Managing Ethical Dilemmas in Mental Health and Addiction Recovery

Individuals in healthcare may experience unusual or emotionally charged situations with coworkers and clients, leading to ethical dilemmas. According to the International Journal of Environmental Research and Public Health, “Moral dilemmas arise when two or more principles or values conflict and there are mutually inconsistent courses of action.” Driftwood Recovery provides comprehensive training and staff support to help clinicians navigate ethical dilemmas with dignity and compassion. 

5 Common Ethical Dilemmas in Healthcare and How to Address Them

Ethics is a cornerstone of good healthcare. Ethical guidelines protect clients and healthcare professionals from legal issues, ensuring people have access to relevant and appropriate care. Identifying and adequately addressing moral dilemmas improves treatment outcomes for clients and reduces workplace stress for clinicians. Below are five common ethical dilemmas encountered in healthcare and how professionals can manage them. 

#1. Maintaining Client Privacy While Addressing Threats to Public Safety

Client privacy is essential to the therapeutic process. Ensuring confidentiality and privacy builds trust and confidence in the client-clinician relationship. However, some situations may make it challenging to maintain client privacy while balancing public health and safety. For example, clinicians may have to break confidentiality if a client expresses intent to harm themselves or others. Finding the right balance between ensuring public safety and maintaining client trust involves practicing good judgment. Driftwood Recovery has strict guidelines and protocols for managing client privacy and adhering to privacy laws. HIPAA and other laws ensure healthcare workers know when to break and when to protect client confidentiality. 

#2. Informed Consent and Clients With Limited Capacity to Understand Treatment Options

The effects of chronic substance abuse, complex mental health issues, and developmental factors may impact a client’s capacity to understand their treatment options. Individuals with a decreased capacity to recognize their needs and identify effective treatment plans may have difficulty understanding their situation. Healthcare professionals are responsible for ensuring clients under their care give informed consent for treatment services. Some clinicians may struggle with determining if a client has the mental capacity to provide informed consent. 

Ongoing assessments and ethical judgment help healthcare workers recognize when a client needs an advocate. Driftwood Recovery ensures all staff know how to identify the signs of a client’s capacity to give informed consent. In cases where clients may not be able to consent, the clinical team follows legal guidelines for working with client families or representatives to make the best decisions for their care. 

#3. Refusal of Treatment Despite Severe or Life-Threatening Consequences

Individuals experiencing complex mental health issues, substance use disorder, or dual diagnosis may refuse treatment despite a high risk of relapse or self-harming behaviors. Mentally competent adults have the right to refuse treatment regardless of how this may affect their physical or emotional health. However, determining mental competency can sometimes be difficult and cause moral dilemmas for healthcare professionals. 

Studies have shown that when “a patient’s illness is affecting their capacity to refuse care, and they are considered a danger to themselves or to others, the healthcare provider is expected to treat the patient regardless of their refusal.” Every state has different laws regarding involuntary treatment. Driftwood Recovery educates clinicians on state, local, and federal laws for treating patients who have refused care. 

#4. Balancing Respect for Cultural Beliefs With Evidence-Based Care

Some people’s cultural beliefs may clash with evidence-based care, making it difficult to treat conditions impacting the client’s mental and physical health. Responding with compassion and curiosity instead of judgment can help healthcare professionals develop tailored approaches to care that meet client needs while respecting their cultural beliefs. 

Mental health and addiction recovery experts balance respect for client cultural beliefs with evidence-based treatments by doing the following: 

• Conducting cultural competency training 
• Actively listening to client needs and preferences 
• Collaborating with clients and their families to tailor treatment 
• Using culturally appropriate assessment tools 
• Providing access to bilingual counselors 
• Encouraging family involvement in treatment 

Healthcare professionals can respect cultural beliefs and stigmas surrounding treatment while gently introducing evidence-based modalities into treatment plans. 

#5. Setting Professional Boundaries With Compassionate Care

Boundaries may become blurred sometimes, making it difficult for healthcare professionals to set limits on how they interact with clients. Professionals set clear boundaries with clients by doing the following: 

• Defining professional roles at the start of treatment 
• Maintaining consistent and clear communication 
• Avoiding dual relationships, such as becoming a personal friend with therapy clients 
• Practicing self-awareness and mindfulness during interactions with clients 
• Consulting coworkers or supervisors if boundary issues become a problem 
• Respecting client autonomy

Boundaries help clients avoid confusion or miscommunication during treatment. Maintaining a professional distance from clients while treating them with dignity and compassion improves the effectiveness of treatment services and helps clients learn to set their own healthy boundaries. 

Mental health and addiction recovery programs involve many gray areas that may lead to ethical dilemmas for healthcare professionals. Strict workplace policies ensure staff members understand when they must legally report certain situations and how to react appropriately to moral dilemmas. Experts are humans, too, and may experience a lack of judgment. Comprehensive workplace guidelines help professionals know how to respond to various complex or sensitive situations. Driftwood Recovery trains staff to recognize and address potentially challenging interactions using compassion, objectivity, and transparency. Healthcare professionals benefit from relying on their supervisors and coworkers to help them navigate unusual issues that may have them worried about providing the best care to clients. To learn more about our policies, call (512) 759-8330.

According to the National Institute of Mental Health (NIMH), an estimated 21.0 million adults in the U.S. experience a depressive episode. Moreover, depression often co-occurs with substance use disorder (SUD). While millions of people are impacted by depression and SUD, women are disproportionately impacted by depression. Women are twice as likely to experience depression, as NIMH notes 10.3% of females compared to 6.2% of males experience a major depressive episode. Addressing depression for women and peripartum depression stigma is vital for sustained recovery.

