My rights: Confidentiality and privacy

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Confidentiality and privacy

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Privacy

Different people have different comfort levels when it comes to sharing personal information. Some people don’t want others to know they are having mental health or substance use challenges or are seeking help. It’s important that your privacy is respected and that steps are taken to make you feel safe and secure.

In Canada, there are federal and provincial laws about privacy and personal health information. In general, service agencies must:

  • get your permission to collect and share your personal information
  • tell you why they are collecting your personal information
  • store your personal information safely
  • let you see your personal health information if you ask to see it.

To find out more about the Canadian laws on privacy, check out https://www.priv.gc.ca/en/privacy-topics/privacy-laws-in-canada/.

Confidentiality

What you tell a service provider usually stays between just you and the service provider—this is called “confidentiality.” You have the right to have the things you talk about with your care team kept confidential. That means that what you share with your care team stays between you and them, except in certain situations, which are outlined below. Every service provider should explain their policies on privacy and confidentiality. If you want more information, ask your service provider for a copy of their policy on privacy and confidentiality, or ask them to go through it with you.

There are times when an agency or service provider can legally share things you talked about WITHOUT your permission or awareness. They might even be required by law to report things you shared. Here are the three most common reasons this would happen:

  1. If you tell a service provider that you or a child (under age 18) is being physically, emotionally or sexually abused or neglected.
  2. If you’re at risk for seriously hurting yourself or someone else.
  3. If you’re involved with the law or legal system, the courts can ask your service provider for your personal health information.

If this is important to you, you may want to ask your service provider the following questions:

  • In what situations would you have to break confidentiality with me?
  • If you feel the need to break confidentiality, would you tell me?
  • How does the agency keep records? Who can access them? Am I allowed access?
  • Under what circumstances will guardians or other authorities be contacted? (This question applies if you are a minor—under age 18.)

Example

Danil is experiencing mental health difficulties but he is unsure about using mental health services. He does not want his family and school to know about his struggles. Danil finds a mental health service close to his house and attends his first appointment. At the appointment, Danil is still unsure about talking to the therapist. The therapist explains what confidentiality is and gives Danil a form to read with the service’s policy on confidentiality and privacy. Danil is now aware of what would be kept confidential between him and his therapist. He is also aware of situations where his therapist may have to break the confidentiality agreement. Danil now understands confidentiality and feels more comfortable sharing his thoughts with his therapist.

"Through the process of seeking help as a young person, confidentiality feels like true empathy and support. It's having your mental health professional walk with you through the process and value the safe space you are sharing with them. Confidentiality is knowing you're safe, heard and seen."
—Vanessa, youth advisor

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Anonymous services are a type of service where you don’t have to tell the service provider who you are. For example, many phone helplines and online mental health services are anonymous. People may want to use anonymous services for different reasons. For example, they may feel more comfortable being “unknown,” especially in a small town where everyone knows one another.

If this is important to you, you may want to ask your service provider the following questions:

  • Do you have anonymous services here? If so, what kind?
  • When I’m using an anonymous service, is there any way someone could find out who I am?
  • How do you make sure everything is kept confidential and anonymous?
  • If I choose to stay anonymous, how will you get a hold of me?

Many services will let you decide who you consider to be a part of your family. You might consider family members to be anyone in your circle who gives you emotional support and helps advocate for you when you don’t feel like you can advocate for yourself.

At different points throughout treatment, you can decide whether it could be helpful to involve family members so they can support you. You get to decide how much or how little your family is involved in your care.

If this is important to you, you may want to ask your service provider the following questions:

  • Can family members book my appointments for me, or do I have to do it myself?
  • Can I bring family members / close friends / partners to my appointments?
  • How will my family be involved in the treatment process?
  • Are there different ways my family can be involved?
  • I do not want my family involved. Are there any situations where they might be informed about my treatment?
  • I don’t want my family to come to my appointments, but I want to keep them informed. Can you give me short write-ups on my progress to give to them?

Example

August has begun counselling for her mental health, but she does not want her family to get too involved. She discusses her concerns with her psychologist. August explains what she would like to share with her family and what she would prefer to keep confidential with her psychologist. August decides that she does not want her family making decisions about her mental health without discussing it with her first. She also does not want her family to attend any of her appointments. But she would like her psychologist to give her short weekly write-ups/reports that she can share with her family to keep them informed about her progress.



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