Communication, Confidentiality and Consent in Mental Health Care

23 January 2015

Families and friends play a vital role in the care and support of people with serious mental illness. However, caregivers often complain that treating teams do not adequately inform them of their loved one’s condition and management plan. Failure or refusal to disclose such information can be very distressing for those offering support and, in circumstances where people with mental illness behave in threatening, violent or self-destructive ways, it can have serious repercussions. Health care professionals owe a duty of confidentiality to their patients. As a general rule, clinicians should seek a patient’s permission before disclosing information to others. This obligation is enforced in law. If health care professionals ignore this obligation, they risk civil liability for breach of confidentiality or statutory provisions that protect privacy, or a finding of professional misconduct by a professional standards tribunal. Generally, if a patient is able to understand the nature and effect of a disclosure of information and refuses to agree to that disclosure, it would be both unlawful and unethical to make the disclosure simply because the professional feels it to be the better course. On the other hand, the right to confidentiality and privacy is not without its limits, and it is widely accepted that confidentiality can be breached if a higher obligation is involved, such as a serious threat to the health and safety of the person or others.