Confidentiality and mental health

Edited by Christopher Cordess.

Jessica Kingsley

£15.95 (paperback)

£47.50 (hardback)

ISBN 1 85302 860 6 (paperback)

ISBN 1 85302 859 2 (hardback)

The revised code of practice to the Mental Health Act 1983
contained the following statement: “Ordinarily, information about a
patient should not be disclosed without the patient’s consent.
Occasionally it may be necessary to pass on particular information
to professionals or others in the public interest, for instance
where personal health or safety is at risk.”

This has been one of the more controversial parts of the revised
code. Multi-disciplinary working and a series of mental health
inquiries have left many mental health professionals with the
impression that current law and social policy errs on the side of
disclosure. The restatement in the code of the importance of
confidentiality came as a surprise. The Human Rights Act 1998 has
also drawn attention to the issue. The publication of this
collection edited by Cordess is therefore timely.

This is a thoughtful book, which manages to look at issues in
sufficient depth to leave the reader satisfied. The exception to
this is for social workers. The dilemmas concerning confidentiality
for social workers are not adequately addressed. There is one brief
reference to the requirement to consult with the nearest relative
when considering an application for detention, but the opportunity
to look at these issues was missed.

The book is written mainly by psychiatrists. The issue of
confidentiality in a range of different mental health settings is
considered by specialists from the field. Ethical dilemmas are
dealt with in a comprehensive manner. There are two chapters
written by lawyers and these are easy to follow with key legal
points backed up by examples of recent case law.

This is a helpful book and should help to stimulate debate on an
important issue at a time when, from a service user point of view,
there are some concerns about loss of respect for privacy and
confidentiality within large health organisations.

Robert Brown is head of approved social work training
programmes in Hampshire, south London and south west England. He is
also a Mental Health Act commissioner.

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