How public are mental health records?

From my experiences of watching Law & Order, I know that what is discussed is confined within doctor-patient privilege. But, other than that, what is public? Is the fact that you visited a mental health practioner public? If I decide to run for public office 20 years from now, will they be able to find out that I visited a psychologist?

Last time I checked, a psychologist also has “privileged” communications status.
The issue that was unsettled the last time I checked was whether or not communications between a client and a CCSW (Certified Clinical Social Worker) are privileged.

The problem is that, if you run for public office, the public’s “need to know”, however dubious that claim, may override the right to privacy if the issue should ever come to the fore.

It may depend on the exact circumstances - “green warrants,” or warrants that are issued for involuntary committment, are on file in the Clerk of Circuit Court’s Office here in VA. If you visit a mental health professional on your own it seems it would be very difficult to uncover; however, if you get committed the paperwork is readily available (at least to the extent that “green warrants” are still used, I’m not sure if they are).

Not true. Mental health and substance-abuse treatment records are held to a higher standard of confidentiality than “regular” records. Most psych practices I’m familiar with will only release records to the patient, and never to another person, even if that person has the patient’s permission. The exception is to another physician’s office, but even then, the standards are pretty high, and requests for records are verified before they’re honored.

That said, this only applies to licensed therapists. Self-help groups like AA do not enjoy the same legal standing as those enjoyed by licensed therapists, and thus, discussions at those meetings are not held to be confidential.

This does not prevent someone from “leaking” information. Thanks to HIPAA, the penalties for doing so are stiffer than they were, but in some cases, there is still some incentive to get privileged information, as in the case of people in the public eye.

If that person chooses to discuss his/her own history, that’s a different story entirely, as the disclosure is voluntary.

Robin

MsRobyn, I was referring to leaked records, not legal channels of release. If a person were to sue someone for leaking health care records, the success of the case in the eyes of a jury may hinge on how much that person is in a position of public trust, e.g., an elected official. It’s a balancing act between laws like HIPAA and case law about the limits of privacy for public figures.

I am a psychologist.

If you’re talking about the compulsion to blab interesting tidbits, sure. Then the psychologist has to balance the personal desire to tell against the ethical and legal responsibility not to. Other than in a few circumstances (if I have a valid release of information from the client, or the client meets my state’s criteria for posing a danger to self or others), it’s hard for me to think of a situation in which I’d be required to provide information (including whether I’d seen the person) to someone other than with a court-ordered subpoena (suggesting a criminal allegation and that the client’s use of my services was already known). Even then, I have options such as requesting of the judge that I be permitted to present the information in camera or to another trained professional of the court’s choosing. Even under these circumstances, I am obliged only to disclose information relevant to the inquiry.

I was just laughing at one of Jonathan Kellerman’s novels today, because he muses something like “privilege had died with Mr. X.” Not in my state it doesn’t. Even if the person dies I can’t just go around talking about him or her, even if s/he’s a public figure.

Why be ashamed of seeking help? If Al Gore had been elected, Tipper was going to work on mental health issues. She had depression. That can be a real eye-opener for a lot of people.

Still not true. Violation of privacy is absolute, and it doesn’t matter whose privacy is violated. Any judgment against privacy and in favor of “right to know” would find itself subject to appeal quickly.

People have the right to keep their private lives private, period. It doesn’t matter if the person is you, me, or the President. Political figures make their records known as a routine matter, but if they wanted to keep their mental-health records private, I’d understand.

Robin

Generally speaking, the ability to obtain a person’s mental health records falls under the doctor-patient confidentiality.

Psychologists and Psychiatrists have a duties both to the patient and the community. If you were to tell a psychologist that you want to kill someone or harm someone and that you have been stalking that person, they do have a responsibility to go to the police.

There was a case a few years back where a foreign exchange college student became infatuated with a classmate and after she rebuffed him he began stalking her, all the while telling his therapist his vivid fantasies of killing her…when he eventually did kill the girl the psychologist was brought up on charges for with-holding information.

If you do plan to be in the public limelight, I’m sure it would possible for the press to find out that you had seen a psychologist or whatever, but I don’t think that they could “lawfully” obtain any further information.