Mental Health Services & Privacy Issues Review
17 February 2002 Media Statement
Review Set To
Improve Ways Mental Health Services Handle Privacy Issues
Health Minister Annette King has released a review, undertaken by the Mental Health Commission, of the ways mental health services share information about at-risk people.
The Mental Health Commission independently reviewed the way mental health services use the Privacy Act and the Health Information Privacy Code after widespread concern was expressed following the deaths of Malcolm Beggs and Lachlan Jones in 1999.
Ms King says the review's recommendations “outline a good programme of work to ensure the system performs better in future. I'm pleased the key players involved have recognised the importance of this issue and are working together to make improvements efficiently and soon.”
Ms King says she will now ask the Mental Health Commission to undertake a full-scale review of District Health Boards in 18 months time to see if changes had actually been made to practice and were proving effective.
“Meanwhile, the commission will also monitor the progress of each DHB in addressing the issues identified. The Ministry of Health will also work with DHBs and the Privacy Commissioner to put together a national policy protocol and implementation plan for mental health services by June 30. It will provide practical tools to make it easier for DHBs to improve the way they share information.
"The report recommends many practical improvements that will strengthen the way the code operates in District Health Board mental health services."
The review looked at whether services have developed their own policies and procedures for sharing client information, if these relate to the code and how well they are communicated, understood and put in place.
It found wide variations in information-sharing policies across mental health services nationwide and some misunderstandings about using the Privacy Act and Code.
Ms King said the Privacy Act and Code did not prevent health professionals sharing information with families and others involved in the care of mental health service users.
“Consent by people who use mental health services to share information about their illness is important, but disclosing information without consent is one of many decisions health professionals have to make to balance the interests of everyone involved. The family's need to know, the clinician's obligation to treat clients and ensure their safety, as well as the community's right to safety, also need consideration.
"There is nothing in the Privacy Act or Code stopping mental health professionals from suitably warning appropriate people, without the individual client's consent, as long as there is a clinical assessment that the client poses a danger to themselves or others.
"The solution is having clear policies on information-sharing as well as professionals who are well-trained, supported and informed about privacy issues."
Ms King said she would like to acknowledge the valuable contribution to the review made by Malcolm Beggs’ family and close friends.
She also thanked former Mental Health Commission chair Dr Barbara Disley for the commitment and energy she put into overseeing the review.
A copy of the review is available on the Mental Health Commission's website at www.mhc.govt.nz
Questions and Answers
Who was on the review panel?
Former Mental Health Commission Chair Dr Barbara Disley, Mental Health Commission Commissioner Mary O'Hagan, Mental Health Commissioner (Acting Chair) Bob Henare, Mental Health Commission kaumatua Denis Simpson, a consumer representative, a family representative, a senior clinician, and Ministry of Health Director of Mental Health Dr David Chaplow. A member of the Privacy Commissioner's office also attended review panel meetings to provide advice.
What was the review timetable?
The review was commissioned following the Coroner's inquest into the death of Malcolm Beggs and Lachlan Jones. The review panel held its first meeting in September last year. The review was presented to the Minister of Health in February 2002.
What were the objectives of the review?
The project's aim was to review the policies and procedures in place in mental health services in respect of the Privacy Code 1994, about the sharing of service user information with families, caregivers and also with other services. It was not intended as a review of the Privacy Act or the Health Information Privacy Code.
The review focused on the following issues:
- How peoples' information is currently used and shared with families, caregivers and with other services or with other parts of the District Health Board's service areas.
- What information is shared and in what circumstances.
- What information is currently not shared and why it is not shared.
- The main reasons for confidentiality and the impact of that confidentiality, or the failure to have confidentiality, on the person's treatment or on their families or caregivers.
- The current policies and procedures in the services for sharing service user information.
- The relevant cultural practices and how these are taken into account in the services' policies and procedures.
- How the policies and procedures are communicated to staff, service users and to their families and caregivers.
- Key issues with the implementation of the current policies and procedures; recommendations for improvements to address the issues identified
Any recommendations for change had to be presented with a clear rationale of the benefits to people who use mental health services, their families and caregivers.