Transcript Ethical Considerations in Acute Psychiatric Settings

Ethical Considerations:
Millennials and Mental
Health
Presented by
Patrick Gorman, LMSW
Goals & Objectives
• Apply critical thinking to evaluate moral and ethical dilemmas
• Increase awareness as to the prevalence of moral and ethical
dilemmas as it relates to the millennial population
•Evaluate and discuss a multitude of vignettes pertaining to ethics
•Participation is encouraged
Background
•Licensed Master of Social Work (LMSW)
•Non-violent Crisis Intervention Facilitator
•Former Ethics Committee member at :
- Signature Healthcare Brockton Hospital ,
Brockton MA (2008- 2012)
- Arbor Behavioral Health Pembroke Hospital,
Pembroke, MA (2002-2007)
•Relocated to Round Rock, TX from Boston, MA in 2013
•Seton Psychiatric Emergency Department (SPED) 2014-2016
•Current Ethics Committee Member for Seton Healthcare
•Current Mobile Crisis Intervention Clinician for Cross Creek Hospital
Exercise 1
The Trolley Problem
a classic thought experiment
Problem A
Should you switch that switch?
Problem A
Problem B
These scenarios seem different…
Perspectives
Consequentialism
the class of normative
ethical theories
holding that the
consequences of one's
conduct are the
ultimate basis for any
judgment about the
rightness or
wrongness of that
conduct.
Deontology
in which rules and
moral duty are
central, and derives
the rightness or
wrongness of one's
conduct from the
character of the
behavior itself rather
than the outcomes of
the conduct.
Problems with
Consequentialism
 This perspective does not look very
imaginatively as to what counts as a
consequence?
Our focus…
Defining the
Millennial
Generation
Generation Y, Generation Me, Echo Boomers, Peter Pan
Generation
1983 – 2001
Noteworthy Statistics
 Largest generation since the baby boomers
 Millennials will comprise more than one in three of
adult Americans by 2020.
 First generation in history that have grown up
totally immersed in a world of digital technology
 Made up nearly 40% of substance abuse treatment
admission in 2015
Commonly Believed to
be:
 Not contributing
 No manners
 Obscene
 Glorify drugs and crime
 Cuss
 Lazy
 Entitled
 Selfish
• More concerned Facebook than
relationships
• Disrespectful
• Unpatriotic
• Divided
• Don’t value anything
• Unappreciative
• Don’t contribute
Accomplishments and ideas
100
90
80
70
60
50
40
30
20
10
0
Have Bachelor's
Degree
Don't Need
Classroom
Influenced by
Peers
Value Flexibility
Skeptical of
Others
Priorities and Aspirations
60
50
40
30
20
10
0
Good
Parent
Succesful Helping
Marriage Others
Owning
Living
High Pay Free Time
Home Religiously
Fame
Stress and Anxiety
6
5
4
3
2
1
0
Over 34
Under 34
The average high school
student today has the
same level of anxiety as
the average psychiatric
patient in the early 1950s.
Suicide is the second
leading killer of college
students in the US.
December 30, 2016
Polk County, Georgia
Social Media as a tool
Ethical considerations?
Vignette
Oncoming AM Emergency
Department social worker
receives handoff that a
18y/o male had been
transferred to an inpatient
psychiatric hospital
overnight following a
suicide attempt on campus
after a break-up with his
girlfriend.
Documentation revealed
that he was under-the
influence of ETOH with a
BAL of 0.20 upon arrival
to the ED.
Vignette
A woman identifying herself
as the patients mother presents
to the ED requesting
information about her son.
There is no ROI on file.
She is visibly distraught and
frightened. She stated that she
received a text message from
her sons friend indicating he
had been brought to ED via
ambulance. And “that is all
that I know?”
What dilemmas exist in
this scenario?
Ethical
Considerations in
Acute Psychiatric
Settings
Fraught with potential
issues related to :
• Self-governance
• Freedom of
expression
• dignity
• Inherent power
differential
• Group Think
Keeping ourselves in check
Self-Awareness
Triggers ?
Prejudices?
Compassion Fatigue?
Group Think ?
Use Multimedia
Let Go of Your
Agenda
Cultural
Competency
In Summary
 The Millennials are coming. Lots of them.
 There’s a lot of misinformation out there.
 Understand your own biases.
 Expand your cultural understanding.
 Do what you’re good at, but be open to adjustment.
Questions? Comments?
References

http://www.cdc.gov/nchs/data/hus/hus13.pdf,

http://www.alternet.org/drugs/millennials-overwhelmingly-oppose-drug-war-and-support-legalmarijuana,

http://www.millennialmarketing.com/2009/12/millennials-are-they-healthier-than-earlier-generations/,

http://www.vocativ.com/culture/society/generation-y/,

http://bmjopen.bmj.com/content/6/10/e011827/suppl/DC1

Pew Research, “Pew Social Trends: Millennials Confident Connected Open To Change”, 2010. PDF

Alison Bryant Ludden and Amy R. Wolfson, “Understanding Adolescent Caffeine Use: Connecting
Use Patterns With Expectancies, Reasons, and Sleep Health Educ Behav” June 2010 37: 330-342,
first published on October 26, 2009

Data & Statistics." Centers for Disease Control and Prevention. Centers for Disease Control and
Prevention, 29 Sept. 2014. Web. 05 Dec. 2014
Thank You.