Why is it important to understand confidentiality?
Opening up to professionals about your mental health can be the first step to getting help. But it can also feel really scary.
You might feel confused about what they're going to do with the information you tell them. Or you might be worried that they will share it with other people, like your family and friends.
We're here to help you understand confidentiality, so you know how and when your information will be kept private.
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When I was looking up ways to help myself, I was too afraid of telling anyone the extent to which I was struggling because I did not want my parents to find out.
What is confidentiality?
Confidentiality is about keeping your information private.
It means that when you talk to professionals they shouldn;t tell anyone else what you've said.
Information that needs to be kept confidential includes:
- Your name and contact details
- Details of any physical or mental health problems you have
- Details of any medication, treatment or care plan you have
- Anything you've talked about in appointments or meetings
- What someone writes about you in appointments
- What's written in your records
For example, if you talk to your doctor and tell them that you've been feeling low, they can't tell your parents, carers or guardians. They have to keep this information confidential.
Mental health rights and privacy
You have a right to your personal information being kept confidential.
Who can I talk to in private about my mental health?
There are lots of professionals you can talk to confidentially about your mental health.
Knowing that they'll keep what you've said private can help you to feel safe and open up about what you're going through.
Some of these types of professionals include:
- Doctors
- Nurses
- Teachers
- School counsellors
- Social workers
- Therapists or counsellors
- Your Child and Adolescent Mental Health Services (CAMHS) team
- Professional advocates
- Helpline services, like Childline
It's not always easy to know when your information will be kept confidential.
If you're not sure or are feeling worried, ask the person you're speaking to. They can tell you about the rules they have to follow, and what will happen with the information you tell them.
Doctors and therapists have to follow special rules around looking after your confidential information.
Other professionals, like teachers, will follow their school or college's own policy. It's important to know that these policies will be slightly different everywhere.
Will my friends and family keep my information private?
Talking to people who care about you can help you to feel supported and less alone.
Most of the time, the more they understand what's going on for you, the better they can help you.
When you do open up to your friends and family, they should respect your privacy and keep the information to themselves. Unless you've asked them to share it.
But it's important to understand that they don't have to keep your information confidential. They might also tell someone else what you've said if they are worried about you or need support for themselves.
For more information, see our page on opening up to family and friends.
I spoke to a counsellor who attended school weekly and who helped me feel comfortable enough to speak about what I was struggling with, and how to deal with it better.
How will my information be stored?
You might be worried about what professionals will do with your information. For example, if you think your school counsellor might save your notes somewhere that other pupils can see them.
The law says that your information should be kept securely. This means it should be stored safely so that it can't be accidentally deleted, lost, stolen or seen by someone else.
There are lots of different ways that professionals can keep your information secure. For example, they could keep your notes:
- In a password-protected folder on a computer
- Locked in a filing cabinet
If you're not sure how your information will be stored, you can ask the person you're speaking to. They should be able tell you how it will be kept securely.
When could my information be shared?
You usually have to give permission for your information to be shared. This is known as giving your consent.
People can share your information with your consent if:
- You ask them to. For example, if you ask your doctor or teacher to share what you've told them with your parents, carers or guardians.
- You agree to this. For example, if you agree to your information being shared with another service, like CAMHS, so you can be referred there.
- It will help you to get good care. For example, if you're getting support from a mental health service, your notes could be shared within the service. This is to make sure that if you see a different doctor, they know how to support you.
If there are certain things you don't want to be shared, you can tell the person you're talking to.
And if you decide you don't want your information to be shared anymore, you can remove your consent at any time.
Could my information be shared without my consent?
In some situations, your information may need to be shared without your consent. This is called ‘breaking confidentiality’.
It should only happen if:
- There are concerns that you're at risk of serious harm or you're in danger. For example, if you've told someone that you're being abused, they may need to share this to make sure you stay safe.
- There are concerns that someone else is at serious risk of harm or that they're in danger. For example, if you tell someone your sibling is feeling suicidal, they may need to share what you've said with someone else. This is to make sure your sibling stays safe.
- You're unable to make the decision about sharing your information. For example, if you're not able to understand what you're consenting to and what might happen if you say yes or no.
- Someone is told they have to by law. For example, if the information is needed for a court case.
If the professional does need to tell someone what you've told them, they should always try to tell you first.
You might be worried about telling professionals that you're self-harming because you don't want your parents, carers or guardians to find out.
It's important to know that this won't always happen.
The person you're speaking to will want to do what is best for you. For example, they will consider how you feel about your parents, carers or guardians knowing, and whether there are any risks to them knowing.
Their decision on whether to tell someone else will depend on:
- Their job. Some professionals, like therapists or nurses, have to follow strict rules around keeping your information confidential. Others, like teachers, have to follow their school's policy. This might say that parents, carers and guardians always need to be told about self-harm.
- How big they think the risk to your safety is. If they don't think there is a risk of serious harm, they might be able to support you to manage your feelings without having to tell your parents or carers.
If you're not sure whether the person you're speaking to will keep what you've said private, you can ask them.
