The Straight Dope

Go Back   Straight Dope Message Board > Main > General Questions

Reply
 
Thread Tools Display Modes
  #1  
Old 06-12-2002, 09:43 PM
Amp Amp is offline
Guest
 
Join Date: Jun 2000
Doctor-Patient Privilege Question Concerning Mental Health

I've been through a lot in my life in the past few months, marital infidelity, seperation, divorce, suicide attempt, etc. and have decided that I really need to seek professional help for my mental health.

The one thing holding me back is the fear that the information that I reveal to my therapist could somehow be used against me in some way shape or form. I haven't done anything illegal but have had some really bad thoughts.

Could someone explain to me, in laymen's terms just how does doctor-patient privilege work when it concerns mental health. Can my therapist have me locked up for being crazy? Could he/she be forced to testify against me in court proceedings?

Thanks in advance for the help.
__________________
My claim to fame on the SDMB.
Reply With Quote
Advertisements  
  #2  
Old 06-13-2002, 01:16 AM
Nevermind Nevermind is offline
Guest
 
Join Date: Apr 2002
I hope someone comes along that can answer this for you better than i can. When you say locked up, I'm don't know if you mean in a psych facility or jail. Maybe if you do a search for committment procedings, voluntary vs. involuntary. I'm pretty sure if a medical professional has reasonable reason to believe you could cause harm to another person, they can report you. But just having angry and violent thoughts doesn't necessarily constitute that. Maybe you need to ask your divorce attorney for help on this. If you are still suicidal, then these legal questions have GOT to take a back seat to you getting help. It sounds like you are probably already in the loop, so ask your psychiatrist as well as your lawyer--then make an informed decision how to proceed. Good luck!
Reply With Quote
  #3  
Old 06-13-2002, 01:29 AM
pravnik pravnik is offline
Member
 
Join Date: Apr 2002
Location: TX
Posts: 13,374
First, I am not a lawyer yet, and even if I were, I wouldn't be licensed to practice in your jurisdiction. No attorney/client relationship is created or implied here. This is just for general edification purposes and should in no way be considered a substitute for the advice of a lawyer licensed in your state.

That being said, not all staes recognize a physician/patient privilege, and when they do it's often very limited. Federal Courts don't recognize the privilege at all. However, the federal courts and virtually all states do recognize a privilege between psycholgist, psychiatrist, or licensed social worker and patient, and in most particulars this privilege operates much like an attorney/client privilege and involves a higher degree of confidentiality. Except in a very few circumstances most of what you tell your attorney in confidence can't be used against you in court.

All these considerations should just be secondary, though. Your well-being and health should be your first priority. If you don't feel well, by all means go to a mental health professional. If you have any concerns about confidentiality he or she can tell you much more specifically what you need to know, and can very likely help you to feel much better.

Please consider it very seriously. I hope you get to feeling better.
Reply With Quote
  #4  
Old 06-13-2002, 01:36 AM
Nevermind Nevermind is offline
Guest
 
Join Date: Apr 2002
I hope someone comes along that can answer this better for you than I can.
When you say locked up, I don't know if you mean in jail, or in an inpatient psych facility. I know that if a medical person has reasonably strong reason to believe someone is going to cause harm to another, then they can report it to the authorities, who may then "lock you up" according to their criteria. (don't you have to commit a crime and not just be thinking about it though?) Anger and bad thoughts go hand in hand and do not always raise flags--in general, I say because I don't know you or what you are thinking but will give you the benefit of the doubt, here.

Do a search on voluntary vs. involuntary commitment. If you are determined to be a risk/danger to yourself you could be committed involuntarily. This is only if you refuse to go voluntarily, and it requires at least 2 docs to sign off on it. Most people don't go around commiting patients willy-nilly, only in extreme cases.
None of this really matters if you are now suicidal. The legal questions must take a back seat to your personal well being. I'm sure your lawyer would like to know you are speaking to someone. Ask him these questions, as well as the psychiatrist. It won't be the 1st time it has come up and their are definite rules about this that they are both aware of. Make an informed decision by asking the people immediatley involved! Good Luck
Reply With Quote
  #5  
Old 06-13-2002, 01:39 AM
Nevermind Nevermind is offline
Guest
 
Join Date: Apr 2002
I lost my 1st post but now i found it
sorry
Reply With Quote
  #6  
Old 06-13-2002, 06:11 AM
ratatoskK ratatoskK is offline
Member
 
Join Date: Apr 2002
Location: Beyond the Pale
Posts: 3,901
Amp, IMHO when you weight the pros and cons, the importance of getting the mental health care you need outweighs everything else.
Pravnik is right, you can ask your potential therapist about privacy issues when you go for the first time.

