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HIPAA Laws: Unintended Consequences January 10, 2010

Posted by Crazy Mermaid in HIPAA Laws, Involuntary Committment, Mental Hospital, mental illness.
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11 comments

Anyone whose loved one suffers from severe mental illness has most likely run smack dab into the HIPAA laws when they try to help their loved one. The way they stand right now, HIPAA Laws (Health Insurance Portability and Accountability Act of 1996) are a hindrance rather than a help for the severely mentally ill population.

While researching this article, I tracked down the original source of the HIPAA laws. For those of you interested in doing your own research, the HIPAA Law is spelled out in its entirely in CFR (Code of Federal Regulations).  Specifically, Title 45- Public Welfare Subtitle A Department of Health and Human Services Part 164 Subpart E Privacy of Individually Identifiable Health Information Section 164.506 through 164.512, Page 750 through 753.  It’s all legalese.

But the bottom line is that Section 164.506 (b) says: A covered entity (Hospital or Medical Clinic) may obtain consent of the individual to use or disclose protected health information to carry out treatment, payment, or health care operations. That, my friends, is the paragraph barring the friends and family of a mentally ill person from acting as the patient’s advocate.  Note the wording doesn’t say “must”. It says “may”.  But in order to cover their asses from lawsuits from patients claiming they didn’t consent to divulging medical information to a particular family member or friend, medical facilities choose to turn the word “may” into the word “must”.  Therein lie the problems.

While the goals of the HIPAA law are admirable, the HIPAA law needs to change when a person is diagnosed with a serious mental illness. This is especially true when a mentally ill person is hospitalized, either voluntarily or involuntarily, in a mental hospital. As the law stands now, the unintended consequences are that the HIPAA Laws work against mentally ill people, preventing them from obtaining advocacy and help in a time of critical need.

Here’s the rub:  The State of Washington has the power to remove my civil rights in order to treat me. But this same entity, thought stripping me of my civil rights, does not allow my husband to step in as my advocate because HIPPA laws prevent it.

It’s important to note that one of the criteria for diagnosis of mental illness is the presence of crippling paranoia, delusions, hallucinations, or a combination thereof. Symptoms so bad, in fact, that the State has to step in and take the step of stripping the patient of civil rights, in order to commit the individual to a mental hospital for an unspecified period of time.  The State gives that hospital the task of pumping the patient full of medication designed to bring about the return of the patient’s reasoning ability.

But the second the patient is committed, the HIPAA laws kick in. The patient is supposedly sick enough to require hospitalization for a chemical imbalance of the brain, stripped of his civil right to forego treatment for his illness, but this same patient, stripped of his civil rights, somehow (according to the HIPAA Laws) retains the right of privacy afforded by the HIPAA laws. The bottom line is that the State selectively decides which rights to strip the patient of and which rights to allow the patient to keep. They make the absolute worst value judgment in the history of humankind: the State assumes that a patient who loses his mind to the point that he has to be committed to a mental hospital has somehow retained the ability to advocate for himself. That patient, stripped of his civil rights and without an advocate, is left at the mercy of the hospital personnel, who don’t necessarily have the patient’s best interests at stake in their decision-making process. The patient is left vulnerable, the paranoia freezing out all other thought. And with their civil rights stripped and an ill brain, the patient’s supposed to be able to make rational decisions and act as their own advocate? Yeah right.

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