Health Information Privacy, Patient Safety, and Health Care Quality: Issues and Challenges in the Context of Treatment for Mental Health and Substance Use

In an era of heightened concern over health care quality and patient safety on the one hand, and health information privacy on the other, finding the right balance between these two broad goals can represent a major policy challenge. No health issues better illustrate this challenge than the debate over use and disclosure of individualized information regarding mental health conditions and substance use disorders. Following an overview of the social and legal traditions underlying health information privacy, this article examines the federal and state legal framework for information privacy relating to treatment for mental health conditions and substance use, focusing on privacy and information-sharing in a treatment context. Examples of "real world" scenarios are presented and various issues brought up are discussed. Various recommendations include using technology to standardize consent systems, ensuring that patients’ decision to withhold information is truly informed, and strengthening tools of enforcement for violations of privacy.