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Mental Health Article Critique Essay


In the last three decades, cases of mental illnesses have increased significantly in the United States, exerting a huge burden on society as well as the healthcare system. One of the major challenges that mental health professionals experience in their job is poor technical linkage between mental care specialists and family caregivers of persons with mental illnesses. Family members bear a heavy burden of care and have to be involved in the treatment. In her article titled “Ethical Challenges and Legal Issues for Mental Health Professionals Working with Family Caregivers of Individuals with Serious Mental Illness,” Katherine R.Bellesheim (2016)summarizes the challenges encountered when interacting with caregivers for persons with serious mental illnesses. A quick read of the article confirms that it is well written as the author’s argument is consistent. Further, she achieves her research objectives and gives validity to her work by citing peer-reviewed works.

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Bellesheim begins her article by giving a historical account of the transition of mental care from the era of involuntary institutionalization of individuals with serious mental illnesses (SRI) to the modern world of the integrative and family-based system. One of the primary obligations of mental health professionals nowadays is to protect the rights of their patients. This duty has inspired the formulation and implementation of mental health policies that affect the family caregivers of persons with SMI. The author acknowledges the complexity of the caregiver-patient-physician relationship and refers to the 2010 ethical guidelines that were published for mental health professionals working with caregivers. The first guideline discussed by Bellesheim is the need for physicians and mental health professionals to define the role of a caregiver they are working with before identifying the appropriate ethical obligations.

The author then discusses the four important roles of family caregivers. According to Bellesheim (2016), caregivers act as legal guardians, therapy clients, financial clients, as well as collaterals of therapy. The author then explains what these roles entail. For example, a family caregiver can act as a legal guardian when the person with a serious mental illness cannot give consent either for reasons of disability or age. In such cases, the legal guardian will be the one sanctioning important medical decisions. In my view, highlighting the specific roles of family caregivers set a informative tone that continued throughout the article. The author then argues that ethical challenges arise when the roles are not clearly delineated. Continuing the discussion on why it is important to consider the specific roles of practitioners, the author cites Fisher (2009), who is an authority in the area, which increases the credibility of his assertions.

While continuing to expound on her hypothesis, Bellesheim discusses the unmet needs of family caregivers and the problems they cause. This discussion takes legal and ethical dimensions. For instance, a legal challenge that came to my attention in this discussion is that the complicated federal rules guiding communication between mental health professionals and immediate family members and caregivers often make practitioners unwilling to share information with caregivers. One ethical challenge is that caregivers do not receive enough support from the mental health system. The author cites extensive literature, highlighting the ethical and legal challenges faced by family caregivers. While the article clearly highlighted the ethical and legal issues, I feel like the author focused more on the issues pertaining to caregivers. Based on the discussion, the caregivers are a vulnerable group and mental health professionals have a moral imperative to intervene on their behalf.

The author proceeds to discuss the ethical principles and standards that guide the relationship between mental health professionals, the patients, and family caregivers. The first principle cited is informed consent, which is extremely important in addressing the ethical and legal issues. APA ethical standards, for example, Standard 3.07, 3.10, 10.02a, which address informed consent, are covered in detail. This focus is commendable as it helps readers to understand the importance of informed consent. Other notable practice standards that the author highlights are confidentiality and the need to balance between beneficence and rights. Bellesheim clearly defines and describes these standards, providing appropriate references to the APA ethics codes. The description of the standards is comprehensive, further adding to the readers’ knowledge and understanding of the topic.

Still within the scope and aim of the article, Bellesheim discusses the legal issues and shifts in the balance between individual rights and societal welfare. In this section, the author highlights situations when it is necessary to break confidentiality. For example, confidentiality should be broken when family caregivers face an increased risk of harm from the individual with serious mental illness. The author also provides a detailed discussion of involuntary treatment and cases of abuse and neglect. Within the category of involuntary treatment, the author touches on the debate of involuntary treatment and where the country is today with regards to it. Bellesheim also critically examines the legal standards that guide involuntary treatment, emphasizing the need for practitioners to be aware of changing laws and standards. In line with the discussion on the ethical issues and legal standards, the author concludes the article by providing guidelines for mental health professionals working with family caregivers.

This article was objective and well organized. The author was strategic in arranging the subtopics as evidenced in the introduction where she gives a historical account of the mental health care system as well as the discussion of the roles of family caregivers, their unmet needs as well as ethical principles and legal standards applied. Further, every section had transitions that enabled the reader to connect the author’s ideas. Bellesheim also used simple language that can be understood by a non-specialist. As a reader, I was able to understand the association between the legal and ethical guidelines and the unmet needs of family caregivers.

Bellesheim’s article is consistent in its capacity to be informative. The author adequately describes the ethical challenges and legal issues for mental health professionals working with family caregivers of individuals with serious mental illnesses. She provides a solid background by giving a historical context of the mental health system in the United States. The extensive literature cited further contributes to the credibility of his arguments. Her conclusion was also sensible and consistent with what she mentioned in the discussion. In addition, her tone was measures and she avoided making exaggerated claims, which emphasized scholastic nature of her study. The clear structure of the article also made it easy for the reader to follow the author’s argument. However, I felt like Bellesheim focused more on the needs of family caregivers compared to mental health professionals, clearly expressing a bias towards the former. In this regard, future research on the needs of mental health professionals is necessary.

Bellesheim, K. R. (October 02, 2016). Ethical challenges and legal issues for mental health professionals working with family caregivers of individuals with serious mental illness. Ethics & Behavior, 26, 7, 607-620.
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