11 - The ethical base for mental health services: ‘the three ACEs’

Summary

Intellect has a keen eye for method and technique but is blind to aim and value.

Albert Einstein

Guiding principles at the international level

We argue in this book that the twin foundations for planning community mental health services are the evidence base and the ethical base. In Chapter 10 we discussed one side of the coin,the evidence base for such planning. The aim of this chapter is to discuss the main principles which should form the ethical base of mental health services. Principles are important because they necessarily guide and shape both aspects of the general organization and specific daily service activities. Even if these ethical issues are not made explicit in planning and service delivery, they will exert a profound influence on clinical practice.We believe that good clinical practice will be the manifestation of a sound ethical base. Indeed it is good practice to make this ethical framework explicit early in a planning cycle, so that the infrastructure of values that underpins any project can be debated by the relevant constituent interest groups at an early stage. It is our experience that if this is not done, then value conflicts will occur later, and may slow, limit or even undermine the viability of the work.

In relation to the matrix model, we shall suggest in this chapter, that each service should produce a written statement of the principles which are meant to guide the clinical activities of all staff. This process will often mean the adaptation and reconfirmation of previously produced declarations at the national or international levels for local use.