One expert has described the current law governing the confidentiality of health care information as a “crazy quilt of Federal and state constitutional, statutory, regulatory and case law” that “erodes personal privacy and forms a serious barrier to administrative simplification” (Waller, 1995, p. 44). This aptly describes the current legal framework for the confidentiality of mental health and substance abuse information as well.
There is at present no national standard for the confidentiality of health care information in general or mental health information in particular. Rather, each state has laws that establish confidentiality rules and exceptions. In response to a serious public policy concern that the criminal justice ramifications of use of illegal substances would significantly deter individuals from seeking substance abuse treatment, a national standard governing the confidentiality of substance abuse treatment information was codified. However, there often are significant differences among states and between the state and Federal requirements, which can create problems for the administrators of health care plans and for those providing treatment for people with co-occurring mental illness and substance abuse disorders.