Should medical privacy laws apply to the mentally ill?

[theboss]

Yes or no.

[Mojorabbit]

1. That is a good question

I have to think about an answer

[liberalnurse]

2. It's already protected

by HIPAA.

http://www.hhs.gov/ocr/hipaa/

http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act

[theboss]

24. I know that

The question is...should it.

There's a lot of threads discussing how everyone should have been informed about the VT shooter's mental health issues.

[zanne]

3. What types of mental illness would be covered?

For instance, Grief Counseling would go under the "mental illness" umbrella. So would depression.

[LeftyFingerPop]

4. Of course they should. Why not? n/t

[jwirr]

5. That is a hard question. The definition of mentally ill covers a very

wide territory. Maybe it could be narrowed down a bit. For instance, is there a category of mental illness that applies only to those who are likely to use violence either against themselves or others? Who should know about the records? Medical community? Police? NSA? The whole community? All of this and more must be considered before anyone's privacy is invaded.

[supernova]

6. Well, yes!

Even the mentally ill deserve some degree of control over their lives. They are individuals; they aren't your' personal puppets.

From what I understand, an adult has to be legally declared , IN COURT, to be mentally incompetent. Then that person has to have somone appointed for them to make medical decisions.

[AuntPatsy]

7. You know, I agree that they need some control of their lives but

what happens when they honestly don't have the ability to do that and yet can fool the courts into believing they do? Only those living side by side with someone can actually witness the decline of ones mental instibility, I know there is abuse or has been by some family members attempting to commit family members so in some ways I understand the laws and yet, for me personaly, I have no evil motives other than trying to get help to a loved one who firmly believes they are not in need and its more than frustrating especially when you know very well they can be harmful to others no matter their size.

[supernova]

9. Forgive me

I noticed that you hinted yesterday that you were having difficutly with a relative, yes?

Honestly, it's a fine line. I don't know what to tell you. My SiL has had problems before and my brother at one point called the sheriff. She got committed for a while until they could figure out what to do. (This was several years ago and she appears to be doing OK now.)

If your relative is violent you're best bet may be to call 911. My heart goes out to you.

[AuntPatsy]

11. I've tried that, she was diagnoised with physcosis and yet the

fact that she didn't harm anyone in the five days she was kept under watch or attempt to harm herself was reason to believe she could never harm anyone...

I'm not sure I could call the police again, after having to do it three times it leaves you almost numb since you know what the outcome will be..

I guess I have to wait until she actually hurts someone, it is my daughter, it really does hurt the whole family, the dynamics are so out of control at times, it is so very hard for even family members to live with and you can't force them to understand when they find it so hard to.

I assume that is why not more is done in the public sector, it is not an easy issue to face.

[supernova]

15. Or as a last resort

you might be able, with tact, to take the line "we're not able to care for you. You might be better off among professionals." She might, MIGHT go for that if you try to impress upon her that she is taxing your resources (emotional) more than you can deal with.

Honestly, I think you shoud talk to a lawyer and a social worker who work with troubled adults and see where the boundaries are. Good luck to you. :hug;

[hlthe2b]

8. Yes, of course...

Do those who advocate public disclosure (or at least a diminishing of privacy protections) wish to drive everyone AWAY from the mental health system, for fear of stigmatization, losing their job, or other issues?

I frankly am shocked we're asking this. Given the most common reason for seeking mental health help is depression, such disclosure could only increase the already epidemic rates of suicide in this country.

However, there ARE mechanisms (both legal allowance and expectations) for mental health professionals to reveal the identity of an imminently or potentially dangerous patient to appropriate authorities...While they are fallible, I can't imagine that mental health professionals would refuse to do so if convinced of danger to the patient or others.

[TX-RAT]

10. Not when it involves purchasing a fire arm.

[AuntPatsy]

12. it is very easy to obtain fire arms illegaly and for a small price....

far too easy, but I do believe that those with past mental problems should be known to gun dealers...and I am a gun advocate.

[WinkyDink]

13. I haven't forgotten that Bushco wants EVERY CHILD tested for "mental illness".

http://www.countercurrents.org/pringle110706.htm

http://www.scoop.co.nz/stories/HL0608/S00010.htm

http://www.beverlye.com/200410131912.html

So, yes, I want those privacy laws.

[Cobalt Violet]

60. I haven't forgot that either.

They want to drug them and take away their privacy rights. It's a win-win for the Bushcos.

[Phillycat]

14. Of course.

[Bridget Burke]

16. Yes.

Read up on HIPAA.

It does not prevent communication within the medical community. But it attempts to limit release of medical information to those who should not get it.

[theboss]

25. I am a health care attorney; I know HIPAA backwards and forwards

Apparently, there is quite a group here that thinks HIPAA is bad law. I'm curious to see the opinions.

[Bridget Burke]

31. OK. You want to see people's opinions.

But you don't offer yours.

[theboss]

32. Yes, it should be protected

A person's individual right to privacy outweighs society's need to "protect" itself.

