Faster than a speeding bullet, more powerful than a locomotive, and able to leap tall buildings in a single bound, so begins almost every episode of ‘50s, The Adventures of Superman.
Of course, this is fiction, but Superman appears to be a risk-taker. As most of us know, he was from another planet, Krypton. Maybe on his planet, it was commonplace, but on Earth, each one was a risk. Also, by accomplishing these feats, Superman had dignity from us mere earthlings.
Is there dignity in risk-taking by any of us? Does this make us feel better before, during and after the risk as its climax approaches? At that juncture, where we left with any dignity or was it lost? Probably not much, but it might have been worth the experience when one gets an exhilarating feeling.
Dignity of risk refers to the concept of affording a person, including one with a disability, the right (dignity) to take reasonable choices to learn, grow and have a better quality of life.
Most practitioners and peers understand this concept of dignity of risk as the chance, choice, or possibility of someone failing in their goals or capacity to self-manage independently. Contrary to popular belief, more often than not, individuals do succeed as long the risk is not too strenuous.
It means there is a level of self-worth promoted by people when we are left to our own devices to make choices for ourselves. We can call it self-esteem or self-respect; people generally feel better about themselves when they are allowed to fail or succeed at whatever they set out to do.
Indisputably, the broad range between disregard and extreme vigilance carries serious implications for clinical practices and peer specialists in mental health. Even within our personal lives, we have friends and family we care for. Yet, we wonder where a specific line in the sand is drawn when it comes to caregiving or caring for a friend or a family member struggling to maintain safe living independently.
For most psychiatrists, therapists, and peers, the terrain between the two poles of dereliction of duty and overshielding is even more unclear. Sometimes, an in-dispute for all these types of teams occurs with workers from different ethical points of view.
Inherently, a major issue with complete autonomy and ‘free will when one is in treatment is twofold:
- Treatment is a contract between a provider and participant, which carries with it the conjecture of compliance/or active participation in one’s care.
- Without direction and control from providers, therapists, peers, and psychiatrists will run the risk of being irresponsible or doing malpractice should something unforeseen happen to a client that may have been preventable should the client have been watched more closely during his time in active treatment.
The limits of the law are written and very clear. It is written down on paper and stored on computers, so they are indisputable. Therefore, we must abide by them, whether in sessions with our psychiatrists, therapists, peers or in everyday situations.
Every state in the US has a regulatory body that decides where this line is drawn between negligence and dignity of risk for peer specialists, therapists, and psychiatrists.
Peer specialists are also working on actively drawing up plans to manage risk more effectively to reduce the likelihood of harm to clients and ourselves. Due to this, we can collaborate more closely with our professional counterparts.
However, there is a very small space between theory and practice when the line gets unfocused when figuring out what to do with a person whose dignity of risk of homicidal or suicidal behaviour is unclear or cannot be assessed.
In situations like this, besides our ‘gut’ feeling, on which side of the negligence versus overprotection spectrum do our instincts tell us to decide? What will help us and inform us of our choice? With the help and assistance of our supervisors, we can make an effective list.
Below are only five
- What will be the alliance we have with our client?
- What is the current ‘professional’ relationship between the client and us?
- What is the trust between the two of us?
- What is the mental status of the individuals?
- What the level of mental distress is seen?
Remembering that peer specialists are professionals also. More importantly, what does it say for practitioners when we decide? Are we taking risks by working with others we don’t know? Hey, we take risks by walking out the front door. Common ground is important here to keep the conversation going.
Boundaries are crucial and must be set at the beginning so the risks of stepping stones do not happen regularly and dignity is kept.
Dignity and risk often occur when we grow in our existence and relationships within the human experience. Whether this is a friend, family, co-worker or supervisor, we take many risks, which can turn into increased dignity.
Be careful when we take risks, but dignity is a good feeling. Occasionally this has happened to me, so take risks and improve our dignity for the days of our lives.
Howard Diamond is a certified peer specialist from Long Island.