Understanding confidentiality

When your young person goes to see a health professional it can be hard to know what to expect. What will you be told? How will you know what’s happening? And how as a parent can you stay involved but also respect your child’s right to privacy? 

Every health professional works differently but there are some key principles they must follow. These relate to privacy and confidentiality, and what’s known as ‘duty of care’. How involved you are in the treatment process will depend upon the age of the young person, where they are at in their recovery process and how much they want you to be involved. 

Why confidentiality is important

Confidentiality is an important part of getting support. If young people know that what they say to a health professional is confidential, they’re more likely to seek help and talk openly about what’s going on for them. This means the health professional can better assess the situation and what treatment might be most helpful.

All health professionals are legally required to maintain their patient’s confidentiality but there are some exceptions. A health professional can break confidentiality if:

  • the young person gives consent to do so
  • they think the young person is going to hurt themselves or somebody else
  • they are required to talk with another health professional about the young person
  • they are legally required to do so – for example, if they learn that the young person is being physically or sexually abused
  •  the young person is underage and requires treatment that they don’t have the maturity or capacity to consent to.

Involving family members

Even if the young person is in your care or under the age of automatic consent, they still have a right to confidentiality. However, the health professional will consider whether the young person is able to make decisions on their own or needs the support of other adults. 

Health professionals have to make an assessment about whether to inform or involve the guardian, family member or primary carer for the ongoing care of the young person. This is based on the young person’s age, maturity, family circumstances, the seriousness of the condition and treatment, and in accordance with local laws (each state/territory of Australia is governed by different legislation). 

The health professional takes a whole range of things into account in making this judgment, including:

  • the young person’s maturity
  • how independent they are
  • how serious the issue is
  • how intensive the proposed treatment is
  • the young person’s capacity to understand and consent to what the treatment involves, such as side-effects.

Developing strong support networks

As part of their early conversations with a young person, health professionals will ask about support networks to ensure the young person is supported and cared for – both during the sessions and at home. Health professionals typically try to involve parents and other caregivers in the young person’s treatment, while also respecting the young person’s rights to confidentiality.

Health professionals may:

  • Talk with the young person about who they would like to have involved in the treatment process. This is a conversation that health professionals may revisit with the young person at different points of their treatment.
  • Talk with the young person about allowing parents, guardians or other support people to attend the first and last few minutes of appointments, giving them some general information about what’s happening.
  • Spend time with the young person’s trusted adults early in in the treatment phase to talk about the goals of treatment, clarify issues of confidentiality, their involvement, and how to communicate with the health professional.
  • Suggest that family members seek support from other services and read up on anxiety and depression.
  • Ensure that everyone understands that the safety of the young person is the top priority – if the young person is thinking about hurting themselves or anyone else, the health professional will have to break confidentiality and pass on this information.
  • Where a young person has a partner, the health professional may also suggest that they are involved in the young person’s care at times.

Respecting privacy

If your young person doesn’t want you to know about their treatment, it’s important to respect their privacy. You can still be supportive and positive about their decision to seek help without knowing the details of what’s going on.

You can help by:

  • reminding your young person that you’re there to help, so you’d appreciate some ideas from them about how you can do this
  • reassuring them that you don’t want to know the details of their conversations. Instead, you’d like to know a bit more about who is helping them, and perhaps some feedback about how you can be more helpful at home.
  • ask whether they have some written information or websites that you can read to better understand what’s going on for them and how you can help
  • consider asking for a joint meeting with the health professional so that everyone is clear on what to expect, what the focus of treatment is, how communication works and how you may or may not be involved with the sessions – reiterating that you don’t want to know the content of their sessions unless they want to tell you. Often young people are hesitant to have parents or guardians involved initially, but may request that you get involved as the sessions progress to address issues together.

Developing independence

There will probably be times when a young person calls on others for help and does not involve their parents or guardians directly. This can be difficult to accept, but it’s also an important part of young people developing their skills as responsible independent adults – making their own decisions about their health and wellbeing.

It can be hard to find the right balance – showing your love and care while also respecting their privacy – but regular, open conversations with your young person about how the treatment is going and what you can do to help offers the best chance for shared understanding.

“Our GP was terrific and kept me informed as much as she could. She was able often to convince my daughter to do something and then agree for me to be told.” Jeannette, parent

Confidentiality and Medicare

There are many health services available for young people, including doctors and mental health professionals that young people can access through the Medicare system. These services are free or partly paid for by the government.

Young people need their own Medicare card or their number on the family card to ensure they have easy access to health services. 

Young people aged 15 or older can have their own Medicare card. This is a simple process requiring them to fill out a Medicare Copy/Transfer Application form and attend a Medicare or DHS Service Centre with identification (such as birth certificate, student id or passport). Having their own card means that all information about their use of Medicare services remains confidential.

If a young person is under 14 years, parents will be able to see what services the young person has used, and when and who is offering the service by reviewing their Medicare claims history. This does not outline the content of the sessions.

If a young person is older than 14 years, parents will be able to see the service that the young person has accessed and when, but it does not show bulk billing claims or any details of the service.

My Health Record

My Health Record is an online summary of your health information, such as medicines you are taking, any allergies you may have and treatments you have received. Your My Health Record allows your doctors, hospitals and other healthcare providers (such as physiotherapists) to view your health information, in accordance with your access controls. You are also able to access it online yourself.

If you have parental responsibility for a person under 18, you can register for a My Health Record as their authorised representative. When you register, you can consent to the inclusion of Medicare information in their My Health Record if you wish. This includes Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data.

Young people can apply to manage their own record from the age of 14. If they choose not to, you will continue to be responsible for it until they turn 18. Any MBS and/or PBS data will not be accessible once the young person turns 14.

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