Mental Health and Privacy Explained

By Kelly Burch

Your mental health is incredibly personal. You might not be comfortable talking about it with anyone—even the people you’re closest to. At the same time, having your family (or trusted people in your life) aware of your challenges and supporting you can lead to better mental health, including fewer hospitalizations and more time between crises. 

Ultimately, if you do need professional mental health support, it’s important to know when you have control over who has access to details about your care. Once you legally become an adult (at age 18), you can make decisions about who’s involved in your care and to what extent. 

Here’s what you should know about privacy and your mental health. 

What Guardians Can—and Can’t—See About Your Health Care

When you turn 18, your privacy around health care is protected by law. This law is most commonly called HIPAA, which stands for the Health Insurance Portability and Accountability Act of 1996. HIPAA protects all your health care information, not just mental health. It means that doctors and other health care providers can’t share your health care information with anyone—including guardians, your college, and even other doctors—without your permission.

If you’re younger than 18, health care privacy laws vary by state. Here’s a breakdown of state laws. Be sure to scroll to the right and look at the column labeled “Mental Health Care.” These laws are current as of 2022.

Colleges Need to Respect Your Privacy, Too

In general, colleges can’t notify parents about mental health issues either in most cases, due to the protections of FERPA (the Family Educational Rights and Privacy Act) and state laws. But there are some exceptions, including, most especially, if they believe a student is a danger to themself or others. If you’re concerned about your privacy, ask your providers about the circumstances under which they would involve guardians in care. 

You Can Involve Your Parents–or Anyone Else You Trust–in Your Care

With your permission, doctors or other health care providers can talk to anyone about your mental health care. You’ll need to sign an authorization form like this one. You can control what information is shared: For example, you might allow doctors to tell your parents about your mental health condition but not about use of birth control. 

If you are in college, your school likely also has an emergency contact form, like this. These forms might be part of the paperwork you fill out while enrolling; you can also find them by contacting the student services office at your university. Filling out the form and keeping it updated can ensure that your trusted loved ones know when you’ve experienced a crisis.

If your parents aren’t safe or use your mental health condition to shame you, you might want to keep your mental health private. In that case, think about whether there’s anyone else whom you’re comfortable sharing this information with. Having support people, whether friends or family, can be critical for managing life with a mental health condition. And you can sign releases allowing health care providers to share information with the people you choose.

Parents and Others Can Always Contact Your Doctor

HIPAA generally prevents your doctors and other health care providers from sharing information with others, but it doesn’t stop others, like your guardians, from sharing information with your care team. And if you’re on your family’s insurance, your caregivers will be able to see what health care providers you’re seeing on billing documents. 

If your loved ones see signs of relapse or are worried about you, they can call or email your care providers. Although this usually comes from a place of love, some people aren’t comfortable with it. If that’s the case for you, keep your doctors’ names private. 

Have an Honest Conversation

People who love you are going to want to help and support you. That will be easier for them to do when they know what’s going on with you and what you are and are not comfortable with. Having an honest conversation with your guardians about what health records you want to keep private and which you’re comfortable with them having access to is helpful for everyone involved. 

You are an adult and entitled to privacy. New boundaries may be hard for guardians to accept, but it’s OK to establish them anyway. Keeping lines of communication open about this and the ways they can be helpful can foster connection and can enhance the likelihood that you’ll receive helpful support. 

Managing boundaries and privacy around mental health is tricky. Don’t feel like you need to have it all figured out at once. And remember, your decisions about whom to share information with can change over time.

Tips for handling difficult family conversations