If they say they need to tell someone, you can discuss this with them and agree on the best way to do this.
This might feel scary, but it's important to remember that opening up can help you to get the right help and support.
For more information on self-harm, see our page on coping with self-harm.
It puts me at ease knowing they genuinely want what is best for you and will only share information to protect yourself and others around you.
I was absolutely terrified that by speaking to a professional my parents would be told. As I am of Asian heritage, mental health is a topic that is ignored and never discussed; there is a stigma attached to it.
What if someone has wrongly shared my information?
This is when a professional shares your information without your consent or another valid reason. For example, if your doctor sent a letter about your CAMHS referral to someone else.
If professionals wrongly share your information it can be very upsetting, but there are things you can do:
- Ask why your information was shared. Get in touch with the person or organisation who shared your information to find why it was shared. You should also ask for a copy of their policy on confidentiality.
- If they don't respond or you feel like you're not being treated fairly, you can make a complaint. You can ask the service or organisation you're making the complaint about how to do this. They might ask you to write a complaint letter or to fill in a form. You might also be able to find a copy of their complaints policy on their website.
If you're still not happy with the way the organisation shared your information, you could speak to the Information Commissioner's Office (ICO).
It's their job to make sure that organisations look after the information they hold about us. They can also investigate complaints about the way organisations handle information. To find out more, go to the ICO website.
The most important thing I impress to students is that I will never run around with a blue flashing light on my head and turn things into a crisis. – Pastoral Lead in secondary school
How can I see what's in my files and records?
You might want to see what information places like your school or CAMHS hold about you in their records.
Sometimes it might be easier to see this information. For example, if you ask your therapist to show you the notes they've taken in your sessions, they might be able to share this with you straight away.
But in other situations, you might need to send an email or letter to ask for this information. When you ask for this information, it's called a ‘subject access request’.
The organisation will normally take one month to reply to you. But if the request is very complicated, they may take a little longer. They’re never allowed to charge you for this.
There are a few situations when an organisation can refuse your request. These include:
- If they think you don't actually want the information and you're asking for it to cause them problems
- If you keep requesting the same or similar information
- If they think sharing the information might cause serious harm to you or to someone else
If you're not happy with their response or feel that you're not being listened to, you can make a complaint to the ICO.
To find out more, go to the ICO website.
Therapist
This is a trained professional who runs or supervises your therapy. Therapists help you explore how you’re thinking, feeling and behaving, and what can help you in the future.
There are different types of training and education for therapists. This means they all have different titles, like psychologist, therapist, counsellor or psychiatrist.
Visit our full treatment and support glossaryCounsellor
Counsellors listen to you and give you a safe space to explore how you’re thinking, feeling and behaving. They also help you find ways to cope with things.
Visit our full treatment and support glossaryChild and Adolescent Mental Health Services (CAMHS)
These are services that support young people with their mental health.
You might see them called different names sometimes, but they offer the same type of services for young people:
- In Wales, they're called Specialist Child and Adolescent Mental Health Services (SCAMHS)
- In England or Wales, you might also hear them called Children and Young People’s Mental Health Services (CYPMHS)
Find out more in our CAMHS information hub.
Advocate
An advocate is someone who can listen to you and help make sure your voice is heard in decisions about you.
In some situations, you will have a right to have an advocate. This is called statutory advocacy.
Even if you don’t have a right to an advocate, there are other types of advocacy that can support you to get your voice heard.
See our page on advocacy for more information.
Visit our full treatment and support glossaryPolicy
This is a document that sets out how an organisation will act in certain situations. For example, a transition policy should explain how an organisation will manage a young person leaving their services.
Visit our full treatment and support glossaryConsent
This is when you agree to something, such as going into hospital or having treatment.
You can’t consent to something unless you are competent to (if you’re 15 or below), or you have capacity (if you’re 16 or above).
Being competent or having capacity means that you understand what you’re consenting to and what might happen if you say yes or no to it.
Visit our full treatment and support glossaryReferral
This is a request to a service asking them to review:
- how you’re feeling
- what support you need.
The referral helps explain to the new service why they should see you, and what the best way to help you might be.
Sometimes referrals can be made by yourself, a family member or social worker. But they’re often made by your doctor as they understand your medical history.
Visit our full treatment and support glossaryPersonal information
This is any information that can be used to identify you. For example, your name, address or even your IP address.
Visit our full treatment and support glossaryCare plan
The name for a plan that explains your mental health problem, what treatment and support you need, and who will provide that support. Care plans might also cover what should happen if you're in a mental health crisis.
There are different types of plans, such as a Care Programme Approach (CPA) or Care and Treatment Plan (CTP). Whatever type of plan you have, you should always be given a copy of it.
Visit our full treatment and support glossaryThis information was published in May 2021. We will revise it in 2024.
The quotes on this page are from young people we spoke to while making this information. They've given us their consent to use their quotes in our information. The words, experiences and opinions in the quotes are not related to the young people shown in any of the photographs we use.
References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.
