Records of your visits to Student Counseling are never released to anyone on or off campus without your written permission, except under unusual circumstances (outlined below).
Law and Ethics
Confidentiality is a crucial concern when it comes to the therapeutic relationship as well as from a legal standpoint. The American Psychological Association (APA) ethics code (2002, Section 4.01) states that psychologists have the "primary obligation" of protecting confidential information which includes all information gleaned during assessment and treatment. The Principles of Medical Ethics (2001) states that physicians (this includes psychiatrists) will "safeguard patient confidences within the constraints of the law." In all but a few rare situations, client confidentiality (i.e., your privacy) is protected by state law and by the ethical rules of the psychology and medical professions. Even so, there are a few limitations on confidentiality.
Here are the most common cases in which confidentiality is not protected by law:
Psychologists and other mental health professionals have a legal and ethical duty to protect patient confidentiality; however, they also have a duty under the law to the courts and to the wider community, particularly when there is harm, threat of harm, or neglect.
- If you make a serious threat to harm yourself or another person, the law requires mental health professionals to act to protect you or that other person. This could include contacting emergency personnel, a friend, a family member or appropriate University staff. This also may involve involuntary hospitalization or referral for additional clinical services. If involuntary hospitalization is required, students may elect not to be hospitalized at Upstate. When possible, this should be arranged by the student or his/her representative with the medical personnel involved in hospitalization decisions.
- Please note that as of March 2013, Student Counseling is required to comply with the NYS SAFE Act. This law requires mental health professionals to inform the County Director of Community Services if you are likely to engage in conduct that will result in serious harm to self or others. If we determine that you are in imminent danger of seriously hurting yourself or someone else, we will alert the Onondaga County Director of Community Services and provide him/her with your name, contact information, and diagnosis(es). This individual then may be required to inform the NY Department of Criminal Justice Services (DCJS), which would determine whether you have a gun permit, and if so, take steps to remove your firearms. This law can also prevent you from obtaining a gun permit for five years following a report to the DCJS.
- Are you suing someone or being sued? Are you being charged with a crime? If so, the court may order the mental health professional to provide his/her records. In such cases, Student Counseling would be required to release your record, with or without your consent. Please consult your lawyer about these issues.
- If, in the course of working with you, your therapist learns that a child has been or will be abused or neglected, we are legally required to report this to the appropriate authorities.
Special Note: Some agencies (e.g., the C.I.A., the Peace Corps) may ask if you have been in counseling or psychotherapy on their application forms. If you tell these agencies you have received such services, they may request permission to review your mental health record. Even so, mental health professionals cannot release this information unless you provide written permission to release that information.
Coverage and Case Consultation
There are two situations in which your therapist might share some information about you with another therapist.
If a therapist needs to be away from the office, s/he will ask (i.e., get your consent) if a trusted fellow therapist may "cover" for him/her. The reason therapists have other therapists cover for them is to protect you in case of emergency. Therefore, the covering therapist would need to know some basic information about you. Generally, your therapist will tell the covering therapist only what he or she would need to know for an emergency. The covering therapist is bound by the same laws and ethical rules to protect your confidentiality.
Therapists sometimes consult other therapists or other professionals about their clients. This helps them to provide high-quality treatment. Consulting therapists are told only as much as they need to know to understand your situation and are not given your name or other identifying information. Consulting therapists are bound by legal and ethical mandates to protect your confidentiality.
If your records must be released to another professional, or anyone else, your therapist will discuss it with you. If you agree to share these records, you will need to sign an authorization to release information. This form states exactly what information is to be shared, with whom, and why, and it also sets time limits on how long the release is in effect.
New York mental health law states that patients have the right to request copies of their mental health records; however, mental health law further states that mental health professionals may deny access to all or part of the information requested or may grant access only to a summary of the information if, after consideration, it is determined that the information may cause harm to the patient. If you are interested in reviewing your mental health record, please speak directly with your therapist.
Resident providers and their faculty supervisors are never placed in a position to evaluate or supervise medical students in the academic or professional setting.
If you have any questions about confidentiality, please don't hesitate to contact us.