With reference to: Stovall et al. (2016) ‘Ethics and the treatment of the mental
With reference to: Stovall et al. (2016) ‘Ethics and the treatment of the mentally ill, homeless person: a perspective on psychiatry resident training’ and at least two other academic articles which you have identified yourself by using the OU Library and other relevant K314 materials, address the following question:
Critically discuss and explore the ethical issues raised in Rodney’s case study and consider how the team managing Rodney’s care might best support his complex health and social needs.
Fictional case study: Rodney
Rodney is a 35-year-old black man whose parents were born in Nigeria. He has been described as having ‘a long history of schizophrenia and homelessness’. He has been ‘in and out of the mental health system’ for several years. On one occasion, he was held in a police cell because there were no beds available in the local acute mental health unit. He felt that the police officers avoided him when he was in the cell because he has mental health problems. The experience of being in crisis in a cell was a major trauma in itself for Rodney, and it has had the effect of making him suspicious of all institutional environments: ‘I was in total chaos; I had just tried to kill myself. I was in a prison cell. I had no belt, no shoelaces, no shoes, because they wouldn’t let me have them, but no one would talk to me. No one.’
Rodney feels that it is not just the police that lack empathy when dealing with people in crisis. The problem extends to professionals: ‘The sort of people you need when you are in crisis are the ones who still see you as a person, who remember you are not just a problem blowing up in their face; you need empathy, someone who sees you as a person.’
Rodney consistently declines medication, and is frequently described by practitioners as being ‘prone to delusions’ that mean he is unable to easily live around others in supervised settings. When the community mental health team (CMHT) began to work with him, they established he had some long-standing substance misuse issues, principally involving alcohol. However, he insisted that he had found his own housing and was managing well enough without their help. Rodney’s sister maintains contact with him and she liaises with the community team, encouraging Rodney to attend the drop-in sessions they run at a local café.
Subsequent team visits found him living in an abandoned caravan, where he had rigged up a supply of water and a wood stove for heating and cooking. The treatment team concluded that in spite of his unconventional living situation and persistent symptoms, he showed an ability to care for himself. This treatment team’s decision, however, is regularly questioned by some new members of the team. They assert he should be involuntarily hospitalised before he hurts himself or someone else.
(Based on an original case study, Mr. R, in Stovall, et al., 2016): Stovall, J., Fleisch, S. B., McQuistion, H. L., Hackman, A., Harris, T. (2016). ‘Ethics and the Treatment of the Mentally Ill, Homeless Person: a Perspective on Psychiatry Resident Training’. Academic Psychiatry, 40(4), 612–616. https://doi.org/ 10.1007/ s40596-015-0330-0
How to approach TMA 03
Learning Guide 11, which discusses complex care needs, will be a key source of information for this TMA. In responding to this question, you may consider the ways in which Rodney’s ethnicity could be relevant to his circumstances, and which interventions or support might be considered suitable for his particular needs.
You may wish to use your learning from Block 1 and Block 2 to explore complex care needs and possible services in the statutory and independent sector that could support Rodney. You may also wish to consider the barriers which might prevent him accessing services.
Learning Guide 6 is also a key source of information as it provides you with information on the team working and ethical concepts to further support the discussion.
You may include discussion of the Care Programme Approach which is outlined in Learning Guide 12. However, references to the newer Community Mental Health Framework will also be accepted.
Stovall et al. (2016) will help inform your discussion of ethical practice and the pressures on practitioners to decide on suitable and safe interventions (or non-interventions). However, your discussion should include a range of sources, and references should be presented in a conventional academic essay style (e.g., using in-text citations and a reference list).
Academic papers you select to help you answer this question should include discussion about diverse populations covering issues relating to equality, diversity, inclusivity and issues of power. You should add a brief sentence or two in the main body of the essay to indicate how you found this written source.
Further guidance
You should start by providing a brief introduction setting out what your essay is going to cover. Ensure that you explain here how you are going to cover all aspects of the question.
For the main body of the essay, you will be expected to define complex needs. You will then consider the team response for Rodney. In doing so, you will need to explore opposing sides of the treatment team’s debates in order to find the best way forward for Rodney, using the ethical principles highlighted in Stovall et al. (2016) and Learning Guide 6. To make this a critical discussion you need to look at the tensions and construct an argument for how Rodney might be best supported, including overcoming barriers to access.
Sum up the main points in your conclusion at the end. Ensure that your references are recorded in a conventional academic essay style, using in-text citations and a reference list.
https://www5.open.ac.uk/library/library-resources you can find the articles on this link or on another site and then verify they are on this library