The field of ethics is expanding and has assumed new significance as a compulsory part of study for psychiatrists and all mental health professionals. Ethics and Mental Health: The Patient, Profession and Community presents a new approach to these ethical dilemmas that have become an increasing part of modern practice. The book begins by exploring current normative theories of psychiatric ethics. It describes how empirical methods can make codes of conduct more representative of professional values. Considering their previous work, concepts of justice, and the moderate communitarian position, the authors outline their methodology, which argues that mental health professionals exist within a perpetual state of tension, caused by conflicts between the Hippocratic Oath, personal values, notions of social justice, and the potentially harmful influences of their social role. Applying their theory to the area of involuntary psychiatric treatment, the authors address the context of psychiatric practice and the moral agency of psychiatrists. They outline the different influences on the craft of psychiatry to better illustrate the diverse forces that impact moral deliberation and the practice of ethics in mental health. In doing so, they cover areas as diverse as cultural, economic, scientific, and political domains. The final section of the book applies the methodology to contemporary problems in mental health ethics, formulating how mental health clinicians can approach these quandaries. The book brings a new perspective to classic dilemmas from the past, to contemporary challenges, and in anticipation, to new concerns that will inevitably arise in a dynamic and complex professional context.

This is a pioneering book and is the first book of its kind. The book offers guidance about the use of ECT in adolescents with up to date and concise information. The editors of the book are Neera Ghaziuddin MD, MRCPsych (University of Michigan, Ann Arbor, USA), and Garry Walter, MD, Ph.D. (University of Sydney, Australia) who spear-headed the re-introduction of ECT as a safe and an effective treatment option for a subgroup of adolescents with severe psychiatric disorders. This book offers a review of the existing literature, firsthand experience of the authors regarded as experts in their respective field and highly informative case descriptions. The book also offers a historical perspective, explaining the reasons why ECT fell out of favor, particularly among child and adolescent psychiatrists, and the resulting lost opportunity to train clinicians over many decades. Starting around the 1990's, there has been a revival of interest, probably due to the recognition of treatment resistance among some adolescents. The chapter about the mechanism of action ECT describes biological mechanisms that are known to underlie mental illness. Other chapters include a discussion about stigma associated with ECT, ethical and informed consent issues, a step-by-step guidance about using ECT, use of anesthesia during ECT and the interaction between ECT and medications. In addition, its use in youth with general medical and neurological disorders is described. The chapter detailing side effects of the treatment dispels misinformation and indicates that ECT is a safe, painless and a highly effective procedure which is not associated with any lasting side effects. The use of ECT in the treatment of specific disorders (mood and psychotic disorders, severe self-injury and catatonia) is described under respective chapters using case examples. Lay readers, families and patients considering this treatment will find the question and answer subsections at the end of each chapter useful. The experience of the editors gives a unique insight to ECT, dispelling myths and stigma and guides the reader about its proper use.

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