There are unusual circumstances when I think the therapist is required to report to the police (i.e. if you actually are on a murdering rampage, and weren't just fantasizing about it). Some people are concerned about the health insurer not being discreet, so they pay themselves without going through insurance. (But that can be expensive.)

Personally, I think the likelihood of any of this happening is extremely remote. Once in a while it gets in the news just because it is so unusual. So go ahead and see a therapist, that's the most important thing.
Reply With Quote
  #7  
Old 06-13-2002, 07:06 AM
Visual Purple Visual Purple is offline
Guest
 
Join Date: Sep 1999
Many states have created very strong mental health confidentiality laws, such that rather little you tell a mental health service provider may be disclosed.

Exceptions: most states require service providers to report even the suspicion of child abuse or elder abuse. Many states require or permit the service provider to disclose a well-defined threat of physical harm to an identifiable individual.

If the service provider believes you are mentally ill, and, as a result of the mental illness, dangerous to yourself or others he or she can institute commitment proceedings.

I hope these exceptions donít frighten you away from seeking any help you need. They are quite narrow. On the whole, communications to mental health service providers have protection second only to communications to lawyers. Your divorce lawyer should have a good idea as to what mental health records could be used in divorce proceedings.

Disclaimer: I am a lawyer, but not your lawyer. Iím not licensed to practice law in Florida, and I am speaking about ďtypicalĒ states, not Florida.

Go get any help you feel you need.
Reply With Quote
  #8  
Old 06-13-2002, 07:49 AM
DVous Means DVous Means is offline
Guest
 
Join Date: Mar 2000
In the hospital that I regularly transport patients to, there is a SOP for nursing staff regarding mentally ill patients who present to A&E. On the question of "detainability", it says this:

It's OK to be mad, but it's not OK to threaten harm to oneself or to others.

I would assume (or hope) a similar rationale applies in most of the western world.
Reply With Quote
  #9  
Old 06-13-2002, 08:06 AM
muttrox muttrox is offline
Member
 
Join Date: Dec 2000
Posts: 2,027
IIRC, If you pose a grave and immediate threat to yourself or others, they can do something. Otherwise, everything must remain absolutely confident.

99.9999% of the time, you are on safe ground. Unless you find yourself feeling like David Chapman or the Unabomber, you have little to worry about.
Reply With Quote
  #10  
Old 06-13-2002, 10:31 AM
BottledBlondJeanie BottledBlondJeanie is offline
Guest
 
Join Date: Nov 2001
Prav don't know what year you are, but try not to spout this kind of stuff out to someone you have MORE legal training than as you sound pretty authoritative... If I were not a lawyer, I would read your post to say that the physician-patient privilege is not very strong and that in a Federal case non-existant...

That would be wrong.

Being a law student, you shouldn't quote "stuff you learned" or things from your Emmanual for real-life situations.

BTW, I'm a lawyer, licensed in TX who does medical malpractice--I know what I'm talking about...

But, I'm not trying to be too critical, just please be careful.
Reply With Quote
  #11  
Old 06-13-2002, 10:37 AM
BottledBlondJeanie BottledBlondJeanie is offline
Guest
 
Join Date: Nov 2001
Amp

Off the subject of commital, I would ask your dr. to keep the note-taking down--write only what's necessary. Also, if you file a lawsuit that would make your mental condition relevant(this could waive anhy privilege), it's possible that the other side can get ahold of your records and possibly depose your dr...

I'm sorting through a woman's 6 years of diary right now--she wrote in it almost everyday--I feel sorry for her--having a stranger read her innermost thoughts. Plus I have 10 years of therapy notes...I FEEL AWFUL!
Reply With Quote
  #12  
Old 06-18-2002, 05:03 PM
Whack-a-Mole Whack-a-Mole is offline
Guest
 
Join Date: Apr 2000
Sorry to resuerrect this thread but I just came across it and feel there is something to add.

How you pay for mental counseling definitely has a bearing on how confidential your records may be.

If you pay for this out-of-pocket then you are fairly well covered I believe. However, if you use insurance many of your priviledges get compromised. Maybe not overtly but the end result can be the same.

I am NOT a doctor or a lawyer. However, I have asked this question very directly to a currently licensed and practicing psychiatrist in Illinois. She said that unfortunately the way insurance companies work the chances of what used to be considered confidential information gets out and can quite possibly come back to haunt you. For this reason the psychiatrist told me that she writes down as little as possible and makes reports to the insurance companies as vague as she can get away with and still meet their requirements.

