New River Valley Community Services (NRVCS) is a state organization that provides mental health services to the New River Valley residents. The nature of the services provided, which range from care provider to therapist, coupled with the intimate and at times invasiveness into clients' private lives demands that staff adhere to a strict code of ethics. Some of the provisions of the code of ethics may at first glance appear to be common sense; however, these provisions became a part of the code of ethics often due to conflicts of interest, loss of therapeutic relationship, or potential harm inflicted on clients, and were added in to ensure that future staff have a clear guide to honorable and ethical behavior as set forth by these provisions. The code of ethics adopted by NRVCS is easy to understand and comprehensive enough to cover the vast majority of ethical conflicts that can arise within organizations that provide a wide range of services to a diverse community.
Human Rights and Ethics Code
The following is a very brief overview of the extensive provisions set forth in NRVCS's code of ethics. The very first provision is for staff to respect and enhance the clients' dignity and rights, followed by a detailed description of the client's rights. Client's rights include, but are not limited to: impartial access to services regardless of ethnicity, race, religion, sex, or handicap; to participate in the development and implantation of treatment plan; to receive written information on programs, policies, procedures, schedules, and rules; to have all information regarding staff, services, relationships, and medical information kept confidential; to receive a copy, inspect, or correct any written information in their charts; to consent or withdraw consent for services; to express preferences; to a safe, clean environment; to clean, comfortable clothing; to be able to communicate freely in writing, via telephone, or in person with complete privacy; to express religious freedom and preferences; to compensation for work performed according to Fair Labor Standards Act; to be treated with dignity and respect at all times; to the same human, civil, and legal rights afforded to all citizens; to not have any rights restricted or denied without due process; and to not have any rights, benefits, or privileges be denied due to being a recipient of mental health services. (New River Valley Community Services, 2007)
Staff is encouraged to recognize the importance of relationships both within the client's family and with the community at large, and staff are expected to encourage, restore, and assist with the building of these relationships. The code stresses that staff are state mandated reporters, and as such staff must be mindful of the client's and the community's safety and to report any suspicion of abuse or exploitation to or by the client and any threats of harm to self or others. Staff is expected to promote the client's wellbeing, foster interests within society, and encourage independence. Staff is to provide services only within the confines of expertise (i.e. CNA's should not be providing counseling services). Staff should actively seek to understand client's culture and social diversity and remain sensitive to and respectful of the differences in each individual. (New River Valley Community Services, 2007)
Staff should be aware of and take steps to eliminate any conflict of interest, including dual/multiple relationships and exploiting clients for personal, financial, or business interests. Staff should never engage in sexual activity, contact, or relations with clients or clients' family and friends; staff should never provide services to someone with whom the staff has previously had an intimate relationship with. Staff should make every effort to ensure services are not interrupted due to unavailability, illness, death, or disability by calling the scheduling staff to schedule replacement. Staff is expected to familiarize themselves with NRVCS's policies and procedures and if a question arises about whether an action, activity, or behavior is unethical, staff will seek guidance from direct supervisor or ethical advisor. The code is summarized by the statement that any violation of the Human Rights and Ethics Code is subject to dismissal and legal action, should the violation warrant it. (New River Valley Community Services, 2007)
Evaluation
The ethical principles or provisions are identified, and the goals of the code of ethics are clear and outlined in a cohesive manner. Additionally, during the mandatory annual training examples are given that serve to explain the reasons behind the provisions, because new staff may not understand why having a dual relationship with a client, among the other provisions, is considered unethical. The grievance procedures are not outlined within the code of ethics itself; rather grievance procedures are detailed within their own section in the policies and procedures manual. At most, the final statement gives a dire warning about how important adhering to the code of ethics is and the potential consequences of violating these codes.
This code of ethics would be stronger if it included a provision for supervisor/employee, employee/employee, and intern/volunteer relationships, since ethics also govern these relationships. The fact that these relationships are not addressed within the code of ethics leaves a glaring hole. The potential that dual relationships can exist within the work environment of a mental health organization is great, since employees also may need to access mental health services or counseling. With the rise in the use of technology in treatment and paperwork, phone counseling, and internet usage, there should also be provisions for the use of technology within the code of ethics plan (Kaplan, 2006).
Enforceability
During the author's tenure with this organization, innumerable employees were terminated due to violating clients' rights or by proven unethical behavior. By having employees to sign a statement annually saying that they have read and agree to abide by the organization's Human Rights and Ethics Code before leaving the annual Human Rights and Ethics training in order to maintain or gain employment, in essence, Human Rights and Ethics Code becomes a contract between the organization and the employee (Steinberger, 2007). With the code of ethics being a contract and having the grievance policies, although separate from the code of ethics, that outline the grievance procedures, there would rarely be a problem in enforcing the code.
Conclusion
It is not surprising that the provisions of the code of ethics for an organization that deals with the mental and physical health of the general public is stressed so strongly. Too frequently, the code of ethics is violated which results in irreparable harm to clients and the confidence of the community in the services provided by the organization, so it is vitally important that that code of ethics be clear, comprehensible, and enforceable. While the author feels that NRVCS's Human Rights and Ethics Code is comprehensive, it could be further improved by including inter-staff relationships, the use of technology to treat and communicate in regards to client information confidentiality, and the grievance procedures. By including these items, NRVCS would further ensure employees act ethically and protect the individuals that the organization serves.
References
Kaplan, D. (2006). Ethics update: ethical use of technology in counseling. American Counseling Association: Counseling Today Online. Retrieved from http://www.counseling.org/Publications/CounselingTodayArticles.aspx?AGui...
New River Valley Community Services. (2007). Human rights and ethics. New River Valley Community Services Policies and Procedures Manual.
Steinberger, J. (2007). Is this contract valid? Learn the nitty gritty about what makes an agreement legally binding. Entrepreneur. Retrieved from http://www.entrepreneur.com/management/legalcenter/legalissuescolumnistj...
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