When and How Should Clinicians Share Details from a Health Record with Patients with Mental Illness?
Stigma associated with mental illness-a public health crisis-is perpetuated by the language used to describe and document it. Psychiatric pathology and how it can be perceived among clinicians contribute to the marginalization of patients, which exacerbates their vulnerability. Clinical documentation of mental illness has long been mired in pejorative language that perpetuates negative assumptions about those with mental illness. Although patients have the legal right to view their health record, sharing mental health notes with patients remains a sensitive issue, largely due to clinicians' fears that review of this content might cause harm, specifically psychiatric destabilization. However, the ethical principles of justice, beneficence, and autonomy as well as nonmaleficence must be considered by clinicians in determining when and how to share psychiatric details from a health record with their patients.
Second-year resident in the Harvard Longwood Psychiatry Residency Training Program in Boston.
Robyn P
RP
Thom
Psychiatrist on staff at Beth Israel Deaconess Medical Center and an instructor at Harvard Medical School in Boston.
Helen M
HM
Farrell
D026686:Beneficence; D030881:Disclosure; D004992:Ethics, Medical; D055991:Health Records, Personal / Q000941:ethics*; D006801:Humans; D007802:Language; D001523:Mental Disorders; D028701:Patient Rights; D026684:Personal Autonomy; D010817:Physician-Patient Relations / Q000941:ethics*; D012935:Social Justice; D057545:Social Stigma; D013240:Stereotyping; D035862:Vulnerable Populations