Is it possible in the US to get psychological/psychiatric records expunged (NOT civil commitment)?

In My Humble Opinion
1

I know that it may be possible in some jurisdictions to get involuntary psychiatric commitments (court ordered treatment) expunged. This question does NOT relate to that.

Is it possible to get counseling visits, evaluations, and diagnoses expunged from one’s medical record?

E.g. John’s parents coerced him to see a psychiatrist at age 15, who diagnosed him with <something in the DSM>, and given an antidepressant. Now, years later, he realizes that he probably was just having some adjustment problems in life and wasn’t mentally ill. Can he get the medical record expunged so e.g. he doesn’t have to say “yes” when asked by insurance companies or licensing bodies if he’s ever been diagnosed with a mental disorder or undergone mental health treatment? If so, would he need to get a current or recent psychiatric evaluation that indicates that the person is free of mental illness and is unlikely to relapse, or is the fact that he hasn’t consulted a therapist (voluntarily or involuntary) in the past X number of years sufficient?

That is, I am asking about expunging medical records, not about expunging court petitions or judgments.

2

This is a really interesting question.

IANAD, IANAL. I do, however, have a job in which I read medical records ALL day long, and make decisions based on what is in said records.

Off the cuff … if I had to guess, I’d say no, it’s not possible to get medical records expunged. That said, I’ve never had any clients actually try to do it that I know of. I have seen doctors purge their records after a certain number of years (usually 7) … however now that I think about it, I’ve never had a shrink or psychologist tell me their records had been purged, it’s always been doctors that deal with just physical problems.

I’ve also never seen a hospital purge records, FWIW. I have read hospital records written in the 60s - kinda cool, actually.

That said … if little Johnny tells the insurance company or licensing board “no, I’ve never been treated for mental health issues” – there’s probably not MUCH chance they’ll find out. Unless they knew exactly where to look, how would they know who to ask for records? Also, with HIPAA being as strict as it is, nobody’s going to give out Johnny’s records without his express written permission.

The only pitfall I can see is if Johnny, for whatever reason, gave up the names of SOME of his former (non-mental health) doctors, and the records of THOSE doctors mentioned that Johnny was being seen by Acme Counseling Services for mental health issues and they had put him on antidepressants/antipsychotics or whatever. That would indeed tip someone off that Johnny hadn’t been exactly forthcoming about his medical history. I find this scenario ALL the time when I’m reading records. Doctors mention other doctors in their records constantly. (To be fair, most patients simply don’t remember ALL of the doctors they’ve seen over the years, so Johnny might be able to get away with “I just didn’t remember” excuse, especially if he only saw one mental health professional in the past. “I forgot about my 3 week involuntary commitment when I was 19 for a psychotic break” probably wouldn’t cut it, though.)

I honestly don’t see what good this would do. It’s not hard to find a doctor that will say whatever you need them to say – I can’t see an insurance company or a licensing board giving the opinion of a doctor that did a one-time evaluation much weight. I definitely can’t see a medical records department going “oh, you were evaluated by a shrink that said you’re fine? Yeah, we’ll totally shred your records!”

This, I daresay, is a huge no. You can be mad as a hatter and not consult a therapist for years. You’d be amazed how many people are seriously mentally ill and disappear off the medical radar for ages. They’re either not disruptive and thus don’t end up getting involuntarily committed … or they simply keep to themselves, hole up in their house and nobody notices. They might seem a little “off,” but not so off that people start asking questions.

Just my semi-educated guess. I can’t wait for someone who knows what they’re talking about to weigh in on this, though, I’m as curious about the answer as you are :slight_smile:

3

I work in a related legal field, and in my experience mental health professionals are very nervous about making these kinds of affirmative predictions. They just have a lot to lose and not much to gain. They will generally only be willing to say, “In this moment, X, Y, and Z.” In the courts, the judges will make of this what they will.

In your situation, practically speaking you’re asking for a forensic-style mental health professional to go back and say “When Johnny was 15, he wasn’t really depressed.” That is a seriously tall order.

In terms of the “expungement,” I don’t know much, but PandaBear77 makes a lot of sense.

Maybe attaching an addendum to whatever forms are giving you trouble would at least temper the issue? Just stating, “As a juvenile,” or something might help.

