Abstract
Health care reform has become an important part of today’s culture in the United States with discussions of how to provide health care for all citizens and much debate about how to improve quality of care and reduce rising costs of health care. Behavioral health is one of the most expensive medical issues. Effective discharge planning can help to cut the costs associated with inpatient admissions and can improve patient care. Discharge planning on a voluntary inpatient behavioral health unit is a dynamic process of complex decision-making. The discharge planner as a representative of the treatment team is obligated to provide quality health care for patients, offer education and support to families, develop continuity of care with outpatient providers in the community, and confirm safety plans after discharge. These complicated plans often contain multiple layers of ethical considerations and decisions that are discussed throughout a patient’s hospitalization. On a behavioral health unit ethical dilemmas may not present as clear black and white issues but often contain subtle nuances with competing values and needs. This article explores the dynamics of discharge planning and offers examples of how to discern ethical dilemmas in the context of an inpatient behavioral health setting.