Shifting the way we think about privacy
Health care providers work to create acceptance and compassion for those suffering from mental illness, but they often cite privacy concerns as a barrier to sharing information and working with families. That’s why an education event on Sept. 23, open to clinicians and the public, focused on why our approach to privacy needs to shift.
Over 100 people were in attendance at Vancouver General Hospital, with others connected by videoconference, to learn or refresh their knowledge about sharing a client’s personal information with health care providers, family members or law enforcement.
It’s privacy, not secrecy
In the past, privacy messages left some health care providers feeling uncertain about what they could communicate and afraid of repercussions if they communicated too much.
“Health care providers are constantly faced with this grey area,” explained Monica Muller, legal counsel for information access, as she talked about situations when clients ask that information be withheld from others. “But it’s important to always go back to what’s in the best interest of the client, and what you need to know to provide the best care.”
The heart of the discussion
The first presentations set the foundation for the discussion, including key elements of the Freedom of Information and Protection of Privacy Act, a new Family Involvement With Mental Health and Addiction Services Policy and a revised Release of Information and Belongings to Law Enforcement Policy. The second half of the event invited all in attendance to join a panel discussion about complex scenarios that are often faced when engaging families and other care providers as part of the circle of care, while supporting the needs of individual privacy.
For instance, what does a physician do when “John,” who lives with schizophrenia, becomes paranoid about his wife’s trustworthiness every time he becomes ill and insists that his personal information not be released to her? What can be shared with his wife of five years when she visits the hospital?
Or what could a case manager do if “Laura,” who has previously attempted suicide and has a significant addiction, misses her last two scheduled appointments? Should the case manager reach out to Laura’s sister for information?
The panel, facilitated by Cynthia Startup, director of regional clinical services, planning and strategic development for emergency/trauma, included:
- Dr. Lakshmi Yatham, regional head of the Department of Psychiatry, VCH/PHC, and the regional program medical director for Mental Health & Addiction Services
- Sally Hull, BC Schizophrenia Society
- Howard Tran, Vancouver Police Department
- Kathy Christakis, patient services coordinator in VGH’s Emergency Department
- Letizia Lorello, peer support worker
- Dr. Eric Grafstein, regional head of the Department of Emergency Medicine, VCH/PHC, and the Regional Emergency Services Council co-chair
- Darren Kopetsky, regional director of Client Relations & Risk Management, VCH
“You don’t have to be perfect,” said Steven Tam, chief privacy officer, in the closing moments of the session. “Health care providers should feel that they have the power to make decisions about sharing information as long as they are done in good faith, in the best interest of the health and safety of the client.”
Overheard during the panel discussion
[Working in partnership with the family] “If the family is around, they want to know.” – Sally Hull
[How we work together with law enforcement] “When we talk about public safety and risk mitigation, it doesn’t always mean prosecution. We have lots of other measures we can take. Communication is always key. We are not about criminalizing mental illness.” – Howard Tran
[If someone is concerned about whether to share information] “In the emergency room, what I’ve found is that doing nothing is always worse that doing something.” – Dr. Eric Grafstein
[The definition of a family member] “A family member is any person who is identified as being in a relationship of importance to the client and provides regular support or care for them.” – Monica Muller
New policy and resources
- VCH has a new Family Involvement With Mental Health and Addiction Services Policy, which recognizes the importance of collaboration amongst clients, families and care providers for better client outcomes.
- VCH has also recently revised its Release of Information and Belongings to Law Enforcement Policy to provide more clarity and direction on sharing information with police.
- A new Quick Reference Guide on Disclosure of Personal Information to Law Enforcement helps guide staff through different scenarios that may arise.