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On compliance and ethics: After the heart and the container comes the work

My prior blogs, “Why is compliance the heart of any behavioral health organization?” and “Building a safety container in compliance work to support ethics”, laid the foundation for the work we do at Addiction Campuses to prevent, find and fix compliance and ethics issues. Because even though we intend always to be ethical, the reality is that in our industry we will always be learning and improving from our mistakes. In the behavioral health sector, I have found it is often difficult to find professionals or programs willing to admit or address mistakes. I remember as a new counselor coming into the field in 1987, I was told that we “circle inward and shoot ourselves in this field” and it saddened me. But my experience has shown that we often look for others making mistakes, point the finger with shame and blame, and hope it avoids others looking more closely at us. With the reality of our work today being even more complex, I think this is an important area for us to address as an industry. When I started in the addiction treatment arena, we had different units for the mental health, alcohol and drug patients with distinct staff and programming. Today, we all know, the patients we serve often have multiple co-occurring issues with traumatic histories as well as complicated medical and family dynamics. To treat them effectively and meet their needs, it seems like the last thing we need is fear of being blamed and shamed, being the victim of gossip and negativity, or contributing to the current ethical crisis of our industry. The complexity of our patients is not something we can change but our quality and safe clinical programs can meet their needs when we have engaged staff and empowered teams to take care of them. The work to be done, in my opinion, is to fully accept and discuss the core of the ethical issues which are our people. When we have staff in a burn and churn environment without needed skills, abilities and support, it is a breeding ground for unethical behavior, and when we have command and control leadership styles, it further damages the trust and safety in an organization. In the last 90 days, I attended compliance training and a conference with the Health Care Compliance Association (HCCA) and became certified in healthcare compliance (CHC). What I was most impressed with was the open and transparent conversations about the mistakes made in all organizations and how important it is to work toward the culture of compliance and the tone at the top that supports compliance and ethics. I am excited to be bringing the HCCA’s standards and resources to Addiction Campuses so we can focus on the elements of a compliance program, the effectiveness of the program and adjust as needed. As more behavioral health organizations build compliance and ethics programs that are preventative rather than reactive, we will have a shared focus on the heart of the organization (our people) with safety containers (our policies, procedures and protocols) and an industry culture that supports the daily work of managing ethical behavior and outcomes. Maeve O’Neill, MEd, LCDC, LPC-S, CHC, CDWF/CDTLF, is vice president of compliance for Addiction Campuses.

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