The Catholic University of America

Director of Counseling Center Responsibilities

DC Mental Health Information Act of 1978
DC Code Section §7-1201.01 et seq.

The Director of the Counseling Center is responsible for ensuring that there are proper procedures in place for (and that staff are aware of the procedures) for complying with the recordkeeping, limitations on access, and authorization of disclosure provisions that are contained in the the DC Mental Health Law. This law is codified at D. C. Code § 7-1201.01 et seq. This law places strict limits on the disclosure of mental health information absent written consent from the patient or an exception in the law, also very limited.

 

Disclosure on an Emergency Basis

The statute (DC Code Section 7-1203.03) sets forth disclosures on an emergency basis. The text of the law, current as of Nov. 2011, is provided below.

(a) To the extent the disclosure of mental health information is not otherwise authorized by this chapter, mental health information may be disclosed, on an emergency basis, to one or more of the following if the mental health professional reasonably believes that such disclosure is necessary to initiate or seek emergency hospitalization of the client under s 21-521 or to otherwise protect the client or another individual from a substantial risk of imminent and serious physical injury:

 (1) The client's spouse, parent, or legal guardian;

 (2) A duly accredited officer or agent of the District of Columbia in charge of
 public health;

 (3) The Department of Mental Health;

 (4) A provider as that term is defined in s 7-1131.02(27);

 (5) The District of Columbia Pretrial Services Agency;

 (6) The Court Services and Offender Supervision Agency;

 (7) A court exercising jurisdiction over the client as a result of a pending
 criminal proceeding;

 (8) Emergency medical personnel;

 (9) An officer authorized to make arrests in the District of Columbia;  or

 (10) An intended victim.

(a-1) Any disclosure of mental health information under this section shall be limited to the minimum necessary to initiate or seek emergency hospitalization of the client under s 21-521 or to otherwise protect the client or another individual from a substantial risk of imminent and serious physical injury.

(b) Mental health information disclosed to the Metropolitan Police Department pursuant to this section shall be maintained separately and shall not be made a part of any permanent police record. Such mental health information shall not be further disclosed except as a court-related disclosure pursuant to subchapter IV
of this chapter. If no judicial action relating to the disclosure under this section is pending at the expiration of the statute of limitations governing the nature of the judicial action, the mental health information shall be destroyed. If a judicial action relating to the disclosure under this section is pending at the expiration of the statute of limitations, the mental health information shall be destroyed at the termination of the judicial action.

(c) Mental health information contained in a certification of incapacity, pursuant to s 21-2204, may be disclosed to initiate a proceeding pursuant to Chapter 20 of Title 21.

Recordkeeping: When a disclosure occurs, a notation must be entered and maintained with the patient's record of mental health information. The notation must include the date of disclosure, to whom disclosed, and a description of the contents of the disclosure. In all cases except for disclosure pursuant to the emergency provision, the disclosure must be accompanied by a statement to the effect that: "The unauthorized disclosure of mental health information violates the provision of the District of Columbia Mental Health Information Act of 1978. Disclosures may only be made pursuant to a valid authorization by the client as provided in title III or IV of that Act. The Act provides for civil damages and criminal penalties for violations."

Form of written authorization of disclosure:

The disclosure must:

(1) Specify the nature of the information to be disclosed, the type of persons authorized to disclose such information, to whom the information may be disclosed and the specific purposes for which the information may be used both at the time of the disclosure and at any time in the future;

(2) Advise the client of his right to inspect his record of mental health information;

(3) State that the consent is subject to revocation, except where an authorization is executed in connection with a client's obtaining a life or noncancellable or guaranteed renewable health insurance policy, in which case the authorization shall be specific as to its expiration date which shall not exceed 2 years from the date of the policy; or where an authorization is executed in connection with the client's obtaining any other form of health insurance in which case the authorization shall be specific as to its expiration date which shall not exceed 1 year from the date of the policy;

(4) Be signed by the person or persons authorizing the disclosure; and

(5) Contain the date upon which the authorization was signed and the date on which the authorization will expire, which shall be no longer than 365 days from the date of authorization.

In addition, a copy of the authorization shall be provided to the client and the person authorizing the disclosure; accompany all such disclosures; and be included in the client's record of mental health information.

Limitations on client right to access: Personal notes are not subject to the patient right to access rules. Personal notes are defined in the code as mental health information regarding a client which is limited to mental health information disclosed to the mental health professional in confidence by other persons on condition that such information not be disclosed to the client or other persons; and the mental health professional's speculations. 

In addition, DC Code 7-1202.06 gives the mental health professional the authority to limit authorized disclosures when: 

(1) Such mental health professional reasonably believes that such refusal or  limitation on disclosure is necessary to protect the client from a substantial  risk of imminent psychological impairment or to protect the client or another  individual from a substantial risk of imminent and serious physical injury;  and

(2) The mental health professional notifies the person or persons who authorized  the disclosure, in writing, of:  (A) the refusal or limitation on disclosure;  (B) the reasons for such refusal or limitation;  and (C) the remedies under this  chapter;  provided, further, that, in an insurance transaction, the mental  health professional shall inform the insurer that the authorized disclosure was  refused or limited.

Any refusal or limitation on disclosure shall be noted in the client's record of mental health information including, but not limited to, the names of the mental health professionals involved, the date of the refusal or limitation, the requested disclosure and the actual disclosure, if any.

Further requirements apply if this provision is utilized by the mental health professional (notification, right to review, etc.) and they can be found in D.C. Code § 7-1202.06. Limited disclosure to third party payor rules are set forth in DC Code 7-1202.07.

Mental health information may be disclosed to other individuals employed at the individual mental health facility when and to the extent necessary to facilitate the delivery of professional services to the client.  Mental health information may be disclosed by participating providers to other participating providers when and to the extent necessary to facilitate the delivery of mental health services and mental health supports to the consumer.

 

This discretion exists even if the client has signed a release, but the mental health professional must believe limited or non-disclosure is necessary to protect the client from a substantial risk of imminent psychological impairment or to protect the client or another individual from a substantial risk of imminent and serious physical injury. Further requirements apply if this provision is utilized by the mental health professional (notification, right to review, etc.) and they can be found in D.C. Code § 7-1202.06.

Tarasoff v. Regents of University of California
Any counselor (in consultation with the Director and OGC as needed) is responsible for notifying campus authorities and intended victims once a counselor determines, or under applicable professional standards reasonably should have determined, that a patient poses a serious and imminent danger of violence to others. In these cases the counselor bears a duty to exercise reasonable care to protect the foreseeable victim of that danger.

FERPA is not listed on this web page as the DC Mental Health Information Act of 1978 is the law that governs non-disclosure and disclosure of student counseling records.

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 updated by kvp 2-9-12