By BARBARA BATE
Privacy documents have been a fact of life for most of us. The Health Information Portability and Accountability Act, HIPAA, was passed in 1996, and additional rules and regulations have been added starting in 2002. As most health professionals know, the rules limiting disclosure of PHI or protected health information are strict, and the financial risks of violating the privacy law are high.
Amanda Terry of Seattle came to Long Beach Peninsula on Sept. 26 to talk about an important new Washington law that went into effect July 23, 2017. Ms. Terry helped draft the legislation known as SHB 1477, which allows for the sharing of mental health information in circumstances in which there is a serious and imminent threat to the individual or the public. This new law now brings Washington in line with federal HIPAA regulations. HIPAA had already permitted the sharing of mental health information when an individual is in crisis and perceived as being at risk for suicide.
The state of Washington has had more restrictions on mental health disclosure than either Oregon law or federal HIPAA regulations. Mental health professionals and others, including volunteer EMTs, have been trained to be silent about client or patient information unless they have a written release from the person. Releases have to be renewed within a specified time. The word “imminent” has been interpreted in Washington law to mean immediate, again more restrictive than federal or Oregon regulations.
No one intended these laws to keep people more isolated from each other or less hopeful about their future. But an unintended consequence of Washington’s mental health law has been to foster secrecy and shame about brain disorders that are both widespread and treatable: illnesses such as post-traumatic stress disorder, panic attacks, and bipolar depression. When family and friends of a person can’t connect with a professional who is providing care to that person, there is much less chance for a supportive partnership that involves everyone who can help.
On Oct. 1, I visited the Peer Helpers Retreat at Falls Creek, east of Raymond, and I had a chance to hear from 20 junior and senior high youth from three school districts. Their responses made clear to me the value of open conversation about the stress, depression, and suicidal thoughts local youth are experiencing. When I asked for a show of hands, half of those in the room said they knew someone who was depressed. At least a third of them knew someone who had been a suicide or come close to suicide. One young woman volunteered that she had walked up into the woods planning to kill herself. She would have done it, except for the person who followed her there and convinced her to come back.
These young people know a lot about emotional struggle. They’re familiar with those problems themselves, and they are choosing to be part of the solution. I was struck by their openness about their own issues and their strong desire to help others become less isolated and more hopeful about their lives.
A few days before I went to the peer leaders retreat, I heard Amanda Terry talk about her goal of educating professionals and the community on the changes in Washington’s patient privacy law. Several local clinicians had told me earlier that they had not heard of the changed law. They believed Washington law was the same as the HIPAA regulations, allowing no disclosure of a client’s mental health information under any circumstances. The contrast was striking — between the teens’ openness with an interested stranger and the professionals’ assumption that privacy was of the utmost importance.
As suicide numbers grow, the pressure to figure out how to prevent future suicides has grown across the nation. Several years ago the National Institute of Mental Health developed and tested a four-question survey for hospital emergency room staff to give to youth and young adults coming into the ER. The first question is, “In the past few weeks, have you felt that you or your family would be better off if you were dead?” I believe that first question goes to the heart of the matter. When someone comes to believe that they are too difficult or damaged to be worth having around, it’s an extremely important signal that the person feels worthless and hopeless. I have heard the words “would be better off if I were dead“ from people I have interviewed, individuals who went on to attempt suicide. Partly because they used pills instead of firearms, they survived, moving into recovery and sharing their story with others.
No one action produces a single result, whether it is considering whether life is too difficult to continue, or choosing to talk with someone else to get support. Our new organization, Peace of Mind Pacific County, developed blue information cards that show three private options for connecting to trained regional and national contacts when a person is in crisis:
• The national suicide prevention line at 1-800-273-8255 [TALK].
• MentalHealthAmericaScreening.net to assess brain/behavior conditions
• The Crisis Text Line: 741741 “Hello” on cell phone
The stigma about brain disorders and mental health conditions has not gone away. But every time we listen to each other without judgment, or share our story where it can bring understanding, the smaller the gap will be between fear and isolation on the one hand and compassionate community on the other.
Closing that gap saves lives.
Barbara Bate of Ocean Park is helping lead Peace of Mind Pacific County. She is the author of “Tsunami of the Mind: Stories of Trauma, Recovery, and Hope. Contact her at firstname.lastname@example.org.
As suicide numbers grow, the pressure to figure out how to prevent future suicides has grown across the nation. Several years ago the National Institute of Mental Health developed and tested a four-question survey for hospital emergency room staff to give to youth and young adults coming into the ER. The first question is, “In the past few weeks, have you felt that you or your family would be better off if you were dead?” I believe that first question goes to the heart of the matter.