Prevention: Ethics, responsibility, and commitment to public well-being.

Abstract

A crisis in mental health services related to the inverse relation between access and supply versus demand has emerged (Satcher, 2000). Research suggests that only 10 to 15% of those with mental illness receive appropriate services (U.S. Surgeon General [USSG], 1999[USSG], , 2001. Access to mental health setvices and the cultural appropriateness of those services pose particular problems for minority and low socioeconomic status (SES) populations (USSG, 2001). The disparity of services affects general health care as well as mental health care (Agency for Healthcare Research and Quality, 2004; Institute of Medicine, 2002). The efficacy of prevention to address current national health and mental health needs has been clearly supported in the literature (Durlak .& Wells, 1997;Greenberg, Domitrovich, & Bumbarger, 2001). These disparities in the availability of mental health services exert a moral imperative to expand health initiatives to prevent human suffering before it occurs (Albee, 1986) and provide an ethical justification to further augment effective prevention efforts.

Guidelines for Prevention in Psychology.

“…The Guidelines and Principles for Accreditation of Programs in Professional Psychology (APA, 2009) stress the importance of education and training that cover the breadth of psychology. Research suggests that prevention helps to reduce the need for remedial interventions (Schwartz & Hage, 2009; Vera et al, 2009). Therefore, remediation and prevention are best viewed as complementary to one another, not in conflict.…”

“…Informed consent poses particular challenges with regard to ensuring that individuals and multiple stakeholders comprehend the implications of their participation. Other ethical issues to consider include equitable selection, confidentiality, cultural relevancy, socially and culturally competent research and practice (APA, 2010, Ethical Standards 8.02 and 2.01b), and researcher bias (Schwartz & Hage, 2009). It is important to evaluate the long-term effects of preventive interventions (Brown & Liao, 1999), especially as they relate to historically marginalized groups.…”

“…In particular, conceptualizations about best practices in prevention, particularly at the environmental level, are lacking (Snyder & Elliott, 2005). In addition, the Ethical Principles of Psychologists and Code of Conduct (American Psychological Association [APA], 2010) do not fully address unique ethical issues that may arise in prevention (e.g., Schwartz & Hage, 2009). Therefore, psychologists engaged in prevention can benefit from a set of guidelines that address and inform prevention practices.…”

Rejecting the Null: Research and Social Justice Means Asking Different Questions

“…Social justice research is not complete when the study is finished and the results have been analyzed and discussed. A major criterion for the value of social justice research is the extent to which it contributes toward liberation of the community involved (Morrow, 2007; Schwartz & Hage, 2009). When considering implications of research findings, researchers need to work with community partners to identify the changes that they want to see occur, and then develop action steps that outline specifically how each member will work toward this goal.…”