News in Nursing

State Board of Nursing Requires an RN to Disclose Psychiatric Treatment

State Board of Nursing Requires an RN to Disclose Psychiatric Treatment

Knowing someone who has or had a case of any mental health problem is common. A neighbor’s child could suffer from bipolar disorder because of family history, and a co-worker could have issues with anxiety or depression due to a life-changing event. This condition is hardly anything new, especially in this demanding and fast-changing world.

However, just because something is typical doesn’t mean anyone can just trample at people’s sensitive matters. Just like other ensuing issues, there should be some level of confidentiality that protects everybody’s rights, and a boundary that ensures personal matters remain personal.

The truth about mental health conditions

Mental health conditions do not result from a single event. Experts suggest that genetics, environment, lifestyle, and various life events could bring them into existence. Stress at home or at the workplace may trigger the condition, so as serious traumatic events like being raped or battered. The ability of one’s brain to resist a negative idea or situation also plays a huge role in how mental health is affected.

A mental problem could also recur. Studies show that at least one in five individuals suffers from it every year., and it may also begin at an early age and worsen overtime if not properly treated. Since early symptoms usually mimic normal behavioral or personality changes, it is important to provide early support. The promise of recovery depends on a multitude of factors, but one of the most effective treatments is immediately observable around us.

Whichever initiating factors are involved, mental illness surely affects one’s thinking, mood, and feeling. It separates people, destroys social life, and even ruins relationships. This is why it is most important to show understanding and support to anyone suffering. Remember that these people cannot recover on their own, but with the help of everybody around, the condition can be overcome.

The registered nurse’s odd case

The story of a registered nurse (RN) who was required to disclose her mental health history made a fuss among health care practitioners. Upon applying for a renewal license in another state, the state board asked her to reveal sensitive information about her psychiatric history and treatment. This, in fact, is a requirement for all nurse applicants. But, knowing her rights, the nurse was upset about the request.

According to the RN, the treatment for her condition was made voluntarily, which means she was aware of her own illness and willingly went on disability for a year. After the treatment, she was then able to render services while taking medication. She had psychiatric history but never had any complaints against her. She was aware that this information should be kept confidential unless a complaint was made.

The State Board of Nursing (SBN) explains that this information is indeed confidential. The treatment facility is not allowed to disclose any information about the condition, the patient, and the treatment. However, it is possible to share such information if the patient gives consent to the concerned facility, which was what the Board was asking her to do.  

Individual protection to mental health patients

The request made to the nurse may be viewed as unethical, especially because she has not broken any law or behaved unprofessionally. Nonetheless, the board has all the rights to require such sensitive data to make sure that applicants meet the set criteria. It does not necessarily mean that the nurse will not be granted the license. The request was mainly done to assure the safety of the public who all nurses serve.

The Health Insurance Portability and Accountability Act (HIPAA) provide patients with certain rights to the disclosure of their health conditions. If a request is to be granted, patients must issue a written permission validated by HIPAA authorization. The letter must be written in plain language and must be very clear with its purpose.

To ensure that no disclosure statement is deceptive, the FTC act must also be considered by the parties involved. Compliance with this law prevents any deceptive and unfair practices with the patient’s health information. Most importantly, note that when patient authorization isn’t granted, no information is to be disclosed for whatever purpose it may serve.

It is important for medical practitioners to be all-the-way honest with any mandatory information, by attaching letters and performance evaluations for support. At the same time, they are highly discouraged to falsify or deny any requested information. Consulting a nurse attorney if they are in a similar situation could greatly help them understand any questions and concerns that they may have.

Pros and cons of disclosing mental health condition

Although self-disclosing one’s mental health condition has been proven helpful time and time again, it still poses a big risk to patients. This is why patients are given the freedom to self-disclose if they ever want to do so. Picking the right people and time are also some of the most important considerations. If one is to disclose, he/she should start telling a small trusted group of people who are more likely to understand them rather than judge them. Self-disclosing is a personal decision, but here are some of the most influential factors to think about:

Pros:

  • Patient’s view about their mental illness would positively improve dramatically.
  • Revealing the condition to trusted people alleviates the stress of having to conceal it.
  • It lessens the possibility of misinterpretation to certain behavioral aspects observed.
  • Being honest could get one the necessary emotional support.
  • Colleagues who may also be suffering could get the courage to disclose their own issues (mental or not).
  • Taking the condition into account, people around it may make reasonable adjustments in the way that one is treated (e.g. work duties could be made more flexible and less stressful).
  • With a positive outlook, patients could become a positive role model to everybody around them.

The patient may not know it, but there are people who choose to understand and show love and support instead of devaluing them. Additionally, governments around the world are strengthening their campaigns against discrimination. Nevertheless, nurses and other healthcare personnel should know the other side of the coin

Cons:

  • Among the most severe negative reaction of people is to reject or ostracize patients.
  • Apart from possible rejections, others may even gossip about the sufferer in the most entertaining yet untruthful ways.
  • Discrimination and unfair treatment in the workplace may also be experienced and could get worse without proper orientation.
  • Meeting people who will undermine the patient is very possible.
  • Self-disclosure may lessen one’s chance of getting hired, or, at the very worst, the individual may not be hired for the desired position at all.

Patients have all the rights not to self-disclose their mental health condition. Even if they choose to, there are a number of laws protecting them. It is most important, however, to be aware of all the possibilities while striving towards bettering their conditions.  

Final thoughts

The concern raised in this article is far from baseless. Self-disclosure of anyone’s mental health condition is a highly sensitive matter, both legally and socially. In fact, people suffering from it are already experiencing some levels of discrimination to which the government has to act.

The case of medical practitioners revealing such sensitive data is a bit more complex since they are torn between protecting themselves and complying with their professions’ requirements. Still, they are encouraged to practice honesty and integrity for the greater good. Weigh the options well, know the legal rights, and do what’s right for everyone.