Mental health issues: ethical considerations

Employer-initiated psychiatric evaluations raise a number of ethical issues particular to mental health in the workplace. This article addresses the ethical concerns and potential legal implications of psychiatrist and employee role ambiguity (e.g., "mutual deception"); describes the elements common to psychiatric examinations in this setting; offers one way to provide information and documentation of a confidentiality waiver; reviews some differences between psychiatric and general medical IME evaluations; discusses interview and report record "ownership"; reviews dangerousness assessment strengths and limitations; and addresses treatment and restoration to fitness issues.