[Bridget Burke]

33. OK, I was being snarky! n/t

[TahitiNut]

17. It's the ol' "liberty vs. safety" argument.

Let's try hard to remember that many centuries of human experience has validated the proposition that human rights and civil liberties are worth the investment of lives - millions have sacrificed their lives to obtain those liberties for their neighbors and descendants. As liberals, such a hierarchy of values should be inarguable.

As soon as we make illness and obtaining treatment for illness a matter of sacrificing liberties for the sake of some statistical, indirect safety consideration, we will become enslaved. It's a shitty bargain.

[Madspirit]

18. As someone

As someone with bipolar disorder, PTSD and depression may I just say...FUCK THIS QUESTION.

...and oh yeah, if YOU...the collective YOU...took a complete battery of psychologicals...they take about three days...YOU would surely show up with something wrong. I promise.

Thank-you but not very much.
Lee

[porphyrian]

19. They already do, and of course. - n/t

[cgrindley]

20. No.

This medical privacy crap has to go. The good of society always has to come first.

[BlackVelvet04]

28. I hope that was sarcasm. n/t

[cgrindley]

29. No, it wasn't.

I'm a huge believer in a strong, centralized, federal socialist government, nationalized rationed health care, free public education and so on. I feel that individual rights occasionally have to be displaced for the greater good of everyone.

[Bridget Burke]

30. He's not really a Liberal

(He just plays one on the Internet.)

[cgrindley]

34. I joined the honest to god liberal party in 1984

in Canada. I am a huge believer in a social democracy and a benevolent "nanny" state.

[Bridget Burke]

36. But you think we all need to carry guns....

www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=118&topic_id=136962

[cgrindley]

46. D'uh, I'm Canadian

We're all armed up there, we just don't really shoot as many people as Americans do.

[mainegreen]

42. Indeed. That's why we have medical privacy laws.

[benEzra]

21. Would you be less likely to seek mental health treatment

if you know it would be public information?

[AZBlue]

22. That depends upon the circumstances.

Do they want to buy a gun? No. For their own sake as well as others.

In most other circumstances, Yes.

[theboss]

26. How would that work?

How do you do a background check for mental illness when buying a gun but protect that information in every other circumstance?

[AZBlue]

27. You have a psychological exam or a doctor's reference.

They do it in Europe.

[depakid]

50. self delete.

[SmokingJacket]

38. Possibly a federal no-gun list. nt

[Madspirit]

23. I PROMISE

If YOU...the collective you...took a full battery of psychologicals, which takes about three days...YOU would show up with something. I promise.

The mentally ill to be afraid of are the ones who DO NOT seek help. This whole argument is inane. The ill people who do not seek help, ergo it would NOT be in their medical records, are the ones who will go buy guns off the streets and shoot you. The mentally ill who DO seek help are the ones not to be afraid of. You people are ludicrous in your illogic.
Lee

[BluePatriot]

35. Yes

Mostly because psychology/mental illness is still so subjective. For example, there are a lot of physical conditions that cause mental effects. A psychologist won't even order a physical exam before doping you up on drugs. (Maybe a competent one would, but the three I bounced around to over a series of years never did) That's how I wound up taking brain-altering mood stabilizers for a month before going to a GP of my own free will due to other physical symptoms/Google, getting blood work, and finding out I had the below:

http://en.wikipedia.org/wiki/Silent_thyroiditis

Much love to DUers with mental illness. The brush with that segment of the medical system was terrible. "But I have thyroid problems! Here is the blood work!" "*pat pat* Oh, you are in denial, here's more drugs..." "I'm going off these drugs. The mental symptoms are side effects of a physical illness. Let's treat that physical illness." "Oh, you are NONCOMPLIANT on your drugs. And your symptoms are PSYCHOSOMATIC."

***nightmare***

I will however admit that the above scenario is relatively uncommon. At least I hope to God it is. I am lucky I'm educated and question authority.

[SmokingJacket]

37. Yes.

People do recover and should have a chance to live their lives on equal footing with everyone else.

That said, MUCH more needs to be done in terms of getting treatment to people who need it.

EXCEPT that I'd say that ONE single psychotic episode or suicidal threat should bar you from legal gun ownership for life. That is one right I feel fine denying someone.

[Cobalt Violet]

39. yes.

[Maddy McCall]

40. Yes. Without a doubt.

[proud2BlibKansan]

41. Yes

unless they want to buy a gun.

[renate]

43. what if it depended on the type of mental illness?

I certainly don't need to know that my neighbor has been diagnosed with depression or bipolar disorder, and I probably don't have any need to know even if they have a more outwardly-directed mental illness like paranoid schizophrenia, as long as it's being controlled with medication.

But if my son or daughter is going off to school and is possibly going to be sharing a room with a person whose mental illness is not under control and they are potentially violent, I think I not only need to know, I should have a right to know. Their right to privacy ends where my child's right to safety begins. At the moment, I don't have that right to know, and that concerns me.

I might get flamed because I probably haven't adequately clarified that I do think people with most mental illness should have a right to privacy. But I don't think that right trumps the rights of others to be safe.

