For people who work within mental health services, there are certain rules that one must abide by to ensure that patient confidentiality remains a priority. These rules state that ‘information sharing’, (i.e., disclosing information, whether that be one’s address, date of birth, diagnosis, care plan, etc.) about a patient to third parties, can only be done in specific situations, with these situations being; when the patient has given permission/consent for their information to be shared with others, or, when the patient lacks ‘capacity’, and is therefore unable to give consent for information sharing to take place. The latter- sharing information without patient consent- can only take place if the patient poses a risk to themselves and/or others, and therefore disclosing confidential information is necessary for the patient’s safety and wellbeing, or, if, prior to loosing capacity, they signed over the right for their information to be shared with specific people, such as a family member or friend, via an ‘advance statement.’
Whilst the above is true for information sharing with a patient’s family and friends, a slightly different guideline is in place for information sharing with other mental health professionals. This guideline sees mental health professionals being able to share patient information with each other without obtaining their patient’s permission (although, many professionals will inform their patient that they will be passing their information on anyway, whether it is a requirement or not, just as a matter of goodwill.) Mental health professionals should, however, only pass on patient information that is deemed ‘necessary’ to be shared, and they should obtain consent when passing information on to services outside of a mental health context (such as the police or social services, for example.)
In terms of mental health professionals, not giving information about patients to other people, as I have discussed in the previous paragraphs, but accepting information from other people about patients, such as any concerns that they might have about the individual, they can do so in any circumstances. However, only in ‘special’ circumstances can they comment on the patient’s care, as, doing so could potentially breach their confidentiality. If a patient’s confidentiality is breached by a mental health worker, legal action could be taken, as it is against the law to do so.
On the topic of law, it is also a legal requirement for mental health workers to follow a list of safeguarding principles. This is of particular importance in the field of mental health as; individuals who suffer from mental health problems are at greater risk of being the victim of abuse, with this being due to them possessing greater vulnerability (hence why anybody working with vulnerable people must complete a criminal record check/DBS check.) To prevent such abuse from occurring in people with mental health problems, people who work within the health and social care sector should provide person-centred, individualistic support, whereby they actively put the individual at the centre of everything, empowering them to have as much control over their lives as possible. To do this- to empower patients to take control over their own care- mental health workers should listen to and respect the right of their patients to have a say in their care plan (with this including their right to refuse treatment), whilst offering them advice and guidance along the way (such as by informing them of the risks that refusing treatment poses to them.) This is applicable to patients who have mental capacity and therefore, in turn, also have a right to refuse treatment.
Even if a patient isn’t said to have mental capacity and essentially has their right to make decisions regarding their care taken away from them, mental health workers still have a duty of care, arguably to an even greater extent than if they were in control of their own care. To maintain the dignity of such patients who are said to ‘lack capacity’ and to demonstrate respect towards them, mental health workers should explain what care they will be receiving and why, as being kept informed like this will give them a sense of having at least some control over their life because, as the well-known saying goes, ‘knowledge is power’, and this, ‘power’, will provide empowerment to patients (principle number one of six, as outlined in the Care Act 2014.) Other safeguarding principles outlined in the act include;
- Prevention– Making patients aware of what abuse is, how to recognise the signs, and where they can seek help
- Proportionality– Delivering the least intrusive response appropriate to the risk presented, with the patient’s best interests in mind
- Protection– Providing support to those in need who wish to report abuse
- Partnership– Working with local services and community groups to help prevent, detect and report even more abuse and neglect, so as to deliver the best results possible
- Accountability– Remaining transparent about the care provided, to ensure that patients understand the role of everyone involved in their care, thus ensuring that they know who they can turn to for help and support in their time of need.
To ensure that all of the above principles can be properly followed, it is vital that mental health workers consider how abuse can take place in many forms, from the more commonly heard of types, such as physical, sexual, and psychological abuse, to the less commonly heard of types, such as organisational abuse, self-neglect, and financial/material abuse. Other types of abuse not included here, but still just as valid, include: neglect and acts of omission (ignoring one’s medical or physical care needs, such as by denying them access to education, medication, adequate nutrition, and heating, for example), discriminatory abuse (racism, sexism, ableism, homophobia, etc), and finally, domestic violence.
If a mental health worker believes that a patient of theirs is the victim of abuse of any kind, they should inform someone as soon as possible, with the act of doing this- reporting any suspected abuse- being referred to as ‘whistleblowing.’ This is essential as failing to do so would translate to the mental health worker having failed to follow the duty of care (a legal obligation) which they have over the patients of whom they care for…