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Psychiatry & Psychology--General/Can my counselor breach confidentiality in this way?


Well I had some things happen with my therapist and am wondering if she was allowed to breach confidentiality the way she did.

Well first off, I am 19, so am no longer a minor. I live in New York, so I am not sure if things are different there or something.

But anyways. So a bit back I was talking to my therapist and told her that I had bought some sleeping medication as a 'back up plan' I didn't tell her that I was going to kill myself on 'this day and this time' with them, just that I wanted to have a back up plan, something to keep in my back pocket.

She made me get rid of them when I got home, and had me call her once I got rid of them.

Then the next week I saw the person that prescribes me medication (she works as a team with my therapist) she is a nurse practitioner. She of coarse asked me if I had any thoughts of hurting myself/committing suicide. Me trying to be as honest as possible told her yes and she asked how I would do it. I hesitated, but told her the ways that i had thought of doing it. She told me she wanted to call my mom to ensure I was safe at home, but I was really scared so she let it slide this time.

But then when I saw my therapist the next day she told me she had chatted with my nurse practitioner and they had decided that my mom needed to be contacted and told that I have suicidal thoughts. She said that it was that or being placed in the psych ED.

She ended up calling my mom because that was her preferred course of action. She said she could breach confidentiality in this case.

Now was she allowed to force me to let her call my mom?  Is that her right? She said too many red flags were going up. But is it legal for her to have done this.

I'm just wondering. And now because of what happened I am now afraid to tell her everything that's going on with me anymore. Is there a way that you can ease my fear as well as answering my question about the legality of it all?

Of course this is really a legal question, not a medical question, in exactly what the laws of New York say, but, ethically, yes, she did the right thing.  It is generally understood that confidentiality does not apply in an emergency situation, and this could easily be considered an emergency.  You should be pleased that she is so very concerned about your safety.  

Psychiatry & Psychology--General

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Daniel S. Harrop, M.D.


Dr. Daniel S. Harrop received his B.A. and his M.D., both from Brown, and his M.B.A. from the Edinburgh Business School, Scotland. Board-certified in adult and geriatric psychiatry, he is a past president of the R.I. Psychiatric Society and a member of the Committee on Medical Quality of the American Psychiatric Association and the Committee on Continuing Medical Education of the R.I Medical Society. He serves as a consultant to four of the top five major medical management companies, including OptumHealth/United Healthcare, Magellan Behavioral Health Services, ValueOptions and APS Healthcare, and maintains a private practice in Providence, R.I. He also serves as chief psychiatric consultant on the Medical Advisory Board at the R.I. Workers Compensation Court. He was formerly on the faculty at the medical schools at both Brown University and Harvard University.

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