Overview of Client Rights
Client rights are the basic considerations and protections to which all clients are entitled. These rights do not have to be earned or specifically requested and they cannot be withheld from the client as punishment or discipline. It is the responsibility of all staff members in the behavioral health setting, including peer support specialists, to ensure that client rights are protected. Peer support specialists may be assigned to complete intake functions with clients in some settings. One of the first things that should be done at intake is to review the client’s rights. Client rights include the right to:
- Informed Consent
- Crisis Support
- Respect and Dignity
Informed consent is the one of the most basic and important concepts in behavioral health services, because it establishes the client’s independence and right to self-determination in receiving services. In recent years, the concept of informed consent has broadened to include the idea of “client-centered or client-directed treatment.” This means that the client has the right to choose or refuse treatment, to set goals for treatment outcomes and to define his or her recovery.
In order to make good decisions, the client needs to fully understand what will happen in the treatment process, the risks and benefits of participating in or refusing treatment and the possible outcomes of treatment.
Ensuring that the consent given by clients is fully informed requires careful attention to a number of dimensions:
- The client must realize that they have the right and the power to consent to – and more importantly, to refuse to consent to – treatment. The client must have the rational capacity to provide consent, the client’s must comprehend the explanation of available options.
- Information about the proposed length of treatment and the conditions for terminating services should also be provided. The policy for making complaints or resolving disputes should be explained to the client.
- Finally, the client must be fully informed of the costs of services and how to access third-party payments if applicable.
Cultural issues are important considerations in determining whether truly informed consent has been obtained. Lack of understanding of professional terminology, language barriers, and poor reading skills may reduce a client’s true understanding of what is contained in the consent for treatment. Cultural values may also affect a client’s willingness to ask questions as part of the informed consent process. The peer support specialist should make every effort to ensure that consent is truly voluntary and truly informed.
The environment in which behavioral health care services are delivered must be safe for both the person receiving services and the staff members. This includes the physical space as well as the way people treat each other in the setting. Peer support specialists have significant responsibility for maintaining safety in the clinical environment.
In order to maintain safety, peer support specialists must learn to recognize and respond to unsafe behaviors, situations and environments. This requires monitoring and observing the persons receiving services and their environments to maintain safety and security. It also means reporting these signs to the supervisor or other appropriate staff when they occur.
Most agencies have established health and safety protocols to ensure safety. Part of the peer support specialist’s job is to ensure that everyone involved complies with these procedures. Some safety protocols apply to routine, day-to-day situations, while others are put into place only during disaster situations.
Recognizing and Responding to Safety Risks
Some of the most important skills that a peer support specialist can acquire are those that go into maintaining safety at all times for persons receiving services, staff, and community members. These skills include:
- recognizing the signs and symptoms of behavioral disorders that can lead to risky or unsafe behaviors
- understanding the legal boundaries regarding what can be done to minimize risk at any given time
- having knowledge of treatment risks including medication side effects and adverse effects
- being aware of institutional issues that can trigger outbursts if a person receiving services is treated without respect or in a humiliating manner.
High Risk Behaviors Associated with Substance Use Disorders
Peer support specialists in both substance abuse and mental health treatment programs need to be constantly alert for high risk behaviors related to substance use disorders. Individuals who are actively using substances can engage in behavior that is dangerous in regard to acquiring money to buy drugs, activities involved in getting the drugs, and using unsafe paraphernalia. Some of these risky behaviors are:
- Criminal behavior associated with drug seeking
- Poor self-care and health problems
- Reckless behavior
- Impulsiveness or impaired judgment
- Unsafe sexual practices
- Suicidal behavior
It is important to remember that even if an individual has achieved abstinence from alcohol or other drugs, they may not necessarily have stopped engaging in other risky behaviors. Also, the consequences of the risky behaviors that an individual engaged in during their active substance use may last well into the recovery process.
Module 7 Activity: Understanding Client Safety
Step One: Make a list of possible long-term consequences from risky behaviors that are associated with substance use disorders. If you are in recovery from a substance use disorder, did you experience any of these consequences? How might you talk to your clients about this issue? Note: This activity is for reflection only and does not need to be submitted along with your workbook.
Notes for Reflection: Did you include possible effects of unsafe sexual practices such as unintended pregnancy, prenatal substance exposure or sexually transmitted diseases? What about legal consequences from prior criminal behavior? You might also have listed health problems, included those resulting from poor self-care over a long period of time. Finally, what consequences to relationships and social networks might have resulted from risky behaviors during active drinking or drug use.
Step Two: Click the box below to complete the Module 7 Activity: Understanding Client Safety.