Mental health confidentiality

• Communicate with your loved one. Let them know you are there to support them in their recovery process.
• Ask your loved one about how you can support them in their treatment and recovery.
• Communicate with your loved one’s service provider (person or agency that provides  the mental health services) and/or family doctor. Let them know you are a family member and give them information that might be helpful. You can share your concerns with your loved one’s service provider even if they are not able to share your loved one’s information with you.  
• Ask your loved one’s service provider and/or family doctor how you can support your loved one and the team.
• Encourage your loved one to sign a consent form with their service provider to share health information with you.
• Encourage your loved one to develop a wellness recovery action plan (WRAP), a plan that a person with mental illness develops to state how they plan to manage their mental wellness and identify what helps when he/she is well or unwell.

If your loved one is already receiving support and treatment from a community Mental Health and Substance Use Centre:

• You can call the community mental health and substance use centre and ask for your loved one’s case manager/service provider or doctor and voice your concerns to him/her.
• Ask your loved one how you can help or support them in their recovery and treatment.
• Ask your loved one’s service provider or doctor how you can help or support your loved one in their recovery and treatment.
• Encourage your loved one to sign the consent form for the service provider to speak with you and place it in your loved one’s file.

If your loved one is not currently receiving support and mental health treatment and you believe he/she needs mental health help:

• You can call the community mental health and substance use centre and ask to talk to someone about your concern.
• Ask your loved one how you can help or support them in their recovery and treatment.
• You can call your loved one’s family doctor about your concern.
• Ask your loved one’s family doctor how you can help or support your loved one in their recovery and treatment.   
• If urgent call 9-1-1 or find out about other emergency help.

If your loved one is receiving treatment on an inpatient psychiatric unit (hospital):

• Ask the staff/service provider what programs/services are offered on the unit.
• Ask what information is available for family members on the unit.
• Let the staff/service provider know if your loved one already has a wellness recovery action plan that identifies the support person he/she would like to involve in their recovery.
• Let the staff/service provider know if your loved one has a representation agreement.    
• If your loved one is certified under the Mental Health Act, the nurse is required to inform a near relative about their admission, if they apply to a review panel and when they are discharged.
• For more information about your loved one’s mental illness, you can encourage your loved one to sign a consent form for staff/service providers to share the information.

• If your loved one has signed a consent form to share information about their mental illness and/or substance use concerns with you, the doctor/staff/service provider can speak freely with you about it.
• If your loved one has signed a consent form to share only specific information, then the doctor/staff/service provider can speak about those things.
• If your loved one has not signed a consent form, the service provider may or may not be able to share some information with you.  

The doctor/staff:

• Can always talk to you about general information on mental illness or substance use.
• May need to share certain information with you if there is a risk or threat of harm to you.
• May be able to share some health information with you for the purpose of your loved ones continuity care/wellness and recovery.

For more information, see the Guide to the Mental Health Act - Appendix 13, Pg. 119 - 126.

You can always provide information to your loved one’s service provider team by that will help in their wellness and recovery. Generally contact is made by phone, a letter, or through a visit at the place where your loved one is receiving services.

• Visiting with your loved one on the inpatient psychiatric unit is a strong way to show support.
• Ask your loved one about his/her experience and what has been helpful.
• Ask your loved one what you can do that would be helpful or supportive.
• Seek out information and support that is available to family members and supporters. 

These are some things that you can do to support your loved one’s recovery.

• Encourage your loved one to take a wellness recovery action plan workshop or ask their case manager/service provider about it.
• Get information yourself about mental illness and mental health recovery.
• Get support for yourself as you continue to support your loved one.
• Provide information to your loved one’s service provider about your loved one’s mental health that may be helpful to his/her recovery. For example, information about the living arrangement and environment, as well as, your role in your loved one’s life and recovery.
• When your loved one is well, encourage him/her to make a representation agreement with the person he/she would like to act on their behalf. 
• Ask the service provider to discuss with your loved one about different ways that information can be of value for you to continue supporting him/her.  

