Ethical Principles for Practice and Business Operation of Collaborative Mental Health Services

For the professions of psychology to fulfill their potential, mental health professionals must uphold public trust in the professions’ ethical and scientific integrity across all domains.  Some activities that fall within the field of operational psychology carry a high risk of undermining public trust and professional integrity, thereby diminishing the reputation and effectiveness of the mental health professions.

Current Ethics Guidelines, Standards and Codes in mental health provide an excellent foundation and are applicable and binding to licensed professionals.  Ethical requirements do not in all cases provide adequate guidance to facilitate the moral discernment necessary for operational business activity. 

Mental health professionals would benefit from supplementary ethical guidance in this specialty area.  The following Fundamental Principles and Guidelines are intended as a preliminary framework for such supplemental guidance.  As preliminary discussion, these principles and guidelines highlight problem areas that are incumbent on psychologists and other mental health professionals rather than provide definitive solutions.

Psychological and Mental Health services as a profession are based upon the core ethical principles of beneficence and nonmaleficence, or “do no harm.” 

Fundamental Principles and Guidelines for Professionals Engaged in Business Operations

1.      Beneficence and Nonmaleficence

Ethical concerns are at their highest when mental health expertise may result in harm to patients, other professionals and the public trust in Mental Health as a profession.  The awareness, expectation, or intention of causing harm, with whatever justification, is in direct tension with the core ethical principles of beneficence and nonmaleficence.  The greater the possible harm the greater the likelihood that participation in a specific activity is not ethically permissible for psychologists or other mental health professionals. 

2.      Full Awareness

The risk of compromised professional ethics is also heightened when, because of secrecy, compartmentalization, strategic manipulation or a lack of transparency, mental health professionals lack full awareness of the business behavior and contracts in which they may be participating.  Mental health professionals must have the necessary information to make informed legal, ethical and clinical practice decisions.

3.      Acceptability

The ethical acceptability of any particular action to be undertaken by mental health professionals serving in business operations must be evaluated independently of the purported effectiveness of the proposed business activities including but not limited to contracted and related legal requirements.  The fact that a particular action is considered necessary, potentially successful or even successful with respect to the business of healthcare does not make it ethical behavior for psychologists and other mental health professionals.

4.      Monitoring and Accountability

The ethical practice of psychology and mental health in every domain of services requires mechanisms for ethical monitoring and accountability by psychologists and other mental health professionals and for obtaining ethics consultation and support.  To be effective these mechanisms must be independent of business and administrative pressures and must exhibit a degree of transparency and accountability consistent with state and federal law, business contracts, organizational policy and bylaws, and ethical and moral imperatives.  Development of comprehensive oversight, accountability, and consultation mechanisms for psychologists and other mental health professionals practicing in business operations is essential. 

 5.      Refusal to Condone and Participate

Psychologists and other mental health professionals have a duty to refuse to condone and participate in activities that will substantially violate their professional ethics.  Some mental health professionals, by virtue of their position within an organization’s administrative structure or their roles in certain operations, will face enormous challenges in refusing to support or participate in actions that are deemed unlawful or lawful (under relevant bodies of law) but that violate their professional ethics.  They must therefore have realistic opportunities for refusal without threat of reprisal.

Abstracted and revised from the Ethics of Operational Psychology Workshop, Brookline, Massachusetts, September 18-20, 2015      Available on the web at

Stephen Soldz, Jean Maria Arrigo, and Brad Olson of the Coalition for an Ethical Psychology organized a three-day workshop to engage in a deep and thoughtful dialogue about the specific ethical challenges faced by psychologists practicing in the field of operational psychology.  This document is abstracted and edited with permission from the Coalition for Ethical Psychology to focus the Principles & Guidelines they discussed toward the Business Operations of Mental Health professionals.

This document was accepted as a guidance document by the Board of AMHA-OR 10-19-2018