Under the Health Insurance Portability and Accountability Act (HIPAA), healthcare providers, including mental health professionals, must use their professional judgment when notifying a patient's family of their psychiatric hold.
More specifically, HIPAA allows providers to disclose protected health information (PHI) when it is in the patient’s best interest or when there is a serious and imminent threat of harm.
According to the U.S. Department of Health & Human Services (HHS) health information privacy fact sheet, “A hospital may notify a patient’s personal representative about their admission or discharge and share other PHI with the personal representative without limitation.”
However, hospitals can also refuse to share PHI with a personal representative if there are safety concerns or it isn’t in the patient’s best interest.
HIPAA allows a hospital to notify a patient’s family, friends, or caregivers if the patient agrees, or doesn't object. The rule also includes situations where healthcare professionals can infer, based on the circumstances, that the patient does not object.
For example, if a patient’s family has been involved in their healthcare decisions without objection, healthcare providers can infer that the patient would not mind such notification in the future.
Sometimes, a patient may be incapacitated or unable to express their preference about sharing information. In these cases, HIPAA allows healthcare professionals to disclose necessary health information to family members if it is in the patient’s best interest.
As evidenced by the HHS, “When a patient is not present or cannot agree or object because of some incapacity or emergency, a health care provider may share relevant information about the patient with family, friends, or others involved in the patient’s care or payment for care if the health care provider determines, based on professional judgment, that doing so is in the best interest of the patient.”
Additionally, if there is a direct link between the family member and the patient’s care, further details may be shared, like what medications the patient is on and if their family involvement can help care for them.
HIPAA allows healthcare providers to disclose information to anyone who could help prevent a situation threatening the health or safety of the patient or others.
As the HHS explains, “A hospital may disclose the necessary [PHI] to anyone [in] a position to prevent or lessen the threatened harm, including family, friends, and caregivers, without a patient’s agreement.”
This rule specifically relies on the provider’s professional judgment. For example, a patient suffering from a mental health crisis has ingested an unknown substance, and their roommate could help identify the substance for the appropriate healthcare treatment.
The also states, “[It] would not second guess a health care professional’s judgment in determining that a patient presents a serious and imminent threat to their own, or others’, health or safety.”
Read also: How HIPAA helps mental health professionals
HIPAA applies to healthcare providers, health plans, and healthcare clearinghouses, including mental health professionals.
Yes, mental health providers can disclose protected health information (PHI) without patient consent to prevent harm or comply with legal mandates.
Violating HIPAA confidentiality rules can result in penalties, fines, and disciplinary actions against the healthcare provider.
Go deeper: What are the penalties for HIPAA violations?