Confidentiality and Access to Records

People who are confined in psychiatric hospitals are entitled to have their records kept confidential. In addition, communications with treatment providers are privileged, and cannot be used in a court of law. C.G.S.§§ 52-146c, 52-146d, 52-146e. This applies whether a person is in a public or private hospital and whether the person is in the hospital voluntarily or by a court order (commitment or Physician’s Emergency Certificate.) Confidentiality includes the right not to have the hospital disclose that the person is a patient there. It also encompasses the right to have conversations with treating professionals in a private place where the conversation cannot be overheard.

The right to confidentiality of medical (which includes psychiatric) records and information is governed by state and federal laws. The Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, was enacted in 1996. It governs the protection and release of health care information by most hospitals and health care providers. If private information was not properly protected, a complaint can be filed with the Office of Civil Rights.

There are exceptions to the right to confidentiality: for example:

  • lawyers appointed to represent respondents in conservatorship and commitment proceedings may see the medical records of their clients C. G. S. § 45a-649a(g);

  • special limited conservators may see the conserved person’s records. C. G. S. § 17a-543a

  • other exceptions, involving reimbursement by providers for treatment and some criminal justice issues. C.G.S.§§ 52-146f, 52-146g, 52-146h. Even the exceptions contain some protections. C.G.S.§52-146j.

The right to access medical records is related to confidentiality. In this area, however, the rights regarding psychiatric records are not identical to those regarding other medical records. In general people are entitled to receive copies of their medical records. C. G. S. § 4-104, C.G.S.§ 20-7c. However, a patient in a psychiatric hospital may be refused the opportunity to inspect his or her records. C.G.S. §17a-548(b) If the request is in connection with litigation related to the hospitalization, access should be given. However, in other cases, the facility may refuse to disclose any portion of your records only when the facility determines that:

  1. it would create a substantial risk that the patient would inflict life threatening injury to self or others; or
  2. the patient would experience a severe deterioration in mental state; or
  3. it would violate an assurance or confidentiality furnished to another person provided that such portion of the record is disclosed which would not constitute an invasion of privacy of another person or violate an assurance or confidentiality furnished to another person.

If a hospital refuses access to records, the decision can be appealed in Superior Court.

The facilities may charge for copies, but no one should be denied copies because of an inability to pay. You may state that you are indigent and unable to pay, and there is a presumption that this is true. C.G.S. § 19a-490b(d)

The right of a person who has a conservator to release his or her own records is part of the right of access to records. In the case of Phoebe G. v. Solnit 252 Conn. 68; 743 A.2d 606; 1999 Conn the Connecticut Supreme Court said that individuals with conservators do not lose the right and ability to retain advocates and lawyers to assist in treatment planning, which includes the right to sign a release allowing that person to access her or his records and to obtain information from her or his case manager. The Department of Mental Health and Addiction Services abides by that decision. (see letter from Tom Ring.)