I’m very interested in what others have to say.

4

This is interesting to me as well.

I have always wondered about how mental health records mesh with your actual medical record, especially since I live in a small-town southern (read nosy) environment where people yap about other people’s business all the time (HIPAA would have a bloody field day down here).

On a related note, WHY do job applications and whatnot ask people if they have been seen by a mental health professional? I mean, it seems to be the trend now for people to be seen by a mental health person just about every time something even slightly traumatic or unhappy occurs. It’s starting to become like asking someone if they have ever been to a doctor. Um, yes. Most people have. Why do you care?

To put it into a sad context, every student at a school where there is a shooting would have to answer that type of question with a “yes” whether there were ongoing trauma issues or not. It just makes me wonder what people are really getting at by asking that of interviewees or patients or whoever.

5

IME (and I do have some), an admission that you’ve received counseling is simply a flag that there is something that needs to be looked at more closely; an admission alone is generally insufficient to deny licensure or insurance. Most likely, the licensing board or insurance company will ask for those records and make their decision from that. Depending on the licensing board/insurance company, they may also ask for a current evaluation from a licensed therapist, just to make sure that you really are OK. I should also point out that, as far as this kind of stuff goes, not all diagnoses are equal. A diagnosis of depression isn’t going to be as potentially negative as a diagnosis of schizophrenia, for example. Also, many teens end up in counseling for one reason or another, so this not a new or unique situation.

6

MsRobyn makes a good point. Teens aren’t completely in charge of their medical care … I have a lot of child clients whose parents drag them to this therapist and that because little Susie gasp argues with her sister over the TV! All kids fight with their siblings, BFD – call me when Susie tries to set her sister on fire.

So yeah … I would think an insurance company/licensing board isn’t going to be wildly interested in some minor adjustment disorder from when someone was 15.

I also want to second what MsRobyn said about some diagnoses being more potentially negative than others. With mental health, sometimes it takes a few visits - hell, sometimes a few different doctors - to hammer down a diagnosis.

ADHD? Zzzz.
Depressed? On Prozac? Never been committed? Me too, big deal.
Adjustment disorder because your sister just died? Congratulations, you’re normal.

The words “paranoid schizophrenia” get my attention quick, though. IME doctors are very quick to diagnose patients with SOMETHING because it’s their job to come up with answers and then fix it … however they are not quick to diagnose the “s” word. They will dance around it for months – schizoaffective disorder, schizotypal personality disorder, and my favorite, schizophreniform disorder, which sounds like they’re starting to say the word “schizophrenia” but they kind of mumble the last half of the word like I do when I say I’m thirtyfrarnshrar years old.

Some of this is because schizophrenia can look like other diseases (bipolar especially, and also substance-induced psychosis), so it’s REALLY hard to tease out sometimes what’s really going on (especially if the patient is a drug user). It takes years for doctors to get really seasoned at this, so they’re reluctant to jump to conclusions – plus schizophrenia is SO stigmatized and definitely the most feared mental health diagnosis, IMHO.

That said … I’ve had schizophrenics at work that got medicated and went on to do ok for years before they decompensated again. It’s just when this happens, if I see that they were diagnosed with it 15 years ago, I’ve already been told a lot of what I need to know and can look at the situation differently than someone who, say, was diagnosed with major depressive disorder 15 years ago. (Not that depression can’t be truly serious but with depression the red flag doesn’t start waving wildly until I start seeing the term “ECT.”)

7

I think you overestimate the permanence of medical records. Go to a new psychologist/psychiatrist, don’t authorize the transfer of your records, and your new doctor won’t have them on his record. Wait about five years (or whatever the policy is at the particular place), and your old doctor won’t either.

It’s actually quite annoying, as I wind up getting put back on medicines that obviously didn’t work before, as neither of us have it on record. My parents and I foolishly assumed we wouldn’t have to keep track of all that.

ETA: I didn’t actually refuse to transfer the records, the places just didn’t ask, so I didn’t know I needed to.

