What is confidentiality?
Confidentiality means information you share with another person, either written or verbal, will be kept between you and that person. It’s common to confide in friends because you trust them. Keeping certain things confidential is kind of an “unspoken rule” in a friendship, but it can also be important that others—like health and mental health professionals—keep your information private as well.
Confidentiality in a Professional Setting
For doctors, nurses, counselors and all other health and mental health professionals, confidentiality is part of a professional code of ethics. Health professionals agree to abide by a set of ethical principles that include keeping your information confidential. Doctors and nurses cannot disclose your medical information unless you give them permission to do so. However, if you threaten bodily harm to yourself or another person, then your physician must reveal this information to the proper authorities.
If you’re unsure about what a health professional might report, you should talk to the person about your concerns. You might also want to find out who will receive the information—in some cases, it could be your family, the police, or state and local officials. In some rare situations, it could involve speaking in court. Private communication between you and your physician is also protected by law.
Like physicians, mental health professionals also abide by a code of ethics that means they will not disclose information unless you give them permission to do so. They also have the duty to disclose information if they feel you or someone else is in imminent danger. Your communication with mental health professionals may also be protected by law, however this varies state by state, and by type of mental health professional. For example, one state may grant by law “privileged communication” between a client and psychiatrists or psychologists, but “privileged communication” may not exist for clients and school counselors.
For both medical and mental health professionals, this becomes further complicated by a patient or client’s age. States have different laws and regulations regarding the age at which an adolescent has the legal right to consent to medical care or mental health care without being required to notify their parents or obtain authorization for care. For minors, in some states, the right to privacy legally belongs to parents or guardians, meaning that the adolescent has the same right to have information kept confidential, yet this information by law cannot be kept from parents or guardians.
And, in most states, physicians and mental health professionals are required by law to report suspected cases of child abuse (abuse of those under the age of 18) and in four states, domestic violence. This is called “mandatory reporting”. This will include physical abuse, sexual abuse, emotional abuse, and neglect. Other circumstances where states may require mandatory reporting include sexually transmitted diseases, communicable diseases, HIV/AIDS, or other conditions deemed to be risks to the health and safety of the public at large.
Talking About Confidentiality with a Mental Health Professional
Generally when you first see a mental health professional, the issue of confidentiality is discussed as part of a first appointment. For those under 18, the mental health professional typically has parents or guardians sign a form that describes the limits of confidentiality and the professional’s expectations for keeping session content private. This means it’s only between the mental health professional and you, and what the circumstances will be when the professional will feel obligated to share information with parents. This is a good time for you to raise any concerns that you may have. You can do this in the privacy of your session with the mental health professional.
How important is confidentiality?
The answer is simple: it’s really important, especially because confidentiality is a big part of trusting a medical or mental health provider. You might be worried about whether this professional will keep what you tell them confidential. This type of worry is normal. Going to see someone might be a new experience for you, and it may take time to understand and trust the person.
It’s also possible that you or someone you know might have had a negative experience with a health or mental health professional. This might affect your ability to trust. If this is the case, try to remember that not all health or mental health professionals are the same. Trust usually evolves over time and as you become more comfortable in the relationship, you will begin to be able to share more about the things that are causing you stress and pain.
It is important for you to find someone you can trust. Sometimes this can happen through word of mouth from friends who have had good experiences or through recommendations from other professionals. If you do not feel at ease with your counselor, don’t get discouraged. It’s OK. Mental health professionals have different personalities, approaches and styles. The most important thing is that you don’t give up, but instead look for a person who you will feel comfortable with.