Avant eLearning module: Managing boundaries in patients with mental health issues

This learning unit describes the challenges associated with identifying mental illness in patients, and managing the practitioner-patient professional boundary. Breakdown in the professional boundary can lead to significant problems for patients, and is one of the major reasons for complaints against practitioners.

The Australian Medical Council states that ‘good medical practice involves…never using your professional position to establish or pursue a sexual, exploitative or other inappropriate relationship with anybody under your care’. Similarly medical boards have used terms like ‘absolute rule’ when describing this behaviour. This should be adhered to even if the patient has consented and regardless of the nature of the personal relationship that develops, such as a mutual loving relationship. Since the Hippocratic Oath in 400BC it has been stated that doctors must abstain from ‘the seduction of females or males’.

D1. Communication skills and the patient-doctor relationship

• Communication is clear, respectful, empathic and appropriate to the person and their sociocultural context

D2. Applied professional knowledge and skills

• Appropriate mode of care delivery to suit the needs of the patient

D3. Population health and the context of general practice

• Barriers to equitable access to quality care are addressed

D4. Professional and ethical role

• Adherence to relevant codes and standards of ethical and professional behaviour

D5. Organisational and legal dimensions

• Medico-legal requirements are integrated into accurate documentation

• Adult health
• Care of older people
• Children and young people health
• Individuals with disabilities
• Men's health
• Pregnancy care
• Refugee and asylum seeker health
• Residential care
• Sex, sexuality, gender diversity and health
• Women's health
• Psychological health