• Obtaining information about your loved one's discharge from hospital is easiest when you and your loved one is in close communication about their stay on the inpatient psychiatric unit or when they have signed a consent for the release of their information. Your loved one may communicate directly with you about when they leave the hospital and the team may be able to confirm this with you in some circumstances.          
• If your loved one was admitted involuntarily and has chosen you as the “near relative”, the staff/service providers should notify you about your loved one's admission, when your loved one leaves the hospital, or if/when your loved one applies to the Review Panel. The Review Panel is a group of people some of whom are appointed by the government to make sure that the persons certificate is cancelled if they no longer need to be certified. This provision is made under the Mental Health Act.  
• Staff/service providers may also encourage your loved one to let you know when they are leaving the hospital. 

Your loved one will be referred back to his/her family doctor for follow up support.

If your loved one needs ongoing specialized mental health services, he/she may be referred to mental health services in his/her community for follow up support.

Your loved one may also be given the names and contacts of other community resources like the crisis line or community services that they can use for support.

Your loved one has been working on their recovery with their service providers and you may have been involved in this process. Finishing services at their community mental health and substance use centre is a sign that your loved one is managing well in their wellness and recovery and can continue their wellness with less specialized mental health services. There may be other services available to them outside of the mental health centre to support or maintain their wellness. For example:

• Family physician can continue to prescribe and monitor psychiatric medication.
• Community services such as support groups or activities offered through recreation centres.
• Mental health support through clubhouses.

These are some things you can do when your loved one is well:

• Encourage your loved one to take a wellness recovery action plan workshop or ask their service provider about it.
• Encourage your loved one to name his/her supporters with his service provider.
• Encourage your loved one to sign a consent form to share the information he would like you to know when he/she becomes ill.
• When your loved one is well, encourage him/her to make a representation agreement.
• Ask the service provider to discuss with your loved one how sharing his/her health information can help you to better support him/her in their wellness and recovery. 

When your loved one is well:

• Encourage your loved one to take a wellness recovery action plan workshop or ask their service provider about it
• Get information for yourself about mental illness and mental health recovery.
• Get support for yourself as you continue to support your loved one.
• Provide information about your loved one’s mental health to the service provider that may be helpful to his/her recovery
• Encourage him/her to make a representation agreement (a legal document that the person signs with another person that he/she would like to make health care or other personal decisions for them if they become able to do so). 
• Talk to the service provider about your relationship with your loved one and the role you currently have in their wellness and recovery.
• Ask the service provider to discuss with your loved one how he/she views your role in their wellness and recovery.  

Your relationship with your loved one can be an important part of their recovery. These are some things that you could try:

• Talk to your loved one about their fears or reasons they don’t want help.
• Talk to your family doctor about your concerns.*
• Talk to your loved one’s family doctor about your concerns.
• Call your community mental health and substance use centre about your concerns.*
• Find out information for yourself about mental illness. There are supports for families through the Family Support Program (1-877-717-5518). They can also help you with ideas of what you can do.
• You can call the Fraser Health Crisis Line.

*This information is based on the Freedom of Information and Personal Privacy Act (FOIPPA).

• Communicate with your family. They are your strongest allies in your recovery process.
• Communicate with your service providers (a person or agency that provides mental health services). Let them know who your family members are and that you would like them involved.
• You can decide which things you would like to share with your family and which things you would like to keep private.
• Ask your service provider about signing a consent form so you can be clear about which information you would like to share with your supporters and which information you prefer to keep private. 
• You can develop a wellness recovery action plan (WRAP) and identify things and supporters that help you to stay well and what helps when you are unwell.
• If you are on an inpatient psychiatric unit, let the staff know who you would like them to inform that you are at the hospital, when you leave the hospital, or, when/if you apply to the Review Panel. A Review Panel is made up of a group of people, some of whom are appointed by the government, to act without bias on behalf of a person who has been certified under the Mental Health Act and the organization that certified the person to see if the person should be decertified (have their certification cancelled).      

The staff will ask you who you would like them to inform that you are on the inpatient psychiatric unit. If they have not asked you, you can let them know who you would like them to contact.

There are many things that can be helpful in your recovery process. One very important thing is having supportive people around you. 

• The staff will share with your family the information that you both agree is helpful to your recovery. 
• You can talk to your staff/service providers about how you would like to involve your family.
• You can let your family know how they can be helpful.
• For your continued wellness/care in the community, staff/service providers may need to speak to other service providers, your family or others who you identify as your support persons.

Your service provider will not openly share information about you, and will make their decisions to share information based on a well thought out decision making process that includes laws on privacy. Supportive family can be a big part of your recovery and including them in conversations about your recovery can be helpful.  

