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I have been a mental health counselor since for many years and part of the problem, as I see it, is that mental health is “governed” by a medical model and included in states’ insurance codes.

I agree that this is a breach of confidentiality. Revoking licensure is where states have the mental health professionals.

Child abuse, threats of harm to self and others are already allowable as breaches to confidentiality because mental health counselors are defined as “mandated reporters.”

I believe that mental health professionals should have privileged communication between themselves and clients — not confidentiality which is subject to subpoena and other reporting requirements.

I explain this difference to clients in their first session. I will say that the ordinary person doesn’t know the difference between confidentiality and privileged communication. I will admit it’s a fine line difference but it’s an important one.

— Jane Reinheimer

Jane, I worked in a mental health hospital and was often forced to report on conversations I’d have with specific patients at the end of my shift. I had to report any suicidal talk or ideation as well as negative or flat affect, despondence, lack of response to psychopharmaceuticals, and any marks or bruises on the body that might indicate cutting or hesitation of harm.

I always felt like I was betraying the trust of the patient when I wrote these reports, but I valued the care that our psychologists provided to them when they were obviously unfit to care for themselves. That being said, I worry that similar expectations will fall upon our LCSWs and standard clinical psychologists whenever a patient seeking someone to talk to mentions suicide or other personal mental issues. This will damage the industry as those who are genuinely mentally unstable will put off seeing a professional in lieu of self-treatment through recreational drug use or alcoholism.

Child abuse, threats of harm to self and others are already allowable as breaches to confidentiality because mental health counselors are defined as “mandated reporters.”

Although I'm not a mental health counselor myself I've worked alongside of many in my day (I worked for 20 years in a large hospital's ER).I understand the importance of confidentiality but I also understand the importance of public safety.In my work I came across some pretty "spooky" folks...as I suspect you have.When does "the public good" supersede personal privacy in a situation like that?

Child abuse, threats of harm to self and others are already allowable as breaches to confidentiality because mental health counselors are defined as “mandated reporters.”

Although I'm not a mental health counselor myself I've worked alongside many in my day (I worked for 20 years in a large hospital's ER).I understand the importance of confidentiality but I also understand the importance of public safety.In my work I came across some pretty "spooky" folks...as I suspect you have.Some of them,IMO,were not fit (at that time,at least) to be in possession of a butter knife let alone a firearm.When does "the public good" supersede personal privacy in a situation like that?