The subject of confidentiality in mental health care persists in being a key concern for families, as discussed in our Listening to Families report.
Trevor Stevens has contributed his thoughts on the issue in a new blog, ’I didn’t know’. A sad, moving and important contribution to the discussion.
Here is our perspective which we hope is useful for families trying to make sense of how confidentiality should be used, but isn’t always.
MFC believes that confidentiality should support safe, compassionate, relational care — not obstruct it. Patient safety is paramount. When someone is mentally ill, suicidal or threatening violence families must be listened to, and actively involved in safety planning and managing risk. Too often, defensive interpretations of confidentiality exclude families, silence concerns, fragment risk information, and contribute to preventable harm and suicide.
MFC would like to see a “presumption of involvement” approach to family carers, routine collaborative safety planning, clearer explanations of what can be shared, and a duty to listen to family concerns even where consent is absent. Families and carers hold critical contextual knowledge. Listening to families is not a breach of confidentiality.
MFC works in partnership with NHS Trusts to support them to develop a culture that is more open and reflective, where services are reviewed and developed in partnership with service users, families and frontline practitioners and professionals know they will be supported by managers and leaders when they share information to protect lives.
We offer training and support to healthcare professionals and organisations to develop family-inclusive care and an approach to information sharing that prioritises and enables safety, humanity, and collaborative care.
We recognise that family relationships can sometimes be complex, and information sharing decisions require careful professional judgement about who to share with; they can of course still receive information.
Our free Life Beyond the Cubicle eLearning resources can help health professionals explore and develop a more nuanced approach to confidentiality where they understand that they should listen to the concerns of families and that safety always trumps confidentiality.
Our Families Panel will continue to explore how we can support improved understanding of confidentiality in mental health care. You can find more information about the panel here.