Reference no: EM133779684

Case Scenario

For this case, I am a social worker working in a mental health clinic that serves a diverse population with varying mental health needs. One day, Jamie, a client diagnosed with severe depression and a history of suicidal ideation, expresses wanting to stop taking his medication. He communicated that the side effects of his medications are making his mental health worse, and he wants to try managing his depression without medication. As his social worker, this decision is concerning due to the risk of his symptoms worsening and the potential of him reverting back to his previous self-harming behaviours.

Jamie's request puts me a in a difficult position where I need to balance advocating for my client and limiting their autonomy. The mental health clinic that I work in prioritizes client safety while respecting clients' autonomy and as social worker I am forced to take my client's mental state and potential risk into consideration.

According to the NASW Code of Ethics, social workers should respect and promotes the client's right to self-determination. "Social workers respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals" (NASW, 2021, 1.02). However, in cases where a client's decisions may pose a significant risk to themselves or others, the social worker is well within their right to intervene and steer the client in a safer direction. "Social workers may limit clients' right to self-determination when, in the social workers' professional judgment, clients' actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others" (NASW, 2021, 1.02). In this case, it is my duty to consider Jamie's current mental health and symptoms, previous history, and the potential consequences of discontinuing medication.

In addition to my role as the social worker, the agency should provide an environment where ethical decision-making and client safety are both encouraged. Based on this situation, I would likely consult other colleagues and/or my supervisor for added insight on how to proceed, but their position on management of this situation may cause conflict if it varies from my own. Tensions could arise from differing interpretations of ethical guidelines, views on a client's right to autonomy, risk management protocols, or personal beliefs regarding mental health treatment.

Despite potential conflicts that may arise, I would have to prioritize compromise with Jamie and potentially my colleagues to achieve and effective outcome. Options like alternative medications or changes in dosage coupled with additional therapy sessions to address Jamie's concerns and safety should be considered. Additionally, the decision to limit Jamie's autonomy would be an important decision that would likely lead to negative feelings and may strain my relationship with my client. However, while navigating this situation, it would be important to acknowledge that the case has the potential to become dysfunctional if the resolution does not address Jamie's needs or if I feel unsupported. Because I may begin to question my ability to balance autonomy and safety and experience discomfort, it would be essential for me to be in continuous dialogue with my agency and colleagues regarding further training and ethical decision-making.

Discuss the following:

Identify and describe the value conflict in the case to which you are replying.

Identify the values of the parties involved in the value conflict, using the NASW Code of Ethics. Identify any personal values that may also be present. You do not have to describe how you would resolve this conflict.