When you see any doctor or therapist, you probably want to know that your visit and the topics you discuss are confidential. This is particularly true when it comes to mental health treatment; no one wants their private matters to be the talk of the staff room or their place of employment. The good news is that most of the matters that you or your adolescent talks to the therapist about do remain confidential, with some exceptions. Read on to find out more about confidentiality and how it relates to mental health treatment for adults and for teenagers.

What Is HIPAA and Why Is It Relevant to Mental Health Privacy?

Every time you visit a medical professional, you should be offered a copy of the office’s HIPAA policy. HIPAA, which stands for Health Insurance Portability and Accountability Act, provides patients with privacy when it comes to who can access their medical records. This also includes mental health records. HIPAA provides clear guidance on whether certain information can be given out to insurance companies, other doctors, your family members, and local authorities.

The reason this is important is that you need to be able to trust your care providers and know what is confidential and what might not be. Read over the HIPAA notice that you’re given so you understand the office policies. Also, if you have questions about what is and is not protected information, ask before you see your therapist.

What Information Can Be Shared?

Most of the time, what you or your teen says to your counselor or psychiatrist is confidential. If you have a teenager who is going to be in counseling, it’s good to sit down with the counselor and your teen to figure out what can and cannot be shared with you. The office will generally have a policy; you and your teen should both agree on what is and is not confidential. Your teen will also be asked what can be shared with you outside of the policy.

As an adult, you can expect confidentiality. There are some exceptions. For example, if you divulge that you are abusing a child or that you are planning to abuse or harm a child, this will be reported to the proper authorities. It will also be reported if your teen says that he or she is being abused. If your teen is planning on harming someone else, that will be reported. It will also be brought to your attention and further treatment will be given if your teen is suicidal. Each state has different laws, so talk to the therapist about what will and won’t be held confidential before counseling begins.

Can My Employer Access My Medical or Mental Health Records?

Many people are concerned that their employers will see their or their families’ mental health records if the employer is the one subsidizing the health insurance that pays for the treatment. The short answer to this concern is no: Your employer cannot access your medical records, regardless of whether they fund the health insurance. While larger, self-insured employers might receive general information on procedures and treatments that employees are receiving, no names are attached to the claim information that they see.

Mental health records also will not show up in a background check if your employer runs them. That being said, if you are looking for a job in law enforcement or the military, you will have to pass a mental health check that will include screening for various mental health conditions.

How Much Information Will My Insurance Company Get?

In order for your therapist to submit your counseling bills to your health insurance, they’ll need to assign you a diagnosis. If you have depression, schizophrenia, or severe anxiety, for example, that’s a clear diagnosis and your insurance company will know about it. If you have some characteristics of anxiety or obsessive-compulsive disorder, however, it might not be a clear-cut diagnosis. Since a diagnosis code will need to be used in order to process your claims, your therapist will need to choose one or more to put on your claim, even if it’s not a definite diagnosis.

The problem with this is that mental health diagnoses generally stay with you as a “pre-existing condition” for many years. This is not currently a problem with the current health care law. If the health care bill were to change, making pre-existing conditions something that insurance companies could use to determine whether you are eligible for services, however, this could become an issue. Talk to your therapist about the diagnosis they are planning to submit to your insurance company and keep this issue in mind.

What Information About Minors Goes to Their Parents?

In general, what your minor child says to his or her therapist will stay in the office unless your child gives permission for you to be involved. Some of this is mandated by law, and some is up to the discretion of the therapist. It’s important that your teen knows what topics or instances will result in you knowing about them.

In many cases, family therapy, where the counseling takes place not only with the teen but also with one or more other members of the family, can be helpful. Teenagers still need their parents to advise and guide them, and family therapy can help you do that. Of course, he or she might also benefit from individual counseling, and so might you. Even if you meet with a counselor without your teen there, the therapist can help you learn helpful communication skills.

Still Not Sure About What Info is Kept Confidential?

If you are seeking therapy and are concerned about whether what you talk about is confidential, ask the office staff about their policies. If you don’t understand them, ask specific questions so that you do understand. Remember that it’s the staff’s job to make you feel comfortable with the way your information will be used. Also, if you have a teenager who is going to be having counseling, make sure that both of you are aware of what type of information can and cannot be shared. It’s difficult to feel truly comfortable with a doctor or mental health professional if you don’t know what stays just between you, so don’t hesitate to ask if you have any questions.