Introduction
In 2018, after the shooting at Marjory Stoneman Douglas High School in Parkland, Florida, the state authorities decided to introduce new requirements stated in a law that aims to protect school safety (Ochoa, 2018). Some schools, referring to the new law accepted by the state, decided to ask for specific data on a child’s contacting mental health services previously, which led to parents’ concern regarding the usage of this data. This paper will discuss the case covering specific fields related to the situation, including confidentiality, medical ethics, patient control of information, and others.
Main body
Analyzing the case, Three-zone Confidentiality Model can be used to differentiate data that can be disclosed with school administration when registering for entering an education organization. In the Three-zone Confidentiality Model, data on the utilization of health care services relates to the “least sensitive and not necessarily confidential” zone (Institute of Medicine, 1997, p. 128). Thus, technically, information on mental health services providers can be included in the outer area. Nevertheless, two other zones of the Confidentiality Model state that illness-related details refer to a “sensitive and traditionally confidential” zone, while psychiatric data relates to “extremely sensitive” (Institute of Medicine, 1997, p. 128). Therefore, schools, which require parents to disclose information on their children’s interaction with mental health services, might suppose that children may have significant psychological issues or illnesses. Thus, these children might be in a disadvantaged position when the school administration chooses whom to accept. Overall, based on the analysis of the Confidentiality Model, it can be stated that schools and the law should define precisely what referral to mental health services means and comply with confidentiality principles existing in the state.
Considering patient control of information, the case presents an interesting dilemma that parents of children are left to solve alone. On the one hand, parents might decide not to disclose the information on mental health services referral of their children, which is acceptable if it might exist. On the other hand, when parents decide not to disclose information when it is valuable and might affect the environment of a child that has issues with mental health, control should be given to health care administration representatives. Analysts state that greater patient health information control results in higher consent rates and better health information exchanges that both parents and schools need in this situation (Abdelhamid, 2018). Therefore, it might be suggested that school authorities and parents should together discuss the transfer of data on the mental health state of children.
Privacy and confidentiality laws that exist on the topic of health issues disclosure can be controversial or unclear. As a result, schools may introduce new guidelines on the procedure of entering an organization, which happened in Florida based on the school safety law (“Laws of Florida,” 2018). At the same time, the Federal Health Insurance Portability and Accountability Act (HIPAA) defines patient privacy and information that can be shared with other organizations with or without the consent of a patient (U.S. Department of Health & Human Services, 2020). It is also highlighted that some data can be shared with parties in specific cases, such as a high risk of a serious crime or serious harm from a patient to others (“Confidentiality,” n.d.). As stated in the article, experts expect lawsuits from parents to schools due to their probable violation of HIPAA (Ochoa, 2018). Thus, before establishing guidelines, it is essential to consult with legal actors to develop specific instructions if schools want to get children’s health data from parents.
When schools ask parents to share information to protect other children from a possibly dangerous situation, the situation can be justified with an argument that data will be used for social good. However, it can be assumed that school authorities might change their behavior, depending on the data that parents provide about their children’s mental health. As was mentioned previously, medical organizations and doctors decide whether the mental state of a person allows them to enter organizations, study, and conduct other activities. Therefore, school authorities who want to have access to data on referral to mental health services might act illegally when making assumptions about a child’s mental health and asking for information.
Talking about medical ethics in the situation when other parties ask parents to disclose information about their children’s referral to mental health services, there is a specific solution that guides medical professionals. American Medical Association has introduced the Code of Medical Ethics that includes principles, rules, and guidelines that a patient and a doctor must follow (American Medical Association, n.d.). There are specific situations when doctors must inform organizations on the mental state of a person when the behavior of a human might be harmful or potentially dangerous for other people that are defined by the Substance Abuse and Mental Health Services Administration in the U.S. (2020). Despite there being an evident ethical dilemma in how parents, schools’ administration, and doctors should act, referral to guidelines might resolve the issue or lead to lawsuits when some parties do not comply with federal laws.
Conclusion
To conclude, one can say that the situation with disclosure of children’s referral to mental health services to school administration is controversial and have unclear rules and consequences. All stakeholders should be transparent about the usage of information and assessment of such data to prevent the dangerous and unpredictable actions of children at schools. Therefore, it is essential to evaluate laws and rules and consult legal authorities to ensure that confidentiality is protected, and rights are not infringed.
References
Abdelhamid, M. (2018). Greater patient health information control to improve the sustainability of health information exchanges. J Biomed Inform, 83, 150-158.
American Medical Association. (n.d.). Code of Medical Ethics overview.
Confidentiality. (n.d.). 2020, Web.
Institute of Medicine & Committee on Improving the Patient Record. (1997). The computer-based patient record: An essential technology for health care (Detmer, D., Steen, E., & Dick, R.). National Academies Press.
Laws of Florida. (2018). Web.
Ochoa, J. (2018). Parents are leery of schools requiring ‘mental health’ disclosures by students. Kaiser Health News.
Substance Abuse and Mental Health Services Administration. (2020). Substance abuse confidentiality regulations.
U.S. Department of Health & Human Services. (2020). Your rights under HIPAA. Web.