Ethical Dilemmas in Mental Health Nursing

Nursing is a rewarding field in which to work, and nurses care for and support patients in all types of specialties. Mental health nursing works with a complex set of patients. Because of the complicated nature of psychiatric illness, ethical dilemmas arise in mental health nursing that other fields don't have to contend with 2.

Mental Health Nursing

Mental health nurses work with people from all backgrounds to assess and treat psychiatric issues through work in the hospital and the community 1. Mental health nurses are registered nurses who have gone through training for licensure. A mental health nurse can undergo advanced training specifically for the care of psychiatric patients.


The scope of nursing has evolved from the early role of a nurse carrying out orders at a doctor’s bidding. According to Jennifer Wilson-Barnett, contributor for the Journal of Medical Ethics, the role of a nurse has expanded, and nurses are now more involved in contributing to patient outcomes 2. Some treatments associated with psychiatric care might cause ethical dilemmas for a nurse involved with treatment decisions for a patient.


Some ethical dilemmas are specific to mental health nursing and are seen rarely in other areas of practice 2. An involuntary commitment to care, or a decision made by a family member on behalf of the patient, is often made to protect the patient from harming herself or others. The patient might contest this decision. This presents an ethical dilemma because psychiatric patients have the same legal rights as other citizens. The decision is often made by administration for the organization, but the mental health nurse is the person who must care for the patient.


Health care organizations have strict codes of confidentiality. If a mental health patient divulges information to a nurse that is potentially harmful to himself or someone else, the nurse faces a dilemma in reporting the information. A psychiatric patient cannot have a stable frame of mind for the information to even be truthful. A mental health nurse faces difficult decisions by caring for psychiatric patients who reveal sensitive information that might end up harming others.


Before attempting to resolve an ethical dilemma, a nurse must consider any legal precedent that is associated with the situation. Breaking the law to resolve an ethical dilemma is in itself a questionable act. According to Loyola Marymount University, the first step in resolving an ethical dilemma is to consider the potential consequences. A nurse should ask herself who might be hurt or helped by the decision. Most nurses follow the standards set by nursing pioneer Florence Nightingale to protect and not harm a patient, and act in a way that respects the person’s dignity.