Issues with the Electronic Exchange of Mental Health Information

Abstract

Texas law and the Privacy Rule approach the disclosure protections for information from mental health records in very different ways creating an uncomfortable maze for both health care professionals and facilities to navigate.

Texas law reaches out and protects even the hint of mental illness by shielding evaluations, whether or not they lead to diagnosis and/or treatment, but this protection leads to ambiguity by not spelling out how such records are to be to be distinguished from regular medical records. In addition, neither Texas state law nor the Privacy Rule adequately address the issue of mental health information that is created incidental to other health records such as when an obstetrician diagnoses and treats post-partum depression or a pediatrician diagnoses and treats attention deficit disorder. There are also ambiguities about how to handle records for patients who have both mental health and substance abuse disorders, and for patients who are also diagnosed with a physical disorder.

The lack of clarity in defining what constitutes a mental health record complicates management of that information for purposes of electronic exchange of the information, but also implicates issues ranging from accessing health data for research to reporting for law enforcement purposes to determine who should or should not have access to firearms.

Keywords: health information privacy, mental health