Understanding confidentiality – for 11-18 year olds

Sharing your mental health information

Opening up to professionals about our mental health can be the first step to getting help. But it can also feel really scary to talk to someone about it.

We might be unsure about what they'll do with the information we tell them. Or we might be worried that they'll share it with other people, like our family and friends.

We're here to help you understand why professionals might need to share your information, and when they should keep it private.

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 our personal information private, safe and secure. If our information is confidential, then nobody should share it unless we agree to it.

It means that when we talk to professionals about our mental health, they shouldn't tell anyone else what we've said.

Information that professionals should keep 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 has written about you in appointments
• What someone has written in your records

For example, if you have a prescription for anxiety medication, your doctor can't tell your school counsellor, even if they ask. Your doctor would have to keep this information confidential.

The law also says that our confidential information should be secure. This means it should be stored safely so that it can't be:

• Lost
• Stolen
• Seen by someone else
• Deleted by accident

Breaking confidentiality

We usually have to agree to letting someone share our confidential information. This is called giving consent.

But in some cases, someone might need to share our information without our consent. This is called ‘breaking confidentiality’.

Professionals should only break confidentiality if:

• They're concerned 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 should share this to make sure you stay safe.
• They're concerned that someone else is at risk of serious harm or that they're in danger. For example, if you tell a teacher that your friend at school is self-harming, they may need to share what you've said with someone else. This is to make sure your friend 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 share, by law. For example, if the information is needed for a court case.

If the professional needs to break your confidentiality, they should always try to tell you first.

Self-harm and breaking confidentiality

If you don't want your parents, carers or guardians to find out that you're self-harming, you might be worried about telling a professional.

It's important to know that they won't always share this with your parents, carers or guardians.

If you tell someone about your self-harm, they 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 about your self-harm 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 own policy. Their policy might say that teachers always need to tell parents, carers and guardians 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 anyone else.

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 treatment and support.

What if someone wasn't meant to share?

We can sometimes face problems when it comes to confidential information. In some cases, a professional might break confidentiality without trying to warn us first. Or they might share our information without a valid reason, or share it with the wrong person by mistake.

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 out why they shared it. You should also ask for a copy of their confidentiality policy.
• If they don't respond or you feel like they're not treating you fairly, you can make a complaint. The service or organisation you're making the complaint about should explain how to do this. You'll usually need to write a letter.

After complaining, if you're still not happy with the result, you could speak to the ICO.

It's their job to make sure that organisations look after the information they hold about us. Find out more about making a confidentiality complaint on 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