Join the Discussion My doctor has added a thyroid med to my meds in order to help stabilize me and kick in an antidepressant without sending me into mania. Does anyone know if this med causes hair loss as can be seen in hyperthyroidism. I sure hope not cause my hair is so thin from the large dose of Depakote already Synthroid for Depression?

Related Resources • When Must your Therapist Break Confidentiality? • The Health Privacy Project Patient Resource Center

Elsewhere on the Web • Bazelon Center for Mental Health Law Privacy Info • The Privacy Rule • The Health Privacy Project

The 1996 Health Insurance Portability and Accountability Act (HIPAA) required that a uniform set of medical records privacy standards be implemented for the first time in the U.S. When congress was unable to pass standards, the Clinton Administration proposed a set of standards which has now been passed by the Bush administration.  The new standards are set to go into effect in 2003. 

Mental health records are treated somewhat differently from other medical records.  Psychotherapy records are specifically granted a different status than other medical records.  The new regulations are complex.  Here are some of the highlights:

• Stricter requirements will apply for psychotherapy notes than for other health information. Specific written authorization is required for most disclosures - a general release form is not enough.  This regulation is thought to apply to detailed psychotherapy "process notes" - not necessarily to brief notes that are entered into a general medical record.
   
• Insurance companies and other health plans are not allowed to condition enrollment or eligibility for benefits on the patient's providing an authorization for disclosure of psychotherapy notes.  Therapists can't be required to send copies of their detailed notes in order to receive payment.  Health plans can still require that detailed forms be filled-out. 
   
• Patients will have the right to request changes to their medical record (adding information that corrects an error).
   
• Patients will have the right to request restrictions on uses or disclosures of medical information (for example, they can request that information not be shared with a particular individual). The provider or health plan then decides if it will honor this request.
   
• Patients will be able to request that communications from the therapist be made in a certain way (such as prohibiting phone calls to the patient's home or work). The regulations state that this request must be honored unless it is "unreasonable and creates an undue administration burden". 

(Summarized from information at the Bazelon Center for Mental Health Law and other sources.)