The impact of practicing in a rural setting on ethical decision-making for clinically practicing mental health service providers

The aim of this thesis is to investigate if there is a significant difference in ethical decision making between mental health service providers (MHSPs) practicing in three different population types: urban, urban cluster, and rural. Currently, there is a lack of research examining the difference in ethical decision-making between the three populations. The literature was reviewed and the following hypotheses were investigated: (1) Rural practicing MHSPs are likely to encounter ethical dilemmas more frequently than urban and urban cluster practicing MHSPs. (2) Rural practicing MHSPs have adapted to encountering certain ethical dilemmas more frequently than urban and urban cluster practicing MHSPs. (3) Rural practicing MHSPs are less likely than urban and urban cluster practicing MHSPs to refer out clients who may generate ethical situations. (4) Rural practicing MHSPs are more likely than urban and urban cluster practicing MHSPs to continue working with clients who may create ethical situations. The sample used for this study included licensed mental health service providers (MHSPs) practicing in rural (n = 12), urban cluster (n = 29), and urban (n = 39) geographic categories within the United States of America. The procedures for collecting data included emailing and handing out a flyer to practicing MHSPs residing in the United States. A three-part survey was created for this study, and four scales were used in a MANOVA analysis. Significance was not found, but the pattern of the means may suggest that rural practicing MHSPs are more likely to encounter ethical dilemmas, have adapted to encountering certain ethical dilemmas, more likely to continue working with clients that increase the likelihood of an ethical dilemma, and are less likely to refer clients out due to the encounter of an ethical dilemma