It is helpful to talk to your service provider (person or agency that provides services) about what information you would like to keep private and what can be shared. If your service provider believes that sharing some health information with your family or support person (that you identify) may be helpful to continue your recovery and mental wellness they will talk to you about why they believe it is important and will make all efforts to obtain your consent to share information.

You can find more information about your right to privacy in the following documents:

• Mental Health Act
• Freedom of Information and Protection of Privacy Act (FOIPPA)
• Mental Health Act of B.C. (MHA) Section 33.2(a) - Appendix 13 Pg. 119 - 126

There are a number of things you can do to keep your supporters involved:

• Talk to them about what helps you to stay well so they can continue to support you.
• Develop your own wellness recovery action plan (WRAP) and name your supporters as part of that plan.
• Bring your WRAP with you to the inpatient psychiatric unit so the staff/service providers know what and who helps you.
• Develop a Representation Agreement when you are well with a person you choice to act on your behalf.
• A legal document signed by a person of ones choice to make health care and other personal decisions for them in the event they become unable to make those decisions for themselves).       
• As soon as you feel ready, let the staff/service providers on the unit know that you would like your family involved.
• Tell your family that you want them involved, and whenever possible, have this conversation together with your family and service provider.

There are a number of things you can do when you are well (before you’re on the psychiatric inpatient unit) to keep your family involved when you are on the unit:

• When you are well, talk to your family about some things you do to stay well so they can continue to support you.
• Develop your own wellness recovery action plan (WRAP) and include your family as part of that plan.
• Bring your WRAP with you to the inpatient psychiatric unit so the staff/service providers know what and who helps you.
• Develop a representation agreement when you are well with a person you choose to act on your behalf.         
• If you’re able, let the staff/service providers on the unit know you would like your family involved.
• Keep your family involved when you are well and let your staff/service providers know that you’d like them to stay involved if you are on the inpatient psychiatric unit.

• Let your service provider know that you would like your family involved in any or all of your recovery plans.
• Let your family know how you would like them involved in your recovery.
• Talk to your service provider about what information you would like to share and what information you would prefer to keep private.
• Sign a consent form for your service provider that outlines the kind of information you want your service provider to share with your family.
• If you find it helpful you may be able to invite your family to some of your sessions.

We encourage you to speak to your service provider about opportunities for your family or others to participate. Each service is different and there may be exceptions to participation. You may decide on different ways you would like to include your family or person who supports you  in your wellness plan and there may be some people you prefer not to include.

These are some different ways you could include people:

• Ask them to accompany you to appointments.
• Ask them to help you to speak about things you may have problems talking about.
• Share with them information about the service you are receiving.
• Ask them to help you to develop your recovery plans.
• Ask them to support you with your plan.
• Ask them to support you in the community or at home.
• Ask them to check in with you sometimes.

Staff/service providers work hard to make sure your wishes are heard and that your plan for getting well and staying well is an important part of your experience on the inpatient unit. The staff will work with you to identify a person or a family member with whom you choose to share your health information. In some situations staff or physicians may be able to share some of your health information with the person you identify as your family or support network or others in your life. 

• If you tell staff that you plan to harm/hurt yourself or others, the staff would need to let the people you mention as well as your doctor and other team members know about your plan. This information is shared in order to help protect you and the persons you mention. See Guide to the Mental Health Act - Section 3.1, p. 5; section 3.2, p.g 9.

• If you are admitted to the psychiatric unit in the hospital as an involuntary admitted for treatment against your will) patient under the Mental Health Act, the staff may be able to share with your family or a person you identify as your family, that you are admitted. Information about when you are discharged  and when/if you apply for a Review Panel hearing. In some cases the staff may need to use their judgment when making a decision to disclose your information. Staff are still required to assess risk and make clinical decisions about when and how they share your information. See Guide to the Mental Health Act - Appendix 2.6 Pg. 70; Forms 15, 16, 17 and Freedom of Information and Protection of Privacy Act (FOIPPA).
• For your continued care, staff may be able to share relevant health information that will assist others with supporting you in your Wellness Recovery Action Plan. See Guide to the Mental Health Act - Appendix 13, Pg. 119 - 126 and Freedom of Information and Personal Privacy Act (FOIPPA) Section 33.2 (a); 31.1(1)m; 34.2.

*This information is based on the Freedom of Information and Personal Privacy Act (FOIPPA) and B.C. Mental Health Act.