Protection of privacy or impediment to care?

Earlier this week a friend of mine told me his nineteen year old daughter had been admitted to a psychiatric inpatient service. His relationship with his daughter is close, supportive and positive. Her illness had taken a turn for the worse and the difficult decision to hospitalize had been made collaboratively by the young girl, her parents and her outpatient treatment team. The next day he called the inpatient service to find out how she was doing. She was involved in a scheduled activity and was unavailable to chat with him. So he asked the staff member a simple question: “how is my daughter doing”? The response – “I can’t talk to you because that would be breaking her confidentiality”.

As expected, he was shocked. Not only was he one of her major supports, he had been involved in her care, her successes and her sorrows for the entire time she was unwell. He had worked with her and her previous health providers to address the challenges of her illness. And now, suddenly, he was told that he could not even be told how is daughter is doing because of “confidentiality”?

What kind of care is this? Does “confidentiality” mean that a concerned, involved and supportive parent cannot receive the simplest information about how their child is doing from a care provider? Is this barricading of children from their parents common across all types of health care, or is this unique to brain disorders? Is this what are trying to achieve when we work together to help people recover from their mental illness?

Certainly, young people need to be able to share their concerns, questions and problems in confidence with their health care provider. Is this the same thing as denying parents access to basic information about their child? Parents have important and essential roles to play in the lives of their children. This obligation does not end when puberty begins. Indeed, it amplifies: and becomes more complicated. Health care providers need to understand how important the relationship between parents and their children is. They need to understand that “independence” is a relative term, one that continues to evolve over the entire duration of the relationship between parent and child. We have to do better.

--Stan