Confidentiality | Patients

What Patients Need to Know about Confidentiality and Mental Health

Standards of Confidentiality3,4

Health care providers are prohibited from sharing protected health information unless it is authorized by you, when authorized due to limits of confidentiality or policy, or when court ordered.

Prior to disclosing anything you are concerned about, carefully read your informed consent. Ask questions to make sure you fully understand limits of confidentiality.

Limitations to Confidentiality1,2,4,5,7,8

Notification is required for the following limits to confidentiality:

  • Harm to Self: Serious risk of self-harm by the service member as a result of the condition itself or medical treatment of the condition
  • Harm to Others: Serious risk of harm to others by the service member to include any disclosures concerning child abuse, sexual abuse, or domestic violence
  • Harm to Mission: Serious risk of harm to a specific military operational mission by the service member due to a disorder that impacts impulse control, insight, reliability, and judgment
  • Special Personnel: Service members assigned to Nuclear Weapons Personnel Reliability Program and other special duties (e.g., military law enforcement)
  • Inpatient Care: Admission or discharge of a service member from an inpatient mental health facility including partial hospitalization programs, intensive outpatient programs, and residential programs
  • Acute Medical Conditions Interfering with Duty: Acute mental health or substance abuse condition that impairs the service member’s ability to perform assigned duties
  • Problematic Substance Use Treatment Program: Voluntary or involuntary enrollment in a substance abuse outpatient or inpatient program due to findings from initial evaluation
  • Command-Directed Mental Health Evaluation: Mental Health Evaluation findings from a command-directed mental health evaluation
  • Other Special Circumstances: Case by case basis when the execution of a military mission outweighs the interest served by avoiding notification to command, or when required by policy

Who has access to Protected Health Information?

  • Chain of command (within limits to confidentiality)
  • Members of your health care team (i.e., nurses, dentists, medical assistants, behavioral health technicians, behavioral health providers, and front desk staff)

Additional Mental Health Resources

Policies to Reference for Guidance

  1. DODI 1010.04 Problematic Substance Use by DOD Personnel
  2. DODI 6490.04 Mental Health Evaluations of Members of the Military Services
  3. DODI 6025.18 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule Compliance in DOD Health Care Programs
  4. DODI 6490.08 Command Notification Requirements to Dispel Stigmas in Providing Mental Health Care to Service Members
  5. DODM 5210.42 Nuclear Weapons Personnel Reliability Program
  6. Military Rules of Evidence, Rule 503
  7. DODI 6400.01 Family Advocacy Program
  8. DODI 6495.02 Sexual Assault Prevention and Response: Program Procedures

Need to Talk?

Contact the Psychological Health Resource Center 24/7 to confidentially speak with trained health resource consultants. Call 866-966-1020 or use the Live Chat.

Remember, 988 Suicide & Crisis Lifeline provides 24/7, free and confidential support via phone or chat for people in distress, resources for you or your loved ones, and best practices for professionals. For the Veterans/Military Crisis Line, dial 988 and press 1 or text 838255. You can also chat online. For OCONUS calling options and online chat accessible from anywhere in the world, visit the Military Crisis Line website.

Updated December 2023

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