Understanding confidentiality – for young people

Understanding 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.

This page covers:

• What is confidentiality?
• Who can I talk to in private about my mental health?
• How will my information be stored?
• When could my information be shared?
• What if I tell someone I’m self-harming?
• What if someone has wrongly shared my information?
• How can I see what’s in my files and records?

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 or carers. They have to keep this information confidential.

“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.”

Who can I talk to in private about my mental health?

There are lots of professionals you can talk to in confidence 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.

The list includes:

• doctors
• nurses
• teachers
• school counsellors
• social workers
• therapists or counsellors
• your Child and Adolescent Mental Health Services (CAMHS) team
• advocates
• helpline services, like Childline.

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.

“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, or 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 or carers.
• 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.

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.

“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.”

What if I tell someone I’m self-harming?

You might be worried about telling professionals that you're self-harming because you don't want your parents or carers to find out.

“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.”

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 or carers 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 and carers 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.

"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

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.

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 quite easy to see this information. For example, you could ask your therapist to show you the notes they’ve taken in your sessions, and 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. This includes: 

• 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.

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This information was published in May 2021. We will revise it in 2023.

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