• Explain the controversy that surrounds dissociative disorders.
• Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.
• Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
• Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important.

Case 1: A 42-year-old female complains of progressive weight gain of 20 pounds over the last year, fatigue, postural dizziness, loss of memory, slow speech, deepening of her voice, dry skin, constipation, and cold intolerance. She claims her menses have been irregular x 1 year. She has an 18-year-old daughter, and has been attempting to have another child with her new partner. She has been unsuccessful. 

Read the following case study and answer the reflective questions.  Please provide evidence-based rationales for your answers.  APA, 7th ed. must be followed. 

The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations. In their role, PMHNPs can ensure a smooth transition from emergency mental health care to follow-up care, and also bridge the physical–mental health divide in healthcare.

In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric emergencies, and identify evidence-based suicide and violence risk assessments. 

TO PREPARE

· Review this week’s Learning Resources and consider the insights they provide about psychiatric emergencies and the ethical and legal issues surrounding these events.

THE ASSIGNMENT

In 2–3 pages, address the following:

· Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released.

· Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.

· Explain the difference between capacity and competency in mental health contexts.

· Select one of the following topics, and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.

· Identify one evidence-based suicide risk assessment that you could use to screen patients.

· Identify one evidence-based violence risk assessment that you could use to screen patients.

Case Study:Dr. Emily Clark, a seasoned cardiologist at Mercy General Hospital, is presented with a challenging case involving Mr. Rajan Patel, a 58-year-old man who recently immigrated from India. Mr. Patel has been diagnosed with a significant heart condition that requires a surgical procedure. While the surgery has a high success rate, like all medical procedures, it comes with its own set of risks and benefits. Mr. Patel, whose primary language is Gujarati, has limited proficiency in English. He nods and smiles politely during consultations, giving Dr. Clark the impression that he understands. However, when asked to explain the procedure back to her, it becomes evident that he does not fully grasp the intricacies of the surgery or its potential complications. Dr. Clark recognizes the importance of informed consent and wants to ensure that Mr. Patel truly understands the procedure, its risks, and its benefits. She believes in the ethical principle of autonomy, which dictates that every patient has the right to make decisions about their own body and health. However, she also acknowledges the principle of beneficence, which compels her to act in the best interest of her patient.  

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:1. briefly summarize the facts surrounding the case study. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.

• Identify who is involved or affected by the ethical problem or issue.
• Access and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
  • Apply the three components outlined in the Ethical Decision-Making Model media.
• Analyze the factors that contributed to the ethical problem or issue identified in the case study.
  • Describe the factors that contributed to the problem or issue and explain how they contributed.

1. Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
   • In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.
     • Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
     • Review the Think Critically About Source Quality resource.
       • Assess the credibility of the information source.
       • Assess the relevance of the information source.
2. Discuss the effectiveness of the communication approaches present in a case study.
   • Describe how the health care professional in the case study communicated with others.
   • Assess instances where the professional communicated effectively or ineffectively.
   • Explain which communication approaches should be used and which ones should be avoided.
   • Describe the consequences of using effective and non-effective communication approaches.
3. Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
   • Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
   • Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
   • Discuss the key lessons this case provides for health care professionals.
4. Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
   • Describe the proposed solution.
   • Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
   • Discuss how likely it is the proposed solution will foster professional collaboration.
5. Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
   • Apply the principles of effective composition.
   • Determine the proper application of the rules of grammar and mechanics.
6. Write using APA style for in-text citations, quotes, and references.
   • Determine the proper application of APA formatting requirements and scholarly writing standards.
   • Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.