Ethical and Legal Aspects of Mental Health Nursing Practice

This essay critically examines ethical and legal issues in mental health nursing, using a case study of a patient named Fergal suffering from severe depression and alcohol addiction. The essay applies the bio-psycho-social approach to analyze Fergal's condition, considering biological, psychological, and social factors. It then delves into ethical principles like consent, autonomy, discrimination, and duty of care, alongside relevant laws and regulations such as the Human Rights Act 1998 and the Mental Healthcare Act 2017. The discussion addresses ethical challenges faced by health professionals, including accountability and the role of regulatory bodies like the NMC. The essay highlights the importance of communication, awareness, and decision-making in providing ethical and effective mental health care, emphasizing the need to balance patient rights with the responsibility to provide appropriate treatment. The essay underscores the significance of the patient's perspective and the application of ethical principles in mental health settings, offering insights into the complexities of mental health nursing practice.

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MENTAL HEALTH: ETHICAL CONCERN
Treatment of mental health patients:
Ethical concern for health professionals

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MENTAL HEALTH: ETHICAL CONCERN
Table of Contents
Introduction................................................................................................................................2
Fregal Scenario...........................................................................................................................2
Part (1)........................................................................................................................................3
Bio-Psycho-Social Approach:................................................................................................3
Inventions for Fregal by using Bio-Psycho-Social Approach................................................4
 Social Intervention.......................................................................................................4
 Psychological Intervention..........................................................................................4
Part (2)........................................................................................................................................4
Ethics and Law.......................................................................................................................4
Consent and Autonomy..........................................................................................................4
Discrimination and Justice.....................................................................................................5
Duty of Care and Beneficence...............................................................................................5
Key issues and legal status of the person: Evaluation of laws and theories..........................5
Health professionals dealing with ethical challenges:...........................................................6
Major International and national regulatory authorities of medical practices.......................7
Part (3)........................................................................................................................................7
Accountability and NMC...........................................................................................................7
NMC Competences................................................................................................................8

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Communication Therapy....................................................................................................8
Creating Awareness...........................................................................................................9
Decision making.................................................................................................................9
Conclusion..................................................................................................................................9
References................................................................................................................................10
Introduction
Mental disorder refers to an abnormal mental state of a person, in which he thinks and
behaves in a different manner as comparative to normal people. Some people have to suffer
from the mental illness because of accidental cases, physical injuries in brain, substance
misused or sudden loss of loved ones. These types of patient need a lot of emotional support
for the wellbeing of their physical and mental health.
Fregal Scenario
In this case, we will analysis the mental health of a person named ‘Fergal’ who is 63 years
old and suffering from severe depression and addict of drinking alcohol up to a dangerous
level. Fergal had hospitalised because his sister wants to see him as a normal person. He is
addict to alcohol and drinks heavily on regular bases. Doctors diagnosed that Fregal is
suffering from severe depression and mental disorder because of substance misuse. Fregal is
having a long term mental disorder which leads towards an unusual pattern in thoughts and
emotions (Stolt, et al., 2018).
He thinks that he is responsible for the death of his seven year old son but in reality his son
died because of the accident from a bike. Intensive care and suitable treatment is needed for
the wellbeing of the mental health patients. The doctors, psychiatrist and nurses should treat
the patient with humanity and need to take care about their dignity (NHS, 2019). Many
international regulatory authorities and government authorities set the ethical norms and code
of conduct for the protection of mental health patients. Most of the countries have psychiatrist
and nurses in HMO’s (Health Maintenance Organisations) working for the wellbeing of the
patients but for handling these types of crucial cases, a lot of care is needed by the nurses,
family members and doctors (Research, 2019).

