July 15, 2013
by Richard Failla, chief executive officer at Research Psychiatric Center | Reprinted courtesy of KC Nursing News
I recently read an article in The Wall Street Journal about the problems that family members encounter when they try to get information on their adult children who suffer from mental illness. Due to HIPPA and the other privacy rules, family members cannot get any information about their loved ones without a signed release. This is especially troubling for families of patients who are diagnosed with schizophrenia or bipolar disorder.
Often times if the family of these patients knew that the patient was not taking their medication, refused community living arrangements, or did not make an outpatient follow up appointment, the families could intervene. Many times psychotic patients lose all touch with reality and have hallucinations, delusions or hear voices which make them paranoid.
We have seen the damage done by individuals suffering from serious and persistent mental illness in the tragedies in the movie theatre in Aurora, Colo., and the school in Newtown, Conn. Perhaps the outcome would have been different if family could have intervened before the violence.
In my opinion, we are doing an injustice to those with mental illness by insisting on such strict privacy rights due to the nature and course of serious mental illness.
It is time to reconsider confidentiality and privacy issues for people diagnosed with severe mental illness. There should be an exception for family members of anyone suffering from schizophrenia or bipolar illness. This designated exception to HIPPA should be made at the time of the initial diagnosis.
Since the illness is a chronic and incurable condition, the exemption would be for the life of the patient for any information regarding treatment or care of the patient for mental illness. Currently there are other exceptions to a patient’s right to confidentiality—for example, if a patient has abused a child or vulnerable older adult or if a patient says they are going to kill or harm someone else or themselves.
All of these exceptions to confidentiality have to be reported to the police, or in the case of harm to another person, the person to be harmed must be notified. Probably the biggest exception to confidentiality is the managing of healthcare by managed care companies. Before they pay the bill of a patient, they want to know all of the history and the treatment that is given.
As a licensed mental health professional and psychiatric hospital administrator, I know the importance of privacy and safeguarding a patient’s right to confidentiality. In my experience there have been many times when I wanted to communicate with family members about their family member but was prevented from doing so because of the paranoia of the patient and a refusal by the patient to release information.
In my opinion, it is time for a new law to be passed that would restrict the right to confidentiality for those suffering from severe mental illness and allow information to be openly shared with designated family members so that the patient’s welfare can be protected when the patient is in an acute episode of illness and unable to make a rational choice for themselves.
My hope is that we can have a national dialogue about the importance of this issue before anyone else ends up a victim of their illness — and people are harmed in the process.