scholarly journals Ethical Issues for Direct-to-Consumer Digital Psychotherapy Apps: Addressing Accountability, Data Protection, and Consent

2018 ◽  
Vol 5 (2) ◽  
pp. e32 ◽  
Author(s):  
Nicole Martinez-Martin ◽  
Karola Kreitmair
Keyword(s):  
Mental Health ◽  
Ethical Issues ◽  
Mental Health Provider ◽  
Ethical Challenges ◽  
Conversational Agents ◽  
Direct To Consumer ◽  
Professional Mental Health ◽  
The Many ◽  
Psychotherapy Services ◽  
Ethical Obligations

This paper focuses on the ethical challenges presented by direct-to-consumer (DTC) digital psychotherapy services that do not involve oversight by a professional mental health provider. DTC digital psychotherapy services can potentially assist in improving access to mental health care for the many people who would otherwise not have the resources or ability to connect with a therapist. However, the lack of adequate regulation in this area exacerbates concerns over how safety, privacy, accountability, and other ethical obligations to protect an individual in therapy are addressed within these services. In the traditional therapeutic relationship, there are ethical obligations that serve to protect the interests of the client and provide warnings. In contrast, in a DTC therapy app, there are no clear lines of accountability or associated ethical obligations to protect the user seeking mental health services. The types of DTC services that present ethical challenges include apps that use a digital platform to connect users to minimally trained nonprofessional counselors, as well as services that provide counseling steered by artificial intelligence and conversational agents. There is a need for adequate oversight of DTC nonprofessional psychotherapy services and additional empirical research to inform policy that will provide protection to the consumer.

Postpsychiatry and postmodern psychotherapy: Theoretical and ethical issues in mental health care in a Polish context

2018 ◽  
Vol 28 (6) ◽  
pp. 780-799 ◽  
Author(s):  
Radosław Stupak ◽  
Krzysztof Dyga
Keyword(s):  
Mental Health ◽  
Ethical Issues ◽  
Therapeutic Process ◽  
Historical Context ◽  
Theoretical Background ◽  
Social Contexts ◽  
Ethical Challenges ◽  
To Come ◽  
Key Aspects

The article reconstructs postpsychiatry’s core propositions and briefly describes its theoretical background and assumptions. It also presents chosen aspects of postmodern psychotherapy, which seem to be in many ways similar to postpsychiatry’s ideas. Although they are drawn from different inspiration, postpsychiatry and postmodern psychotherapy seem to come to similar conclusions, especially regarding the role of the patient in the therapeutic process, the meaning of psychiatric diagnosis, and the importance of the institutional, cultural, and social contexts in mental health practice and research. The paper also aims to place postpsychiatry and postmodern psychotherapy in a Polish context, focusing on the ethical challenges faced by psychiatry and showing that some of postpsychiatry’s ideas and solutions to contemporary problems were already present in the Polish psychiatric literature of the 20th century. It also contains a brief description of the Polish social and historical context of psychiatry, as well as key aspects of the Polish legal system that relate to mental health and seem to reflect the nature of biomedical explanations of mental distress. It concludes that the model of psychiatric care postulated by “postmodern” approaches seems more ethical and scientifically and philosophically grounded and promises better treatment results than the “traditional” biomedical model.

Text Messaging and Private Practice: Ethical Challenges and Guidelines for Developing Personal Best Practices

2013 ◽  
Vol 35 (3) ◽  
pp. 211-227 ◽  
Author(s):  
Michael Sude
Keyword(s):  
Mental Health ◽  
Best Practices ◽  
Private Practice ◽  
Text Messaging ◽  
Ethical Issues ◽  
Ethical Challenges ◽  
Ethical Concerns ◽  
Message Service ◽  
Impact Of Technology ◽  
The Impact

The impact of technology on mental health practice is currently a concern in the counseling literature, and several articles have discussed using different types of technology in practice. In particular, many private practitioners use a cell phone for business. However, no article has discussed ethical concerns and best practices for the use of short message service (SMS), better known as text messaging (TM). Ethical issues that arise with TM relate to confidentiality, documentation, counselor competence, appropriateness of use, and misinterpretation. There are also such boundary issues to consider as multiple relationships, counselor availability, and billing. This article addresses ethical concerns for mental health counselors who use TM in private practice. It reviews the literature and discusses benefits, ethical concerns, and guidelines for office policies and personal best practices.

