PRESERVING PRIVACY: HIPAA TRAINING FOR MENTAL HEALTH

Therapists and mental health professionals know that every conversation in the counseling room is deeply personal. They’re also legally protected. Below, we’ll explore how HIPAA protects patient privacy in mental health care, the unique psychotherapy notes rule, best practices for HIPAA mental health compliance, and why it’s important to look for specialized HIPAA training courses for mental health professionals.

Why Is HIPAA Important to Mental Health Professionals?

The Health Insurance Portability and Accountability Act (HIPAA) has several mandates, but the privacy provisions are the most well-known. HIPAA's goal is to strike a balance between a patient's right to privacy and the fact that sharing necessary health information is critical for their well-being.

No health information is more privacy-sensitive than the mental health and substance use disorders commonly dealt with by the mental health industry. The field also includes some of the most ethically challenging decisions on what information to share and when.

A person whose mental or behavioral health is compromised needs the support of informed loved ones, but they also have a right to medical privacy. HIPAA provides a helpful legal framework for patient privacy

Are Psychotherapy Notes Shareable Under HIPAA?

Understanding the Privacy Rule for mental health providers is a particular challenge because, while the rule applies uniformly to most protected health information (PHI), psychotherapy notes receive special protections.

Psychotherapy notes, as defined by HIPAA, are “notes recorded by a healthcare provider who is a mental health professional documenting or analyzing the contents of a conversation during a private counseling session or a group, joint, or family counseling session and that are separate from the rest of the patient's medical record.”

HIPAA’s psychotherapy notes rules differ from other health information in two ways.

Unlike the rest of their medical records, patients do not have a right to access their therapy notes. A provider can share them, but they can keep them private if they choose. That's because disclosing these notes involves an element of the provider's own private thinking and because they contain information that is not required or useful for treatment, payment, or healthcare operations purposes.

Additionally, most health information may only be disclosed with patient consent or by subpoena, but there are cases where a mental health professional is legally obligated to share psychotherapy notes without a patient's authorization. The circumstances vary slightly by jurisdiction, but most mandatory reporting laws apply to abuse and threats of serious and imminent harm.

What Mental Health Information Is Considered Part of the Medical Record?

Further complicating HIPAA mental health compliance is the fact that some types of mental health information are supposed to be treated like any other PHI, including information that is useful for treatment, case management, and coordination of care.

Mental health records that must be treated as normal PHI include:

• Medication prescription and monitoring
• Counseling session start and stop times
• Modalities and frequencies of treatment furnished
• Clinical test results
• Summaries of:
  • Diagnosis
  • Functional status
  • Treatment plan
  • Symptoms
  • Prognosis
  • Progress to date

How to Protect Patient Privacy in Psychotherapy Notes

While tips and best practices for regular PHI are well-documented, special care is necessary for managing psychotherapy notes under HIPAA regulations.

Below, we’ll detail some best practices for HIPAA compliance in mental health practices.

Store Psychotherapy Notes Separately

Therapy notes must be kept separate from the rest of a patient's medical record. Because separate storage is a defining characteristic of psychotherapy notes under HIPAA, your organizational strategy is a crucial part of protecting patient privacy in mental health practice.

Psychotherapy notes stored within the regular medical record don’t qualify for the full protections normally afforded to them.

Anonymize Your Psychotherapy Notes

To further reduce the chances that sensitive disclosures will be linked to an individual, remove any identifying details from the information in your therapy notes.

Use initials, pseudonyms, or "the patient" instead of full names, and avoid including details like birthdates, addresses, or social security numbers.

Describe a patient's problem in generic terms rather than recording specific information.

But Make Notes Accurate and Complete

Even as you employ strategies for protecting patient privacy in mental health notes, you must remember that they can become court documents.

As such, your notes need to be accurate and complete. Always err on the side of too much information. If you need to correct your notes, date and initial the change for clarity.

Destroy or Securely Store Old Notes

When process and progress notes are no longer required, they must be destroyed or stored in a way that protects privacy.

That means shredding or incinerating paper notes, scrubbing digital records, or relocating notes to a secure location.

Other Mental Health Compliance Considerations

While mental health professionals face some unique challenges in HIPAA compliance, they also must contend with the same difficulties as other healthcare providers.

More mundane HIPAA compliance challenges to keep in mind include:

• Restricting PHI access
• Ensuring data security and integrity
• Running periodic risk analysis
• Managing third-party vendors (ie, Business Associates)
• Ensuring the security of telehealth sessions and other technology
• Complying with HIPAA’s documentation requirements
• Keeping staff members up-to-date and compliant with their HIPAA training

As with other areas of medicine, mental health practices face serious costs if found non-compliant, including civil penalties, jail time, loss of employment and/or licensure, lawsuits, and a loss of trust with current and potential patients.

HIPAA Compliance Training for Mental Health Providers

This article is, of course, the tip of the iceberg for how to manage HIPAA in a mental health office. All of these exceptions and nuances are reasons why mental health providers should seek out HIPAA training for staff that’s tailored specifically to their field.

Our course, HIPAA for Mental Healthcare Providers, is online, comprehensive, and designed specifically for what mental health providers need to know. Enroll today!