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'Shhh! Please don't tell…’ Confidentiality in child and adolescent mental health

  • Aaron K. Vallance

Summary

Confidentiality in child and adolescent mental health is a complex and often challenging matter. Not only do young people frequently present to services in situations of risk, they often prefer to keep information confidential from parents and/or other professionals. This article explores confidentiality in the context of child and adolescent mental health services (CAMHS), particularly when the clinician is having to make decisions on whether to maintain or to breach it. Ethical principles (both deontological and consequentialist) and legal and regulatory frameworks (relating to human rights, case law and General Medical Council guidance) are outlined. Four hypothetical case scenarios are used to illustrate how to apply such principles: when a young person seeks confidential access to treatment, and when he or she discloses information that could signify a risk to self, to others or from others. Finally, practical suggestions on how to share information are explored.

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Copyright

Corresponding author

Dr Aaron K. Vallance, South Surrey CAMHS Community Team, Bray Road, Guildford GU2 7LQ, UK. Email: aaron.vallance@sabp.nhs.uk

Footnotes

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LEARNING OBJECTIVES

• Outline some relevant ethical principles and legal/regulatory frameworks, and apply them when weighing up the pros and cons of maintaining or breaching confidentiality

• Apply strategies for breaching confidentiality that balance the need to share information appropriately against the need to preserve therapeutic rapport and engagement

• Judge how one's own ethical perspectives might influence decision-making in confidentiality dilemmas

DECLARATION OF INTEREST

None

Footnotes

References

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'Shhh! Please don't tell…’ Confidentiality in child and adolescent mental health

  • Aaron K. Vallance
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