In an earlier edition of Cambridge Quarterly,
in the “Networking News” section (CQ
Vol 9, No 4), Larry Gottlieb sought advice on ethics committee
assembly and policy implementation for a community mental
health center. One concern mentioned is that staff members
frequently encounter ethical issues—specifically,
questions about competency, informed consent, and treatment
refusal—regarding the care of clients whose decisionmaking
abilities are impaired by chronic mental illness and/or
substance abuse. My response offers a suggestion for policy
development and implementation, which may be integrated
into guiding staff members of community mental health centers
toward a model of care planning that is centered on clients'
experiences of their treatments and on relationship-building
among clients, community members, and mental health professionals.