As the Centers for Disease Control and Prevention (CDC) notes, about 1 in 10 women of reproductive age in the U.S. experience a major depressive episode. In addition, during and after pregnancy, about 1 in 8 women experience depression. Yet, the challenges women experience with depression rooted in gendered experiences like pregnancy and birth have often been overlooked. Mental Health America (MHA) notes that myths have led people to believe depression is a part of being a woman. Thus, understanding peripartum depression stigma can provide insight into the challenges women face in rebuilding their lives and maintaining recovery.

At Driftwood Recovery, we recognize how important a sober community is for building a strong foundation for sustained recovery. With our commitment to connection and community, you can find the support you need to thrive. Through a community of compassion, respect, and support, you are reminded that you are not alone on your recovery journey. You can use alumni services to dismantle peripartum depression stigma.

Expanding your understanding of depression and gendered experiences can support maintaining recovery as you pursue goals like becoming a parent.

Understanding Depression Recovery and Relapse

Due to your time in treatment, you are likely aware that challenges with co-occurring depression can complicate treatment and recovery. Similarly, withdrawal and abstinence in early recovery can increase your risk of experiencing depressive symptoms post-treatment. The thought of experiencing depressive symptoms during a vulnerable period of recovery can feel understandably scary. Moreover, you may be concerned about relapsing in your depression and or SUD. Some signs of a potential relapse can include low mood, irritability, fatigue, and social withdrawal. 

You may question how you can prevent a depression relapse. Recognizing triggers is an important first step in addressing depressive symptoms:

• Family changes
  • Loss of a loved one
• Health issues
  • Chronic illnesses
• Financial difficulties
  • Unemployment
  • Low income
• Hormonal changes
  • Pregnancy
  • Menopause

Looking at different potential depression triggers speaks to the various types of depression and their roots. 

Types of Depression

When people think of depression, they are often thinking of non-clinical depression, major depression, and seasonal depression. However, several different types of depression can impact well-being and recovery. Some of the different types of depression include:

• Major depressive disorder (MDD)
• Persistent depressive disorder (PDD)
• Seasonal affective disorder (SAD)
• Premenstrual dysphoric disorder (PMDD)
• Peripartum depression

PMDD and peripartum depression are examples of gender-related depression influenced by reproductive hormones. Thus, forms of depression like peripartum depression highlight fears of peripartum depression stigma in recovery. Yet, what exactly is peripartum depression? Is peripartum different than prenatal depression and postpartum depression?

What Is Peripartum Depression?

Peripartum depression highlights the presence of depression before, during, and after pregnancy rather than breaking them into prenatal and postpartum depression. According to “Perinatal Depression (Formerly Postpartum)” from the American Psychiatric Association (APA), perinatal or peripartum depression replaces the term postpartum to account for depression occurring during pregnancy and/or after childbirth. APA notes in “What Is Perinatal Depression?” the term perinatal recognizes that depression related to having a baby often begins during pregnancy rather than only after birth. 

As the Maternal and Infant Health Assessment (MIHA) states, unlike the baby blues, which is common after birth, peripartum depression is characterized by intense feelings of sadness, anxiety, or despair during or after pregnancy. The symptoms of peripartum depression can last for two weeks or longer and occur at any time, from conception to a year postpartum. Therefore, addressing peripartum depression sitgma is significant for supporting the health and well-being of you and your baby.

Addressing Peripartum Depression Stigma

Peripartum depression can be caused by factors like a family history, a difficult or traumatic pregnancy or birth, SUD, or lack of social support. Yet, peripartum depression stigma continues to stigmatize women and new parents. Images of pregnancy and parenthood often paint a beautiful picture of joy. 

Although pregnancy and parenthood can be joyful, they also have their stressors. Thus, many new parents are left feeling like they are failing when their feelings and experiences do not match the rosy images presented to them. Thoughts of failure and feelings of guilt coupled with peripartum depression stigma can make you feel too ashamed to reach out for support. As a result, peripartum depression stigma is a major barrier to help-seeking behaviors.

Impact of Peripartum Depression Stigma on Well-Being

According to Frontiers in Psychiatry, the possible impact of peripartum depression stigma on perinatal women can harm the well-being of you and your baby:

• Preeclampsia
• Low birth weight 
• Premature delivery 
• Cognitive and emotional development problems 
• Co-occurring mental health disorders

Thus, dismantling peripartum depression stigma is vital to well-being and preventing depression relapse in recovery.

Dismantling Peripartum Depression Stigma at Driftwood Recovery

The thought of peripartum depression and peripartum depression stigma in your recovery is understandably distressing. However, you can support your well-being and reduce the impact of peripartum depression stigma by engaging in help-seeking behaviors like a support group and therapy. At Driftwood Recovery, we know access to a peer-driven network can give you the tools and support you need to thrive in recovery. 

With a strong and vibrant sober community, you can find the service, accountability, and encouragement needed to meet and overcome the challenges life throws at you. Whether you are thinking about becoming a parent or are in the process of becoming a parent, being involved in an active alumni program can help you lead the courageous life you deserve. 

SUD and depression often co-occur, and depressive symptoms can return in early recovery. The risk of depressive symptoms in recovery can be particularly harmful to females, who are twice as likely to develop depression compared to males. Moreover, depression related to sex, like peripartum depression in pregnancy and birth, can increase concerns about depression relapse. The ability to reduce depression in recovery for women of reproductive age is compounded by peripartum depression stigma. However, with greater awareness and a strong support network, you can combat stigma, peripartum depression, and other types of depression to thrive in recovery. Therefore, at Driftwood Recovery, we are committed to providing a peer-driven community of alumni for sustained recovery. Call us at (512) 759-8330 today.