• Learning objectives for AI and its applications in healthcare, education, and professional use.

References and Specifics

• Numerous references included likely to specific scholarly articles. Note study guides often list specific items and the authors. Focus on the topics within the notes.