Perhaps the issues are different in Florida. If you haven't already I strongly encourage you to visit a psychiatrist/psychologist at least once and ask these questions. They should be upfront with you about how it all works. Certainly your mental health is a very valuable thing and you should not continue to suffer needlessly when help exists.

Take care...
Reply With Quote
  #13  
Old 06-18-2002, 10:13 PM
AHunter3 AHunter3 is offline
Charter Member
 
Join Date: Mar 1999
Location: NY (Manhattan) NY USA
Posts: 16,245
Re: Doctor-Patient Privilege Question Concerning Mental Health

Quote:
Originally posted by Amp
The one thing holding me back is the fear that the information that I reveal to my therapist could somehow be used against me in some way shape or form. I haven't done anything illegal but have had some really bad thoughts.
Mostly doctor-patient privileges ensure confidentiality here. If you are using insurance to pay for it, though, find out from your therapist what information the insurance company insists on receiving about you in return for picking up the tab. If your insurance is through your employer, check also for the extent to which any of this can be reported back to your employer.

Quote:
Can my therapist have me locked up for being crazy?
In a heartbeat. I have colleagues who were incarcerated after meeting a therapeutic professional for less than 5 minutes, deciding that they didn't like this person, and leaving the office. And similar tales.

Quote:
Could he/she be forced to testify against me in court proceedings?
Generally not. Only under very selective circumstances. I believe that if you reveal that you killed someone, or indicate that you plan on doing so, the mental health professional has the right and under many circumstances the obligation to intervene by contacting the police. Simply having homicidal feelings towards someone, on the other hand, incur no such obligation. It is a pretty rare thing for a shrink to be subpoenaed and forced to testify against a patient.
__________________
Disable Similes in this Post
Reply With Quote
  #14  
Old 06-18-2002, 11:13 PM
pravnik pravnik is offline
Member
 
Join Date: Apr 2002
Location: TX
Posts: 13,374
Quote:
Originally posted by BottledBlondJeanie
Prav don't know what year you are, but try not to spout this kind of stuff out to someone you have MORE legal training than as you sound pretty authoritative... If I were not a lawyer, I would read your post to say that the physician-patient privilege is not very strong and that in a Federal case non-existant...

That would be wrong.

Being a law student, you shouldn't quote "stuff you learned" or things from your Emmanual for real-life situations.

BTW, I'm a lawyer, licensed in TX who does medical malpractice--I know what I'm talking about...

But, I'm not trying to be too critical, just please be careful.
I appreciate your concern, but for god's sake don't ever accuse me of quoting "stuff I learned" out of an Emanuel. If you feel I've misstated the law, tell me exactly how and correct me, don't condescend.

To clarify, Federal Courts interpreting FRE 501 regularly hold that the physician-patient privilege is not available in federal criminal cases and federal question civil actions. Only when state law provides the rule of decison, as in diversity tort action, are the benefits of physician-patient privilege likely to apply. Thus my saying "Federal courts don't recognize..." under their own decisonal law, they often do not.

As to a physician-patient privilege not being strong, compared to the attorney-client privilege, generally it isn't.

Better?
Reply With Quote
  #15  
Old 06-19-2002, 12:06 AM
pravnik pravnik is offline
Member
 
Join Date: Apr 2002
Location: TX
Posts: 13,374
Okay, that was pretty uncalled for on my part.

Yeesh. My apologies, Jeanie, I see now that I've calmed down a bit you're just trying to warn me about doing anything that could be construed as practising w/o a license. Forgive my nastiness; I'm sitting for the bar in a month, totally stressed out, and the girl I'm dating isn't returning my calls because I've been neglecting her. So it's been a bad day. Guess I didn't realize how upset I was.

Anyway, apologies-

-p
Reply With Quote
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump


All times are GMT -5. The time now is 10:44 PM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2014, vBulletin Solutions, Inc.

Send questions for Cecil Adams to: cecil@chicagoreader.com

Send comments about this website to: webmaster@straightdope.com

Terms of Use / Privacy Policy

Advertise on the Straight Dope!
(Your direct line to thousands of the smartest, hippest people on the planet, plus a few total dipsticks.)

Publishers - interested in subscribing to the Straight Dope?
Write to: sdsubscriptions@chicagoreader.com.

Copyright © 2013 Sun-Times Media, LLC.