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Part (1)
Bio-Psycho-Social Approach:
According to the case study, Fregal has been suffering from severe mental disorder. He even
did not take bath and shaved from a long time. The BPS model of analysing the mental
health stated that there are three characteristics responsible for the mental health of any
person. These factors are as follows:
(a) Biological factors: These factors represent the genetic characteristics present inside
the person from the birth which are responsible for his mental illness. Infections,
damages and brain injuries also lead towards the poor mental conditions of the person.
Those persons who have a family history of mental illness are more likely to develop
the mental disorder in comparison of people with normal family background, because
of the genetic effect of family. Disturbance in early foetus brain development and or
suffering from trauma from an early stage is responsible for the poor mental
conditions of the person. Sometimes, insufficient consumption of nutrition and
consumption of toxins or illicit drugs from a long time may also results in a mental
disorder (Ioannidis, 2019).
As discussed with this case, Fregal is not able to do his daily tasks. He has a
very poor memory and low BMI. He had to admit to mental care hospitals for
improving his mental condition. Fregal was eating very poorly and not taking
essential nutrition and minerals which are required for the proper functioning of brain
and body. He drinks heavily and excessive use of alcohol results in a severe damage
on his mental and physical health (Ioannidis, 2019).
(b) Psychological Factors: Psychological factors are related to the mental state of a
person which is affected by various factors like physical, emotional or sexual abuse
faced by the person. Early loss of close ones or parents, neglecting by family
members and society, social isolation, frustrations and break in relationships are
responsible for the poor mental health conditions of the person (Loni Crumb, 2019).
Sudden loss of a close one and poor economic conditions may also results in the
awkward and unusual behaviour of the person. Unpleasant feelings or emotions are
realised by the person because of his disturb functioning of brain. Sometimes the
person may adapt the violence in his behaviour (Gil, et al., 2019).

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(c) Social factors: living in isolation and living without parents from an early childhood,
lack of social support, rejection by society or friends, bullying by colleagues and
classmates, unemployment, work pressure at working place and poor financial
conditions are the major cause of the abnormal behaviour pattern adopted by the
person (Bulletin, 2006).
Inventions for Fregal by using Bio-Psycho-Social Approach
 Social Intervention
Fregal was separated from his wife after the death of his son. He was not able to continue his
job because of over drinking and excessive use of alcohol. He has very few friends and they
are also heavy drinkers. He has only one sister who sometimes visited to him. This situation
is representing lack of support from his family member and society. This could also be a
reason for his disturbed mental condition. A full family and social support is required for the
healing of Fregal from his critical condition (Courtney Esther, 2019).
 Psychological Intervention
As discussed with this case, the son of Fregal died at an early age in a bike accident. At that
time only Fregal was taking care of his son. He found himself very guilty and he thinks that
he is responsible for the death of his son. He started to drink heavily just after the funeral of
his son and did not continue his job because of his habit of excessive drinking. He had to
suffer from poor economic condition because he spent most of his money on expensive cider.
This problem arises because of fluctuations in the psychological factors of the person.
Sometimes this type of accidental cases results in the mental disorder of the person (WebMD,
2019).
Part (2)
Ethics and Law
Consent and Autonomy
According to the Human Right Act 1998, every human has a right to live with a prohibition
of torture. Everyone has a right of security with prohibition of discrimination. As discussed
with this case, Fregal has to treat with a polite manner with humanity. The health
professionals should deal with him in order to ensure about his dignity and human rights.

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Some other laws are also made by the government and international authorities in order to
improve the mental health conditions of persons and for protecting the public from unusual
and unpredicted nature of mentally sick persons. Although the safety and wellbeing of the
mentally ill person is also need to be taken care. The regulatory authorities ensure about the
supportive and sufficient treatment of the patient with intensive care provided by the health
care professionals (Health, 2019).
Laws and regulatory authorities help in maintaining the fair and ethical medical practices
without the exploitation of mental health patients. Some ethical code of conducts and
standards are established by these authorities in order to ensure about the moral and ethical
conducts of nurses and health care professionals. These laws are aimed to protect the human
rights of mental health patients (Bulletin, 2006). Some of the laws are as follows:
Discrimination and Justice
Fregal is discriminated by his wife after the death of his son. In spite of having supportive
relationships they both got separated after the death of his son. According to the case study
Fregal does not find himself supported by society, colleagues and family members. He has
few friends and they are also addict to the consumption of alcohol up to a dangerous level. It
can be said that Fregal is discriminated by most of the people of society except her sister.
According to the case, the sister of Fregal admitted him into a hospital and wants to see him
as a normal and well behaved person. She wants to see him physically and mentally fit.
Duty of Care and Beneficence
As discussed with this case, the sister of Fregal was worried about him. She observes that he
is deteriorating in physical and mental health. She contacted to mental health team to ensure
about the sound health of Fregal by receiving the help and treatments from mental health
organisations. She realised that Fregal should get rid of his habit of heavy drinking. For
achieving a normal health condition, Fregal was admitted in St. Ann’s mental health care
hospital in London and once he was detoxed by doctors and he returned to home as a sober
and normal person but again the condition of Fregal becomes very critical (Council, 2019).
Key issues and legal status of the person: Evaluation of laws and theories
Fregal is facing a severe depression and addict of use of alcohol at a dangerous level because
of the unsound mental position. He received the warning from his doctors that he is near the

