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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by pinkeye on September 20, 2004, at 18:26:32
Hi,
I have a question if I go to a therapist here, and if it is covered by insurance, will all the details go into a mental health history database? She said something like that, and I am worried. Also do you have any idea if that will affect the issuance of Green card or citizenship?
Thanks
Pinkeye.
Posted by Dinah on September 20, 2004, at 19:23:56
In reply to Mental health history, posted by pinkeye on September 20, 2004, at 18:26:32
Where are you located? I'm sure the rules vary. I think they are creating some sort of national database in the US that is supposed to be for our benefit. I being one of those people with a pathological distrust of the government and centralized information storehouses, I object mightily.
Posted by pinkeye on September 20, 2004, at 19:25:22
In reply to Re: Mental health history » pinkeye, posted by Dinah on September 20, 2004, at 19:23:56
In California.
> Where are you located? I'm sure the rules vary. I think they are creating some sort of national database in the US that is supposed to be for our benefit. I being one of those people with a pathological distrust of the government and centralized information storehouses, I object mightily.
Posted by Dinah on September 20, 2004, at 19:33:16
In reply to Re: Mental health history, posted by pinkeye on September 20, 2004, at 19:25:22
You might want to google the relatively new medical privacy act. It seems to me that I recall it was anything but. The doctor can no longer say your name in the waiting room, but I seem to remember that it provides for the consolidation of medical information. I could be wrong though, or it's possible my info comes from my conspiracy theorist mother. You migth want to ask on Social. I think there are some people there with some familiarity with the law.
At any rate, that's why I'm not keen on anything ending up on my permanent record. My therapist doesn't diagnose, and he doesn't write anything of that sort down.
Posted by pinkeye on September 20, 2004, at 20:12:34
In reply to Re: Mental health history, posted by Dinah on September 20, 2004, at 19:33:16
What do you mean he doesn't diagnose or he does not write anything down? I went to the therapist here who wrote down everything we were talking.
I was not very comfortable with that. Can I ask her if she can avoid writing down everything?> You might want to google the relatively new medical privacy act. It seems to me that I recall it was anything but. The doctor can no longer say your name in the waiting room, but I seem to remember that it provides for the consolidation of medical information. I could be wrong though, or it's possible my info comes from my conspiracy theorist mother. You migth want to ask on Social. I think there are some people there with some familiarity with the law.
>
> At any rate, that's why I'm not keen on anything ending up on my permanent record. My therapist doesn't diagnose, and he doesn't write anything of that sort down.
Posted by alexandra_k on September 20, 2004, at 20:13:14
In reply to Re: Mental health history » pinkeye, posted by Dinah on September 20, 2004, at 19:23:56
I read in Kaplan and Saddock "Brief Synopsis of Psychiatry" that there is the hope that ones file might be put on a database computer chip and inserted into the body. This would assist clinicians with access and continuity of care issues. I was absolutely horrified. I think that there is a difference between clinicians notes that are intended for their personal use, and ones that become part of a (I think this is the term) public register which is accessible to any medical provider and / or insurance company
Posted by Annierose on September 20, 2004, at 20:25:53
In reply to Re: Mental health history, posted by pinkeye on September 20, 2004, at 20:12:34
pinkeye -
I am not terrified over my T's notes. I believe they help him/her remember certain important facts/feelings. It is a tool some of them might rely on. And those are their personal records.
You would have to sign off on a release form for any of that information to be made available to whomever. I'm not trying to sound harsh. In other words, my T takes notes all the time and it does not bother me. In fact, I wonder sometimes why he isn't writing something down!!
Posted by Racer on September 20, 2004, at 20:42:48
In reply to Mental health history, posted by pinkeye on September 20, 2004, at 18:26:32
This is a controversial issue, of course, and you might want to google "HIPAA" for information on the laws involved. The stated idea is that your health records can follow you and be "portable" for your benefit. The reality may or may not live up to that goal, of course. (I tend to be pretty close to Dinah, of course, on this issue.)
The good news is that your history cannot be made available without your written consent in most cases. The bad news is that there are situations in which your consent is not necessary. On the other hand, some aspects of your health history are available pretty easily to just exactly the sorts agencies that most worry me: government, health insurance agencies, etc. How easy is it for them to access that information? It varies. For instance, since I was involuntarily hospitalized last year, that information is available to the government -- for my own protection, of course, so that I can't -- for example -- buy a gun. (Whether or not it's going to be a problem if I reapply to the school district isn't clear -- yet -- but I'm sure I'll report back on that if that time comes.)
The good news, of course, is that the ADA does offer some protections to patients. How much, again, is pretty unclear, and will depend on exact circumstances.
As for notes, that's pretty much at the discretion of the individual therapist. Some take copious notes -- whether during sessions or afterwards -- others take few notes, and many fall in the middle. The more detailed a therapist's notes, the more exposure to you if those records are made available to anyone for any reason. Therapists know this, though, and many choose to include only general themes in their notes -- enough to satisfy any insurance company, for example, or to refresh their own memories.
If you're uncomfortable with this therapist's note taking, you can either ask him/her to take more marginal notes, or you can look for another therapist. Honestly, many therapists don't take notes during a session, because it really and truly is distracting for clients. I know I find it to be so, although I don't object to marginal note taking -- just to someone who seems to be trying to write down everything I say.
I hope that helps.
Posted by Dinah on September 20, 2004, at 21:07:13
In reply to Re: Mental health history » pinkeye, posted by Racer on September 20, 2004, at 20:42:48
That's why mine doesn't take notes about anything I consider sensitive. He's aware that it would at best jeopardize the therapeutic relationship and make me reluctant to disclose. At worst, it could be supoenad in a divorce or custody hearing.
Posted by DaisyM on September 20, 2004, at 22:31:42
In reply to Re: Mental health history » Racer, posted by Dinah on September 20, 2004, at 21:07:13
My therapist told me once, "in order to get the insurance company to do such and so, I'll have to tell them stuff you don't want me to tell them." Since I have political aspirations in the future, I don't want stuff out there about my history or my family.
But Racer is right, HIPPA is making it harder for confidential infor to get around. Which wasn't very hard in the first place.
Posted by Passerby on September 20, 2004, at 23:17:06
In reply to Re: Mental health history ? Dinah, posted by DaisyM on September 20, 2004, at 22:31:42
Not to be the one that rains on everyone's parade again, but a database with a lot of insurance information has existed for sometime. The database is called the Medical Information Board or MIB. HOWEVER, THE WAY THE INFORMATION IS KEPT IS VERY SPECIFIC - BE SURE TO READ HOW THE INFORMATION IS STORED.
If you want to know if the MIB has information about your condition, you can order your file. Go to www.mib.com. It could be that none of your information is on file - it all depends what kind of insurance you have applied for in the past and with which insurers.
Posted by Dinah on September 21, 2004, at 8:07:12
In reply to Re: Mental health history, posted by Passerby on September 20, 2004, at 23:17:06
Thanks for the information. I think I will look myself up there.
I always wonder if I'm a bit paranoid about this. Or perhaps just a bit private. I *know* my own insurance company got the information when I was diagnosed with diabetes. But I was still extremely offended to get an informational packet in the mail from them uninvited.
This is the end of the thread.
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