I should probably add that the vast majority of people with mental illness have no more of a tendency towards violence than people without. So I'm only talking about those very few who pose a risk to others.

[theboss]

49. It's not an exact science

And how do you know that it is or isn't under control? Who monitors these things?

Central Headquarters: "He has not taken his meds since Tuesday. Send in a team!"

[uppityperson]

44. What if the mental illness is pedophelia? And my take on the OP

Throwing a wild option out there. Pedophiles are mentally ill, according to most definitions, yet convicted ones have alerts posted, you can look them up online, etc.

2 comments on the original post: I am torn between what is good for society and what is good for the individual, whether mental or physical health. While I appreciate what HPPA is trying to do, I do not think that it is right yet, it still needs modification.

[meldroc]

45. For which illnesses, and what severity?

Right now, we're on one extreme side of the pendulum swing, but there were times in this country when we were on the other side - people could be declared "insane" and institutionalized at the drop of a hat. Frequently, people who were not truly mentally ill were institutionalized, maybe because they had malicious relatives who wanted them "out of the picture" or because they were a little odd, or because they pissed the wrong person off. Homosexuals used to be institutionalized.

Then as in now, people who were mentally ill were neglected, only instead of in jails and on the street like today, they languished in hellhole institutions. Treatments were such fun things as bathtub electroshock and icepick lobotomies. State-run institutions always had tight budgets, so they didn't pick the cream of the crop for their staff, so doctors and nurses tended to be awful.

Also, when suggesting committing someone or taking away his liberties, what kind of mental illness are you talking about, and what severity? There's lots of people with low-level depression who could use treatment, but realistically won't hurt others or themselves. There's so much "odd" and "eccentric" and "abnormal" behavior that's just individual traits that don't harm anyone, and absolutely should not result in forced treatment or institutionalization. I listen to heavy metal music, I play violent video games, and I read science fiction novels. Certainly, Stephen King and Chuck Palahniuk wrote some really disturbing stuff, but would you commit them and pump them full of thorazine? Also, just because someone is psychotic today doesn't mean he's psychotic for the rest of his life. Give most mentally ill people proper treatment, and their symptoms will be relieved to the point where they can live normally and make their own decisions. At that point, they'd better damned well get all their liberties back.

The present laws evolved because of all the abuses, now you have to prove beyond a shadow of a doubt, in a court of law, that a person is mentally unfit before a judge will take away his rights and order him treated or institutionalized against his will. It may have gone too far in that now it's too difficult to take a person who's clearly psychotic and a potential danger to himself or others and get him the treatment he requires, but it should be hard to take away liberties.

[bobbolink]

47. NO! Go after the suckers! Nail 'em!

It's so much easier to go after the most vulnerable, rather than looking at our own violent nature.

And that includes us all. Just look at the attack patterns right on this forum, and how it's defended.

No, keep blaming and cornering those who already suffer the most!

It's the (self) righteous thing to do.

[Joe Fields]

48. yes

[mdmc]

51. yes

[depakid]

52. It depends. In this case there was an adjudication

albeit it involved and outpatient referral, which apparently was the loophole.

Nevertheless, there was a finding on the record that this guy was a danger to himself or others.

In other countries, being "scheduled" or "sectioned" as they call it, would preclude one from obtaining a shooter's license. That should be the case in America too- or, at the VERY least, it should be a rebuttable presumption, requiring a hearing and clear and convincing evidence to reverse.

I would personally have no problem with licensure requirements where a person had to prove up front that they are mentally stable, through a physician's declaration or affidavit.

It would be similar to what the FAA does with private pilot's licenses- one has to have a flight physical and my understanding is that the FAA has regulatory power to inquire into medical records, as a precaution against people who'd submit false statements or cover up their disorder(s). With the FAA, many psychiatric conditions can be waived, and a license issued or renewed provided that physicians certify that the applicant is being or has been treated and is stable.

My understanding is that this is more generous than other countries; Canada apparently applies a blanket prosciption on people with certain forms of mental illnesses.

Privacy laws don't and obviously shouldn't trump many valid regulatory concerns. A balance must be struck that affords the individual suitable protection against discrimination and stigma on the one hand, while protecting the interests of society at large on the other.

In the medical context, it's been mentioned that there is a federal prescription database. I was unaware that indentifiers were being used that could easily be traced to individuals. I understand the need to regulate physicians with respect to potential abuses of their prescription pad, though I can see such a database being put to nefarious uses.

Do you know in more more detail about how that system works?

[melm00se]

53. yes

[etherealtruth]

54. Yes

[piedmont]

55. Yes. nt

[Bluerthanblue]

56. absolutely!! do you want to make people even MORE resistant to treatment.

it's a no-brainer.

this is really turning into a witch hunt against the mentally ill-
and it's disgusting.

[EFerrari]

57. Definitely. And, the laws need to be tinkered with to provide

equal protection to the person suffering mental illness and to the community. This will never be an easy balance to achieve, imho, but we need to keep working it.

[flying_monkeys]

58. Yes.

nt

[BurtWorm]

59. Of course, yes.

Mental illness has enough stigma attached to it to exclude it from privacy rights.