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death, if he would continue to drink at the massive level. He even did not want to come out
from his position because he wants to meet his son in heaven. This unusual and illogical
behavior is adopted by Fregal because of his unsound mental condition, depression and
substance misuse (Courtney Esther, 2019).
As discussed in this case study, Fregal is about to die because of excessive use of alcohol,
three to four times near around the death anniversary of his son. The friends, family members
or even the people of the society should inform to NHS about the suicidal tendencies of
Fregal. However Fregal did not accept that he want to commit suicide. He was saying that
committing suicide is a mental sin but he wants to die with natural causes to reunite his son in
heaven. The health care professionals of NHS have to behave in a decent and supportive way
with Fregal to improve his abnormal thinking while maintaining the human rights of the
Fregal (Executives, 2019).
Health professionals dealing with ethical challenges:
The Mental Healthcare Act 2017 (MHCA) discussed about the rights of patients with mental
disorder. It focuses over the ethical and legal duties and responsibilities of the mental health
professionals who are dealing with the treatments of mentally ill persons. The mental health
care professionals not only responsible in help the patient in improving their mental
conditions but also to provide a caring and helpful environment to the patients (Donovan &
Gijbels, 2006). This act provides the human rights even to those patients whose mental
conditions are very critical. A strict need of care giver nurses is required in this field for
treating the patients in such a manner in which they feel comfortable (Fumincelli, et al.,
2019). The government of every country provide certain rights to every human being. They
should be treated in a torturing way. The way of treatment should be moral and ethical. In
case any psychiatrist, doctors, physicians and nurses found treating the mental patients
against humanity and ethical norms, they will be punished by the law of government
(Council, 2019).
Even the norms of confidentiality are also attached with the act. The health care professionals
are not supposed to disclose the personal information of the patients to the public. In case,
they disclose the information, they would be penalised or punished by the act. The General
Medical Councils (GMC) of the country set the ethical standard for the health care
professionals of UK. GMC works to protect patients by providing supportive and caring
practices through doctors and nurses (Council, 2019).

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Major International and national regulatory authorities of medical practices:
The various government and international regulatory authorities such as WPA (World
Psychiatrist Association), American Academy of Psychiatry and NCBI (National Institute for
health and care excellence) stated that all the health care professionals have to take care about
the dignity of the patient. They should treat the patient with humanity. They are not supposed
to exploit the patients. Health care nurses and doctors should provide the best care to mental
health patients (Dunn, 2019). Psychiatrist and nurses are aimed to provide best care and
medical treatments to improve the mental health conditions inside the country. Moreover,
health care professionals should create awareness related to mental health problems in the
public (Samuel Adjorlolo & Bambi, 2016).
Part (3)
Accountability and NMC
Nursing department is one of the crucial departments in the field of medical profession. The
nurses are responsible for caring the patients in order to overcome from their illness. The
NMC (Nursing and Midwifery Council) defined the role of nurses. They stated that NMC
exist to protect the human rights of public. They are making the country ensure that only
those persons are allowed to do nursing practices who meet the requirements of a good nurse.
NMC may even take the actions against nurses, midwifery and nursing associates if found
guilty (Council, 2019).
NMC maintain the register of all the nurses practicing throughout the country. If anyone
found working as a nurse without registration in NMC, he will be suited by the law. NMC set
the ethical standard and code of conduct to the nurses, midwives and nursing associates for
the welfare of humanity. These standards are the fundamental part of the medical profession
(Council, 2019).
The major expected code of conducts for health professionals and nurses:
 Treat the patients with kindness, respect and compassion with upholding their dignity.
 Effectively provide the fundamental care and treatment for the patients.
 Respect the human rights of every person including mental health patients.
 Listen to the patients carefully and respond to their concerns and preferences.