8

BigT- I have PERSONALLY seen paper records from the 1950s and 60s in my curent patient’s notes. They aren’t always available, and might be in a distant locked filing room rather than on an up-to-date computer record, but those things don’t just disappear.

robert_columbia You can ask to have factually incorrect information removed from your records. You cannot, however, ask to have factually correct information or information which you disagree with, but which a clinican entered in good faith removed. you may be given the option of adding a note of your own beside any pieces of information you disagree with.

i.e.
You can have “The patient is a banker” removed if you were never a banker.
If you had this:“The patient, who I know to be a bar-tender, reports that he is a banker and earns millions of $ a year from this. Based on this, I feel he may have delusions of grandeur” you would find it much harder (if not impossible) to get it removed.

The first step is obviously to access your full records and see what is actually in them and if there is anything you feel you need to challenge.

9

IANA lawyer, but the term ‘expunge’ seems to be a legal technicality that has no bearing on the existence of documents. Once you get put something in the internet tubes now-a-days it may never go away. If there is something inaccurate in your ‘permanent record’ expect to have it re-appear forever, and be prepared to challenge it each time.

Even in the legal system, Jeannie Pirro, a New York prosecutor and TV judge would maintain a private list of suspected sexual offenders even after courts had dismissed charges, ruled accusations as unfounded, and ordered records expunged.

10

This is how it happened for one of my children.

At age 16 the child was having anxiety problems and came to me about it, asking to go to the therapist. I put the child in therapy. There was a psychiatrist associated with the practice who also saw the child. Psychiatrist prescribed a medication. Medication did not agree with child. Practice recommended a different psychiatrist. Child saw the new psychiatrist, who prescribed a medication with even worse side effects. I stopped sending the child to psychiatrists and the child saw only the talk therapist for the next couple of years.

In the meantime, the child aged out of insurability on my insurance (since the child was unable to attend college full-time). Here is where I made my fatal error. I did not attempt to get the child insured for a period of about a year. When I did, I found out that nobody would insure the child.

The past record of seeking mental health is a deal-breaker for the insurance companies. It is my understanding that statistics show a higher lifetime medical expense for persons who recieve mental health services, and that is why.

I have been told that a letter from a current psychiatrist showing that the patient is stable, or showing a milder diagnosis, can be helpful, but that has not been my experience.

OP, I think you are screwed. Sorry.

11

Sure they do. It’s going to depend on how the doctor practiced- hospital and clinic records will exist for years. Records from private practices are another story - if someone new takes over the practice the records generally remain, but I’ve gotten letters stating the Dr X will be retiring effective December 31, let the office know by Jan 15 if I want my records forwarded to another doctor, otherwise they will be destroyed.
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12

:eek:

Oh boy! It’s a bit different here!
There are pretty strict legal requirements to keep records.

GP records - until 10 years after the patient’s death or after the patient has permanently left the country, unless the patient remains within the European Union. (Exceptions are patients serving in the armed forces or serving a prison sentence, when the records must not be destroyed.)
GP records relating to children and young people (including paediatric and vaccination records) - until the patient’s 25th birthday, or 26th birthday if an entry was made when the young person was 17; or 10 years after the patient’s death, if sooner.
Maternity records - 25 years after last birth.
Records relating to persons receiving treatment for a mental disorder within the meaning of the Mental Health Act 1983 - 20 years after the date of last contact between the patient and any healthcare provider, or eight years after the patient’s death if sooner.
Cite:[Withdrawn] Records Management: NHS Code of Practice - GOV.UK

13

I’m guessing you have some sort of central records there, because my former doctors have no idea if I am alive or dead. Each state in the US will have different rules for record retention , but in my state, (and I suspect most) records must be kept for a specific period of time from the last visit. For children’s and obstetric records , they must be kept until a specific birthday, or the specified time from the last visit , whichever is later.
BTW, I didn’t mean to imply that my records could be destroyed immediately if a doctor retired- I could have received those letters from doctors I hadn’t seen in ten years.

14

Statutory retention periods in the US typically run between 7 and 10 years, except in the case of minors.

That doesn’t mean that medical providers will destroy the records after 10 years, though; typically, records are only destroyed if the provider is short on space, and somebody in the office has time to do it. Even then, they may simply be sent to an electronic record management service and scanned.

In Florida, you’ll be lucky to find records more than 10 years old even on microfiche in big urban hospitals. The more “country” hospitals, though, often keep that stuff for years and years.

I reviewed records the other day from 1969. Well, I saw records from 1969. They were completely illegible other than the top and bottom of each page.