Has my psychiatrist crossed the line of patient confidentiality?

[crazycatlady8]

Hi all, new to this forum thingy. Just as a quick background, since I lost my unborn baby in November last year I have been very depressed, which has been getting worse in the last two weeks. My psychologist who I have been seeing weekly for 3 months said she wanted some medical support and referred me onto a psychiatrist. I saw this psychiatrist today and I was (strangely) able to be completely honest with her, I found it really easy to talk to her. I spend half my session with my psychologist in silence, so when I felt comfortable I just let it all out. I told her about a recent severe suicide attempt, which I have not told anyone else, including my husband. I was unconscious and unfortunately was admitted to hospital because of the effects of what I had done, but immediately self-discharged when I was conscious and out of ICU. Anyway, at the end of the session she said the first thing she would do was contact my husband and tell him everything I had told her. I was shocked and obviously argued against this - I do NOT want y husband to know, I have hurt him enough being sick for so long I couldn't bear the guilt of him knowing I had tried to end my life. We argued about it for a while and in the end she just kept saying its for the best, you have to trust me, he needs to know. I said no I refuse, to which she responded I don't have a choice.

Why not? I was of the understanding that if someone said they had a plan & intent to kill themselves tomorrow - THAT would warrant her breaching confidentiality, I understand that. But I told her today that I am currently safe and have no intention of ending my life right now. I had reached a crisis point when I attempted suicide, but now that crisis has abated. She still went ahead and called my husband and told him everything!

I feel betrayed and alone.

I should also say she suggested hospitalisation which I refused, so as a compromise she suggested CATT team - which I also refused! She said that at the very least she will be contacting them and putting me on their radar (I said no referral but I would happily take the phone numbers with me in case i needed them) and she agreed to this. Low and behold an hour ago I got a call from the CATT team saying they are coming over tomorrow! I told the lovely nurse thank you for your time but I decline the referral I don't need it. She said you can't decline, it compulsory.

WHAT is going on!? all control is being taken away 😞

Any advice appreciated.

Jen

[james1]

Hey Jen,

I'm sorry to hear about what has happened. It's crap when confidentiality is breached when we don't think that was necessary. I can understand why you feel like all control has been taken away, just when you had regained it.

In fact, I had a similar case. I went to a GP who my psych suggested for anti depressants and she sent me to hospital for recent semi-attempts, despite me saying I was okay now. I had no choice in the matter, and I also had no choice in having an acute care team. My psychologist was basically just like, "well, I trust you so you don't need them."

Basically what eventuated was I stopped seeing the GP and saw a different one and once the psychologist had a word with my acute care team, they stopped checking up on me.

Can you speak to your psychologist about what has happened? Does she know about the suicide attempt?

James

[kanga_brumby]

Jen welcome to beyond blue. All doctors, nurses, police, even school teachers have a thing they must do which is called a duty of care. If they are aware of certain issues they are obliged to report it or pass it on to other people. If they don't they can lose there jobs and or go to jail. The people they talk to cannot pass it on to anyone outside again loss of job fines jail. Its for the protection of the individual. It doesn't make it right it's just the way the law works. For there protection as well as yours.

Kanga

[MsPurple]

Hi Jen. I am really sorry this has happened to you. I am not completely sure if this is breaching confidentiality or not and have enquired regarding this. I do not want to say if it is or isn't because I am not a professional. Maybe I'll ask my dad who is a dr (remember this is a confidential forum so my dad doesn't know you nor do I).

I have had a psychiatrist kinda breach my confidentiality before. Now I say kinda because I was 12 and the rules of confidentiality are different for children. I had a vent about my step mum. When I saw him, I would see him alone, then once every few session my mum, dad and step mum and myself would have a group session. He then told all my parents what I said regarding my step mum. He did say "MP said that one of her parents..." he didn't say which one but it was obviously about my step mum. I knew it and she knew it. From there my relationship with her got worse (she and I never got along and I am glad she is no longer in my life). From then I never opened up to him again and said how I couldn't trust him again. He tried to get it back, but I never trusted him again. I ended up stop seeing him because of this and my parents could tell I was no longer compliant. When I was 15 I went to a psychologist with ednos and I told her how I didn't want to go to therapy regarding confidentiality issues, and I told her about my psychiatrist as a kid (then I had ocd). She promised me she wouldn't tell my parents anything. It took time to build this trust with her, but to her word she never told my parents anything without my permission, and she made it clear what the rules of confidentiality were before seeing me. I know you may have lost trust in this psychiatrist but please do not lose trust in all mental health workers. They are here to help you and they will help you. Yes it will take time to build up trust again for therapy but you will get there. I now trust my counsellors. I was so paranoid that I refused to give counsellors my parents details (only friends) because I was scared they would tell them for the sake of it, but they never did and now I give them my parents details closest to me (e.g. I live in qld and so does my dad so he is my next of kin)

If you have any questions regarding confidentiality feel free to ask email bb using the tab on the bottom right of the page.

Hope this helps. We are here to support you. We are all anonymous here so you know we won't breach your confidentiality

MP

[Guest_128]

Hey Jen,

I am sorry for your loss,it's not nice I know.😢

What I am concerned about is the reaction from hubby after he was informed of how low you have Been? Have you any close friends or family that you can get some support from?

I know how hard it is to give in to hospital but I am sure you are totally exhausted,or maybe if you could go away somewhere nice and quiet just with hubby.

we are here for you,whatever you want to talk about. Ok

Later

[Dr_Kim]

Hi Jen,
 
This is such a difficult line to walk for any professional . Sometimes it works out that the patient comes back to thank you even though they were mad at you at the time . Other times , the patient will never be able to accept or understand that you were just trying to be absolutely sure they were safe and would rather they be alive and mad at you than dead and think you are a "good guy”.

Being a health professional often means making decisions that are not necessarily liked but responsible. 

So, back to you. There are a couple of things that make me think that it's possible you are UNDERestimating your own risk:
 
1. Your psychologist referred you to a psychiatrist ( so they were clearly worried about SOMETHING)
2. Your husband who presumably lives with you had no idea that you had an admission to hospital ( and the ICU even !) and you were able to keep that from him
3. You say you have been getting worse over the last few weeks.
4. You had a suicide attempt that led to you being admitted to an ICU and there is secrecy and shame around it

Maybe it's not the psychiatrist who is getting it wrong , maybe, just maybe it might be you?

Is it at all possible that you are finding it hard to let people care for you , you are resisting allowing yourself the care of this psychiatrist , the hospital , the psychiatric inpatient stay , the CATT team , even your husband?

Is it possible that you feel so guilty about your feelings that you are not allowing yourself to be aware of them until they are TOO overwhelming and frankly dangerous. 

Maybe this psychiatrist and psychologist are not bullies or trying to take your rights away, but maybe they are really just trying to CARE for you . Someone who they see as really needing comfort and care and treatment , but who feel may not have the right to those things as you feel you have “hurt him enough” and don’t want to show your husband how bad things are.

Well, I wonder if you are not allowing him to make that decision for himself . Maybe its time to allow him the opportunity to make that call. I wonder if the table was turned if you would like the chance to do the same for him or would you prefer for him to behave as you are , i.e. put on a brave front ?

Jen , I am similarly concerned for you. I worry that all the guilt and shame you have about your feelings are just going to wear you down . It IS important to get the help you need without feeling ashamed about it or that somehow you are letting yourself or your husband down. Most people recover from depression but primarily the doctor needs to make sure that you are alive as a start so you can heal.

Don’t be mad at them. Place that energy into getting better. Allow the caring in.