Oct 052015
 October 5, 2015  Posted by  Breaches, Healthcare, Laws, U.S., Workplace, Youth & Schools

On September 26, I noted that the Oregon state board for psychology  proposed disciplinary action for the University of Oregon psychologist who turned over a student’s counseling records to university attorneys.  The psychologist was the head of the university counseling service.

Today, the The Register Guard has an editorial that begins:

The University of Oregon is getting mixed signals from authorities charged with enforcing codes of professional conduct. In June, a division of the Oregon State Bar found that UO lawyers did nothing wrong in 2014 when they obtained the records of a student who claimed to have been raped by three members of the university’s basketball team. On Sept. 25, the state Board of Psychology Examiners recommended that the director of the UO’s Counseling & Testing Center be fined for providing the records.

The inconsistency is jarring.

You can read the full editorial here, but basically, each profession has its own ethics code and professional standards. Nothing barred the university lawyers from requesting information. The mental health professionals providing the counseling services, however, were under standards that prohibited them from breaching patient confidentiality.

There is really nothing unusual here, as most mental health professionals will recognize – we get requests for information, but we are not supposed to just comply with them if we are ethically or legally prohibited from providing the information. Yes, even if the requestor is our employer.

While it may help to clarify education laws like FERPA, as the U.S. Department of Education has now tried to do to protect student patient privacy, even if there was no such clarification, those of us in the field of mental health have always known we are duty-bound to protect confidentiality except in limited circumstances. Having laws may make it easier for some to say “no” to employers’ requests, but it doesn’t really change what has always been our obligation.

Students who go to a university or college counseling center are not experts on HIPAA, FERPA, and/or state confidentiality laws. They are young people who seek help and likely have an expectation that their records and counseling will be kept confidential. We need to reassure them that they will be – and that the only exceptions will be “(a), (b), (c).” It’s something I do even with my pediatric patients during the very first session, and if it’s not part of the first counseling session at unis, it should be. It helps patients understand any obligations we have as mandated reporters, and it also serves as a reminder to ourselves that we have an obligation to that patient to protect confidentiality.

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