Home » It’s complicated: When ethics ends and legality begins

It’s complicated: When ethics ends and legality begins

Posted on: January 29th, 2015 in Mental Health No Comments

ethics confidentiality mental health treatment

The nature of mental health treatment often means that a patient’s personal information is often shared as a part of the therapeutic process. However, though this sharing between client and mental health professional is usually understood to be confidential, there are exceptions. It will be in the best interest of both parties to have a clear understanding of what these circumstances are. These guidelines have been created with the best ethical interests of the treatment process in mind.


Perhaps the best example of when confidentiality may be broken is if the patient is considered to be a danger to themselves or others. This will be done to protect the person in question who might be harmed. This includes awareness on the part of the practitioner that child abuse may be occurring. Yet there are several other instances where confidentiality may also be breached.

It should also be noted that if determined necessary by a court of law, then a therapist may be asked to testify about what has been discussed in appointments. Though this is not a common occurrence, the professional will be expected to comply in such cases. Records of therapy may be made public at a trial if a claim of emotional distress is pursued. This is so even in cases where the therapy is not necessarily connected to a lawsuit matter.

The client’s insurance company may often receive certain facts about your treatment as well. Though this was at one time regulated to sharing a diagnosis, this has since changed due to case managers who have insisted on more specifics. Furthermore, one’s medical records may be present as part of a wider medical record.

In the case of treatment for adolescents, the client will be advised to discuss certain decisions and information with their parents when appropriate. However, if the therapist decides that confidentiality will need to be broken, then they will first need to make the patient aware of their decision to do so. The professional will need to explain why the revealing of confidential information is necessary. However, the practitioner may allow the patient to make the information known themselves while in their presence. At all times, the mental health professional should do their part to first seek out any possible alternatives to breaching patient confidentiality beforehand. This is important to make sure that trust remains a focal point of these relationships.

Prevention of Complications

In order to prevent any misunderstandings and to minimize resentment that the treated person may experience, it may be best to take a proactive approach. For instance, the patient should be made aware at the beginning of treatment about confidentiality and its limits. This will be especially important with adolescents, whose parents will need to be notified of certain information in more extreme cases. Of course, certain confidentiality laws may vary from state to state and it will be essential for a therapist to familiarize themselves with how these apply in their case.

In cases where an adolescent patient needs to have tests taken, then he or she will need to make arrangements regarding lab results and billing if their parents are not to be made aware of this. Also, the mental health professional should strive not to leave messages on answering machines or phones, as confidential information may be revealed in the process. Instead, the therapist may choose to communicate by e-mail or fax. However, it will be especially important to be sure that the right address or number is used in such a case, so that confidentiality is not accidentally breached.

A patient has a right to be concerned if confidentiality is breached, it may compromise how they are viewed professionally at their job and personal life. Another common worry is that one’s health insurance may be lost or denied. Therefore, in cases other than the noted exceptions, it will be necessary to share the minimum amount of information required if complete confidentiality is not possible. The client should also have the opportunity to correct any information not believed to be completely accurate. On the other hand, the medical professional should be able to be protected from retaliation if a report of a violation is necessary. The goal, as is common with ethical issues, is to minimize the amount of harm done to all parties involved. While absolute confidentiality is naturally a preference, certain circumstances do not allow this as a realistic option.

At Sovereign Health Group we know how important privacy is when our patients are going through their treatments. Trust is our number one concern, which is why we employ a top notch legal team as well as the best doctors and clinicians in the business. When anyone walks through our doors we want them to feel safe and know that we are here to help.

Contributed by Sovereign Health Writer, Ryan McMaster

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