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responsibility for translating empathy into appropriate actions. In Jess and Kate’s workplace, a culture of care may be facilitated by modelling effective care behaviours, including showing concern for others, demonstrating that colleagues are valued by the way we speak with them and about them, and by openly discussing strategies for self-care. Opportunities for face-to-face contact with colleagues, team collaboration, and the perception that contributions are valued by others, may mediate speech pathologists’ work stressors (McLaughlin, Lincoln, & Adamson, 2008). Frequent interactions demonstrating care may also make it a little easier for Jess to approach a colleague or her manager for support and for Kate to initiate a conversation regarding observed professional behavioural changes and concerns. Kate may also benefit from accessing specific resources available for developing mentally healthy workplaces (National Mental Health Council, 2013). Importantly, Jess as a caregiver is ethically responsible for providing competent intervention by taking active steps to monitor and maintain her health. Kate is ethically responsible for taking actions that will facilitate her colleague’s efforts to address issues that may have harmful consequences for clients or the workplace. Ethical considerations from a health care consumer’s perspective Health care consumers may expect that health professionals, including speech pathologists, have a reasonable understanding of mental health conditions they may be dealing with in daily practice – for example, understanding the incidence of postnatal depression in mothers, and that this disorder may be impacted by complications at the time of birth or by other complex medical or social issues for the family. A challenge for speech pathologists is to tread that fine line between “normalising” a mental health condition e.g., being sensitive to the possibility that depression may accompany a major change in health status (e.g., CVA or TBI), and trivialising or putting aside the profound impacts of such conditions on clients and families. Consider, for example, the potential outcomes of referring to postnatal depression as “baby blues”. Sometimes we may avoid using a mental health term, for example, a depressive illness in Jess’s case, and this may be a sign of discomfort in talking openly about mental health. However, acknowledging mental health issues in a more open way can assist professionals overcome the perception that “this only happens to someone else”; that “someone else” may be my client, my colleague or myself as a practising clinician. Speech pathologists working with clients who have mental health issues need to understand not only what mental health “looks like” by identifying a list of symptoms but also what it “feels like”, by listening to consumers’ stories of lived experiences with mental health and well- being. New initiatives in this area include recovery colleges where people with lived experience may share insights with practising health professionals. For example, South Eastern Sydney Recovery College (http://www.seslhd. health.nsw.gov.au/Recovery_College/) offers education and training programs, developed and delivered by people with lived experience of mental health concerns and health professionals to help carers and professionals acquire better understanding of mental health concerns and to support people during their recovery.

demanding her time and attention. Jess perceives herself as a competent speech pathologist but feels anxious and overwhelmed by workload and family pressures. Jess finds it increasingly difficult to manage client care and complete administrative tasks. She frequently arrives late following problems sleeping, but works through lunch and takes incomplete tasks home. Jess avoids discussing her experiences with her manager because she perceives she will be “judged” as not coping, and it is difficult to find permanent positions in her local area. Kate notices concerning changes in her colleague’s behaviour. Jess avoids interacting with team members, professionally and socially. She appears tired and frequently complains of headaches. Jess is constantly busy but not productive. When Kate commences intervention, with two clients Jess assessed, she finds an incomplete report and no record of a recommended referral to occupational therapy. However, Kate understands that Jess has a demanding family situation and overall Jess is a great therapist. Kate wants to help but has her own busy caseload to manage. Reflect upon the following questions when considering your response to the scenario: 1. What are key ethical concerns for Jess and Kate? 2. What potential consequences may result from not addressing these concerns? 3. What steps can Jess and Kate take to respond ethically in this scenario? Our Code of Ethics (Speech Pathology Australia, 2010) states that respect and care for ourselves and colleagues is a core professional value: “We maintain our personal health and well being to effectively fulfil our professional responsibilities” (section 1. Values, Respect and Care). For Jess, it is important to reflect upon ethical principles of beneficence, non-maleficence and professional integrity. Is her health status impacting her skills to provide quality intervention? What are potential risks to her clients? Is she currently functioning as a competent team member who can meet professional commitments and fulfil her “Duties to clients and her employer”? Kate has equally important ethical considerations. The Code specifically addresses our duties to the profession and ourselves with an obligation to “identify and act on concerns we may have about colleagues’ competence or conduct” (clause 3.3.1). Furthermore, Kate may reflect upon her duties to “uphold the reputation of the profession” (clause 3.3.3) and support her colleagues to “develop professional integrity, identity and ethical behaviours” (clause 3.3.6). It is also important to note that speech pathologists have obligations under the National Code of Conduct for Healthcare Workers (COAG, 2015) to report colleagues who have health concerns that may compromise the safety or quality of client care. Herein may lie conflict for Kate. How can Kate address her ethical concerns in a supportive manner that acknowledges Jess as an autonomous decision-maker and focus on positive outcomes for her colleague, clients and employer? An Ethics of Care framework may provide a helpful approach to such an issue. Ethics of care is grounded in the concept of caring as both being “receptive to” and “responsible for” others (Branch, 2000). A receptive speech pathologist listens with attentiveness and empathy and then takes

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JCPSLP Volume 19, Number 3 2017

Journal of Clinical Practice in Speech-Language Pathology