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 Encourage and empower the people and patients in taking decisions for the wellbeing
of their health.
 Make sure that the needs of the patients are responded in a proper manner.
 Respect the human right of privacy and confidentiality.
 Recognise and understand the behavior of the patient and communicate effectively
with the patient. Take help of verbal and nonverbal communication using suitable
gestures.
 Provide best possible medical services to the client and make a record of your patient
history.
 Be accountable for your decisions.
 Be open-up and clear if any harm or misconduct took place.
 Always work for the protection of the client in order to establish a safe and
satisfactory health conditions throughout the public.
With the help of all these code of conducts, NMC maintain ethical standard in the medical
profession (Janie B. Butts, 2019).
NMC Competences
Communication Therapy
The patients and people should be well-communicated by the health care professionals and
the regulatory authorities in order to improve the mental health of persons. Fregal need to be
communicated by the professionals about his condition so that he can improve his position
and knows the reality.
As discussed with this case, the doctors of Fregal warned him because of his excessive use of
alcohol and tell him that he is about to die if he would continue to drink. Fregal thinks that he
is responsible for the death of his Son. Fregal should be treated very politely by the doctors
and nurses in order to remove his depression. He has to make understand that he is not
responsible for the death of his son because it was an accidental case. Moreover supplements
and medical aid should be given to him to stop his drinking habits. The health care
professionals make sure about the proper treatment of Fregal with intensive care (fund,
2019).
Creating Awareness

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People should be aware about the mental disorder of persons for several reasons. Awareness
should be generated over the consequences of excessive use of alcohol by the persons. By
creating awareness in the people of society, the safety and well- being of the health of the
persons can be ensured. Awareness should also be generated with reference to taking
balanced diet on a daily bases and doing regular exercise with proper hygiene maintenance.
As discussed with this case, Fregal was suffering from a severe depression because of the
sudden death of his loving son. Just after the funeral of his son, he started to drink up to a
dangerous level. He did not take bath or shave from a long time. He did not want to eat
properly and continue the use of alcohol in a heavy amount. He even found himself in
struggling position for fulfilling his daily routine tasks. All these characteristics showed that
the mental health of Fregal is very serious and dangerous. He admitted in St. Ann’s for
receiving the treatment with ensurity of maintaining his human rights and dignity. Moreover,
with the help of care and treatment on a daily bases, the condition of Fregal may be improved
(Anderson KK, 2007).
Decision making
Final decision regarding the treatment of Fregal has to be taken by health professionals in
order to improve the mental and physical health of Fregal. According to the various codes of
conducts of NMC, the patient has to be treated with kindness. The human rights of the person
should be protected (Burbage, 2019). As discussed with this case the nurses and psychiatrists
should treat the Fregal with a lot of care. Permission should be taken before giving any
medicines (Ashok Malla, 2019). A polite and supportive environment should be created by
team members of mental hospital and health care professionals in order to fulfil the
requirement of Fregal and ensure about the best treatment received by the patient (Malcolm P
Forbes, 2018).
Conclusion
On the bases of the analysis of the case study, it can be concluded that patients having severe
depression and mental disorder should be treated with a lot of care and concern. With the
help of supportive and favourable behavior of nurses and health care professionals, the
mental conditions of the patients could be improved. For achieving better mental health
conditions throughout the country, the people should be aware about the symptoms of mental
health illness. Proper diagnose and treatment should be provided to the patients in a healthy

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manner while ensuring the respect of human rights. The nurses, doctors and other health care
professionals should be well trained and aware about their responsibilities. The ethical
standard for medical professionals should be strictly followed. If any medical professional
found guilty and captured violating the ethical standard, a tough punishment should be
imposed by the laws of the government. All these practices are maintained for the protection
of human rights and to improve the conditions of mental health patients.
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