Natasha Bita, The Australian, National Education Correspondent, writes:
Warring parents are subpoenaing mental health records to “fish’’ for ammunition in child custody cases, psychiatrists have warned the federal government.
The Royal Australian and New Zealand College of Psychiatrists has asked Health Minister Sussan Ley to protect patient confidentiality by restricting the use of health records in court.
RANZCP president Malcolm Hopwood said psychiatrists were being forced to hand over patient records in civil litigation and Family Court cases. “Family law is a particularly grisly area,’’ he told The Australian yesterday.
“We are very concerned we are seeing misuse of clinical records in a family setting.’’
Professor Hopwood said that courts and lawyers had traditionally requested reports from psychiatrists. “Now we’re more frequently seeing a subpoena of the whole medical record,’’ he said. “We believe that at times that’s being done as a fishing exercise … they are looking for anything they decide may be useful.
“We’re very concerned that pays insufficient respect to privacy, reduces patient trust in their doctor and runs the risk of the material being misused in a legal setting.’’
Professor Hopwood said that medical records should only be handed to third parties with the patient’s consent — except in cases of mandatory reporting of child abuse, or if the patient posed an immediate threat to themselves or others.
Melbourne psychiatrist Frederick Stamp told the RANZCP’s annual congress in Brisbane yesterday that government agencies were also accessing mental health files without patients’ permission.
He said 75 departments and agencies had the power to demand patient files be handed over — including Medicare, the Department of Veteran’s Affairs, the Victorian Transport Accident Commission and WorkCover.
Agencies often demanded patient files as part of financial audits on doctors, to check if they had treated patients for the time they claimed payment.
“The legislation does not require them to get the patients’ consent or, even worse, inform them,’’ he told The Australian.
“They are able to make copies of the file, and presumably store them electronically.’’
Dr Stamp said he always told patients when a government agency demanded to see their file, and often they became “extremely disturbed’’.
“If you decide you want to see a psychiatrist, why the hell would you go along and lay your heart out if you thought there was some sort of risk it could go in another direction other than the doctor’s filing cabinet?’’ he said.
“If you say you’ve been having an affair for 20 years and your husband doesn’t know about it, if it gets out that is going to destroy a relationship.
“I recognise there have to be professional and financial audits, but I think for the vulnerable people who are seeing psychiatrists they’ve got to have some form of protection. The confidentiality belongs to the patient.’’
Professor Hopwood said that patients might stop speaking openly and honestly to a psychiatrist if they feared their secrets might be used against them in court.
Ms Ley said while she understood the doctors’ arguments, “it is a matter for the courts’’.