Ethical Research in Global Child Health

2018 ◽  
pp. 299-320
Author(s):  
Deborah Dewey ◽  
Eveline T. Konje ◽  
Elias C. Nyanza ◽  
Francois P. Bernier ◽  
Mange Manyama
Keyword(s):  
Child Health ◽  
Health Research ◽  
Ethical Issues ◽  
Global Health Research ◽  
Ethical Challenges ◽  
Middle Income ◽  
Ethical Research ◽  
Research With Children ◽  
Child Health Research ◽  
The Many

Global child health research plays a pivotal role in addressing inequities in children’s health and development worldwide. To achieve this goal, research must be based on sound scientific and ethical principles. This chapter focuses on ethics in child health research in low-, middle-, and high-income countries. It reflects on the key principles underlying ethical research in general and in global health research and child health research in particular. This is followed by a detailed discussion of 3 core principles underlying child health research: respect, benefit, and justice. Research with children poses important and universal ethical issues across world contexts, including establishing consent, protection from harm, privacy, and payment and gifts. Cultural, social, political, and economic factors that can interact to pose particular challenges with regard to these issues in different contexts, especially in low- and middle-income settings, are explored. As methodology and ethics are integrally linked, this chapter also examines the ways in which children have been included in health research studies: research on children, research with children, and research by children. This is followed by a brief discussion of ethical mechanisms that are in place to ensure that ethical standards are met and maintained in research on global child health. The chapter concludes with a discussion of the many positive changes in ethical research involving children in recent years. Emerging ethical challenges in the fields of genetics and genomics are highlighted.

Perinatal Mental Health

2019 ◽  
pp. 209-232
Author(s):  
Lori d’Agincourt-Canning ◽  
Deirdre Ryan
Keyword(s):  
Mental Health ◽  
Psychotic Disorders ◽  
Ethical Issues ◽  
Medication Use ◽  
Perinatal Mental Health ◽  
Relational Autonomy ◽  
Ethical Challenges ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Medication Decisions

This chapter reviews ethical issues pertaining to the care of women with mental illness during pregnancy and the postpartum period. The incidence of perinatal depression and anxiety and psychotic disorders and their respective treatments are described. Ethics principles and perspectives that guide perinatal mental health care are discussed critically. Relational autonomy is shown to be a key principle to guide treatment decisions for these women. The value of relational autonomy in addressing ethical challenges is illustrated by three cases in reproductive mental health: psychotropic medication decisions during pregnancy; enforced treatment; and disclosure of medication use to fathers. A fourth case addresses social justice considerations of mother–baby units for women experiencing a perinatal mental health crisis. This analysis calls for a notion of self-determination that accounts for how autonomy occurs and is enacted within specific relational, social, cultural, and political contexts.

scholarly journals Methodological challenges in the use of focus groups with people with severe mental illness

2017 ◽  
Vol 33 (6) ◽  
Author(s):  
Rosana Teresa Onocko-Campos ◽  
Alberto Rodolfo Giovanello Díaz ◽  
Catarina Magalhães Dahl ◽  
Erotildes Maria Leal ◽  
Octavio Domont de Serpa Junior
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Community Mental Health ◽  
Focus Groups ◽  
Severe Mental Illness ◽  
Ethical Issues ◽  
Collaborative Work ◽  
Mental Healthcare ◽  
Community Mental Health Services ◽  
Ethical Challenges

Abstract: This study addresses the practical, methodological and ethical challenges that were found in three studies that used focus groups with people with severe mental illness, in the context of community mental health services in Brazil. Focus groups are a powerful tool in health research that need to be better discussed in research with people with severe mental illness, in the context of community mental health facilities. This study is based on the authors’ experience of conducting and analyzing focus groups in three different cities - Campinas, Rio de Janeiro and Salvador - between 2006-2010. The implementation of focus groups with people with severe mental illness is discussed in the following categories; planning, group design, sampling, recruitment, group interview guides, and conduction. The importance of connecting mental healthcare providers as part of the research context is emphasized. Ethical issues and challenges are highlighted, as well as the establishment of a sensitive and empathic group atmosphere, wherein mutual respect can facilitate interpersonal relations and enable people diagnosed with severe mental illness to make sense of the experience. We emphasize the relevance of the interaction between clinical and research teams in order to create collaborative work, achieve inquiry aims, and elicit narratives of mental health users and professionals.

