Ethical Issues In Managed Care

An essential job duty for any healthcare professional is to be able to service clients. The Code of Ethics (1999) outlines that service means to use the knowledge that a social worker has acquired through training and education to assist clients with issues that are inhibiting them from living their life completely and without suffering. By this definition, a social worker’s job is to assist a client with real-life issues, such as depression and anxiety, which are faced by the majority of the elderly population (Richardson & Barusch, 2006). For a social worker, assisting clients who face mental illness means

The American Counseling Association and the American Mental Health Counselors Association Codes of Ethics both provide guidance and direction in making ethical decisions for their members (ACA, 2005) (AMHCA, 2010). Both the ACA and the AMHCA Codes of Ethics cover a wide range of moral and ethical situations that could present themselves to mental health professionals. Both of these codes of ethics have significant impacts on the counseling profession. The tools provided by these codes of ethics ensure that mental health professionals are able to conform to the regulations set forth. They address common concerns from varying points of view. Understanding these codes of ethics is essential to all mental

Making it difficult for patients to receive adequate health care for their psychological issues. From a nursing standpoint, this book was interesting and informative. It demonstrated that the legal and psychological health care systems need to be fixed. At the end of the story, Pete concluded that mental illness is a disease that his son must endure for the rest of his life. However, he will be there to help his son, and will never abandon Mike (Earley page 361).

The EAI indicates that ethical guidelines have changed from individual character to organizational ethics (Ethics Awareness Inventory, 2011). The prime focus of this change are client-patient relationships in psychological counseling and clinical practice (Fisher, (2013). Psychological counseling and clinical practice are both constructed on ethical guidelines with the possibility for misuse of power and negligence to discretion (Fisher,

The main pathway for a counselor to help the client is by learning as much about them as they can. Through interviewing and sometimes evaluating say Remley & Herlihy (2015), the counselor decides if they have a diagnosis and together the client and the counselor match a treatment option or options with the client and their diagnoses and goals. In order for a client to use their health insurance, they must have a mental health diagnosis. However, the act of downcoding or upcoding is unethical as well as illegal.

Problem Statement: The World Health Association defines ‘good’ health as: “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” However, in the United States, access to care and funding for mental health care are grossly neglected and underfunded in comparison to other aspects of health care.

In the book, Crazy, by Pete Earley, provides a detailed overview of the mental health system in the United States, as it presents a first hand narrative of Earley’s family journey through the system. The author’s major premise and arguments, in the book, is to highlight the history of mental health, navigation through the judicial system with mental illness, the bureaucracy and policies of hospitals, society views on human rights and client safety, and the impact on the individual, family, and community. The content suggests that human service workers and public health workers should extend their professional lens to advocate for change in the mental health system in the United States.

There are several ethical dilemmas that the mental health professionals that are working as a team will face including “ensuring that the client has given informed consent, maintaining client confidentiality, and involving professionals, paraprofessionals, and family in appropriate coordinated processes that benefit the client” (Paproski & Haverkamp, 2000, p.96).

Policy analysis of mental health care under the ACA as well as description of how mental health care/service are organized under the ACA from federal to local levels.

The United States has never had an official federal-centered approach for mental health care facilities, entrusting its responsibility to the states throughout the history. The earliest initiatives in this field took place in the 18th century, when Virginia built its first asylum and Pennsylvania Hospital reserved its basement to house individuals with mental disorders (Sundararaman, 2009). During the 19th century, other services were built, but their overall lack of quality was alarming. Even then, researchers and professionals in the mental health field attempted to implement the principles of the so-called public health, focusing on prevention and early intervention, but the funds were in the hands of the local governments, which prevented significant advances in this direction.

What is left is that we have many citizens who are mentally ill and are not receiving treatment. However the patients who are able to receive treatment are only able to have some treatment covered. Health insurers are responsible for covering the immensely large cost of substantial treatment, a mixture of medication and therapy; since therapy is highly priced, less reliable, and time consuming; patients typically do not receive treatment for therapy. Health insurers would much rather cover medication because it is cheaper, it heals patients faster, and it is more reliable than therapy. However, medication is not made to heal, but to only coax symptoms of a mental illness (Sandberg).

Under the Employee Retirement Income Security Act (ERISA) and the Mental Health Parity and Addiction Equity Act (MHPAEA), plan participants and providers are entitled to receive access to certain plan information, reasons for denial of coverage or benefits, and copies of the medical necessity criteria used to make benefit determinations. In order to facilitate these document requests, NYSPA prepared form letters that can be used by psychiatrists and patients. Through document requests and sharing of materials, they hope to identify ongoing patterns and practices of discrimination, the next step in ensuring full enforcement of the parity laws.

The article, “Deliberate Misdiagnosis in mental Health Practice,” by Kirk & Kutchins, was written after analyzing a survey given to clinicians on under or over-diagnosing their clients. There are times when a clinician feels pressure to use a label that they do not believe is the best description of a person’s symptoms. The first one describe in this article is the pressure by insurance companies often require a diagnosis to obtain reimbursement for treatment. Other times, insurance companies will only cover certain treatment, so an incorrect diagnosis must be given so that the client will continue to receive treatment. One example I see often is that substance abuse treatment is not covered by TriCare (insurance used by military members and

This leaves the client and their family in a sticky situation. They can pay cash out of pocket for the treatment, wait for a mental health diagnosis so that the insurance companies will pay, or look for an alternative form of treatment that might be more effective an affordable. Sometimes the insurance company actually will refuse to pay any more benefits for the client for the year since he or she has been in and out of treatment centers so many times that

In the mental health profession of counseling, therapy, psychology, psychiatric and social services ethical dilemmas are faced primarily on a daily basis. Being that mental health professionals are working with clients who are often fragile and vulnerable, they must develop an intense awareness of ethical issues. On the other hand, mental health professionals would never intentionally harm their clients, students or colleagues and others whom they work with. Unfortunately, good intentions are not enough to ensure that wrong doings will not occur and mental health professionals have no choice but to make ethically determined decisions. Depending upon the experience and expertise of the professional determines the outcome of the ethical