title: Best practice when service users do not consent to sharing information with carers. National multimethod study.
abstract: BACKGROUND
  Service users with psychosis may not consent to sharing information with carers. However, carers require access to relevant information to support them in their role.
  
  
  OBJECTIVE
  To inform clinical practice when service users withhold consent to share information with their carer.
  
  
  METHODS
  Study data were derived from a synthesis of policy review (n=91), national survey (n=595) and individual interviews (n=24).
  
  
  RESULTS
  Key principles to guide information-sharing practices were identified. Service users highlighted confidentiality being guaranteed by consent processes. Carers suggested a 'culture shift' was required, with professionals trained to work with carers. Professionals emphasised mental capacity, professional judgement and the context of care. A best practice framework is proposed.
  
  
  CONCLUSIONS
  An important distinction is between general information, which can always be shared without consent, and personal information, which is new to the carer and where consent needs to be considered. Clinical judgement is central to balancing conflicting ethical imperatives in this area.
authors.affiliation: Health Services Research Department, Box PO29, Institute of Psychiatry, King's College London, London SE5 8AF, UK. m.slade@iop.kcl.ac.uk
authors.forename: Mike
authors.initials: M
authors.lastname: Slade
authors.forename: Vanessa
authors.initials: V
authors.lastname: Pinfold
authors.forename: Joan
authors.initials: J
authors.lastname: Rapaport
authors.forename: Sophie
authors.initials: S
authors.lastname: Bellringer
authors.forename: Sube
authors.initials: S
authors.lastname: Banerjee
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuipers
authors.forename: Peter
authors.initials: P
authors.lastname: Huxley
mesh_terms: D001294:Attitude to Health; D017028:Caregivers / Q000592:standards*; D003156:Community Mental Health Services / Q000458:organization & administration / Q000592:standards*; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D011368:Professional-Family Relations / Q000941:ethics*; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*