Rural Ethics and Mental Health: An Overview for Rehabilitation Counselors

2015 ◽  
Vol 46 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Wendy A. Coduti ◽  
Melissa Manninen Luse
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Ethical Issues ◽  
Service Providers ◽  
Rehabilitation Counselors ◽  
Ethical Challenges ◽  
Health Service Providers

Individuals living in rural areas have similar prevalence rates of mental health conditions as individuals living in urban areas, yet face a number of challenges in accessing and receiving proper mental health services. For mental health service providers there are unique ethical challenges when working in rural areas. This paper will examine aspects of rural living, and ethical issues surrounding provision of mental health services. Implications for practice and research are assessed for rehabilitation counselors working in these settings.

Discussant: Ethical challenges

2016 ◽  
Vol 33 (S1) ◽  
pp. S36-S36
Author(s):  
M. Kastrup
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Adverse Effects ◽  
Ethical Issues ◽  
Health Sector ◽  
Economic Policies ◽  
Ethical Challenges ◽  
Health Security ◽  
Economic Changes ◽  
The Impact

Europe has undergone considerable economic changes that have an impact on mental health of its citizens; have consequences for the organization of mental health services; and raise ethical issues, such as the distribution of wealth, and equity in access to care. Furthermore, Europe is current undergoing serious economic problems that will produce adverse effects on the mental health of its citizens, among them increase in substance abuse related disorders as well as an increase in suicide.The consequences that economic changes have on mental health relate to the conditions of the particular country, as countries with better health security nets would be less likely to experience adverse effects. Different policy measures may reduce the impact on mental health not only within the health sector, but other sectors of society have to be engaged in the process.The symposium will consider these problems from different selected perspectives.An overview of the impact of economic policies on health services will be followed by a presentation of the important role of international organizations like EPA in outlining the problem and finally a presentation of the initiative Choosing Wisely that focuses on communication between health professionals and patients with recommendations of decisions about the most appropriate care based on the patient's individual situation.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Everyday ethics of suicide care: Survey of mental health care providers’ perspectives and support needs

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249048
Author(s):  
Marjorie Montreuil ◽  
Monique Séguin ◽  
Catherine P. Gros ◽  
Eric Racine
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Ethical Issues ◽  
Care Providers ◽  
Ethical Challenges ◽  
Or Education ◽  
Perceived Needs ◽  
Care Survey ◽  
Additional Support

Suicide occurs in people of all ages and backgrounds, which negatively affects families, communities, and the health care providers (HCPs) who care for them. The objective of this study was to better understand HCPs’ perspectives of everyday ethical issues related to caring for suicidal patients, and their perceived needs for training and/or support to address these issues. We conducted a mixed methods survey among HCPs working in mental health in Québec, Canada. Survey questions addressed their perspectives and experiences of everyday ethical challenges they encounter in their practice with people who are suicidal, and their perceived needs for training and/or support therein. 477 HCPs completed the survey. Most participants mentioned encountering ethical issues when caring for people who are suicidal. The challenges HCPs encounter in their practice with people who are suicidal are numerous, including issues related to maintaining privacy, confidentiality, freedom and the therapeutic relationship. The lack of time, resources and professional support to address these issues was emphasized. Most HCPs reported that the training or education they have received does not allow them to address everyday ethical issues related to suicide care. In sum, there is a clear reported need for better training and support for HCPs who are offering care to people who are suicidal in relation to everyday ethical issues they encounter. Implications for practice include providing greater access to training, including access to specialists in ethics to address specific issues. This additional support could alleviate morally distressing situations for HCPs.

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