Should school counselors uphold patient privacy or report students who become unstable?
Previously published on April 9, 2008
In late summer of 2006, Allegheny College, the school to which I am an alumnus, defeated a lawsuit alleging college policy, the inaction of various school administrators, and the negligence of the college psychologist were responsible for the death of a student who committed suicide after a long history of mental illness.
Although the parents were more than familiar with their son's illness and had been involved in his treatment at school, drastic improvements in his mental state left the student in a far more stable condition that enabled a less involved relationship with his parents. Moreover, the parents credited the school psychologist for this success.
In his junior year, a breakup with his girlfriend forced the student to spend hours in the school counseling center receiving treatment from the school psychologist. Once the student reached a level of stability, he and the psychologist decided the parents' involvement would be unnecessary.
After the student left the counseling center, he soon found his ex-girlfriend speaking with another male student; he committed suicide later that night. The parents felt they could have saved their son's life if the councilor had violated patient privacy and informed them of their son's visit to the Counseling Center.
Albeit this case involved someone over the age of eighteen, the issue of patient-caregiver confidentiality impacts those under the supervision of their parents' care as well as those who are not. The Law strives to protect individual privacy because there are those who could and would use private information to harm an individual while privacy ensures a degree of personal freedom. In the case of healthcare, privacy exists as a means of protecting the patient while it more broadly ensures a patient can trust a caregiver.
For medical providers, privacy helps facilitate the ability of caregivers to acquire information and encourages patients to be more forthcoming when it comes to key information. In most cases, family likely plays a significant role in an individual's healthcare, especially in the case of minors; however, there are times when an individual may not want to involve their family. If a healthcare provider is required to automatically relate private information to parents or authorities, the patient will simply neglect to report information that the patient does not want his or her parents to learn.
Meanwhile, there are cases where a child's mental health issues are cased by the parents' behavior toward the child, i.e. physical, emotional, and sexual abuse as well as more benign mistreatments. Without patient confidentiality, the patient cannot feel safe to explore issues that may be affecting his or her state of health.
The ability to confide in a councilor is important for any aged student as councilors can provide an opportunity for those individuals in need of immediate help to find help. At times, councilors, outside of schools, can take months before they have time to see a patient; however, school councilors can often see students within hours even if they do not have medical insurance. While it would likely be ideal for family to be involved in an individual's treatment, a student must have their right to privacy respected by schools while schools cannot be held responsible for setting policies that respect student privacy.
The psychological community strives to setup safeguards to help protect their patient, but sadly, there are times when a lack of information or poor circumstances result in unforeseeable behavior by the patient. If schools are to be held responsible for events that they cannot reasonably predict, they will likely be unable to take on the liability of counseling centers and far more students will suffer the consequences.
On the other hand, there are times when psychologists may be liable for misdiagnosing or poorly treating patients; however, the nature of psychological treatment leaves many openings for unforeseeable error. Moreover, violating the privacy of patients is something caregivers can do when there is a clear and present danger, but the consequences of requiring full disclosure to parents or authorities presents a broader danger.