Your Rights in Telehealth and Outpatient Mental Health Care

Author:

Emma Loker

B.S

Editor:

Ashley Pena

LCSW

Patient rights in mental health care extend beyond the walls of a mental health professional’s office.

If you require the flexibility of telehealth and outpatient mental health care, know that you still have access to rights as a patient. Whether you’re worried about confidentiality in mental health services, your rights to a second opinion, or access to medical records, a mental health professional can guide you through these issues. This article can also provide the information you need to stay empowered by covering:

Your patient rights in mental health care
What informed consent in psychiatric care is
Rights to refuse treatment and seek second opinions
Confidentiality in telehealth services
How to access telehealth and outpatient mental health care

Your Patient Rights in Mental Health Care

One of the most critical aspects of getting your voice heard in treatment is exercising and understanding mental health patient rights. These rights are designed to protect you and ensure you receive quality care from mental health professionals. Here are some of the most important legal protections for mental health patients and how to exercise them.

1. Right to Humane Treatment

Negative stigma around mental health problems is unfortunately common in the general population – and even sometimes among medical professionals. These negative beliefs or understandings can lead to healthcare professionals experiencing burnout, a loss of confidence, and a reduction in the quality of the care they provide.¹

If you’re seeking help for mental health problems, you deserve access to compassionate and effective treatment despite the effects of negative stigmas. The United Nations principles help to protect anyone with a mental health issue, ensuring that you are treated with compassion and respect. After all, everyone needs to be treated in ways that safeguard their dignity.²

But how can you ensure you’re receiving humane treatment and that providers are respecting your rights? Some things to consider include the following.

The Right to Safety Around Your Therapist

Different states have mental health treatment legal rights through their Department of Consumer Affairs. However, one widespread right is the right to a safe environment, free from sexual, physical, and emotional abuse.³

Be honest with yourself about whether you feel safe around your therapist. Do they say or do things that make you uncomfortable? Even inappropriate comments during telehealth sessions are red flags.

Other signs of inhumane treatment and abuse from your provider may include:

Feeling anxious when thinking about therapy sessions. If this anxiety comes from discussing emotions, this is normal. However, you shouldn’t feel anxious about your therapist’s actions.
Feeling like you are walking on eggshells around your therapist.
Belittling, inappropriate, or aggressive behavior from your therapist.
Being pressured into doing or saying things during therapy that make you uncomfortable.
Believing that your therapist doesn’t respect your boundaries.

Trust your gut and speak up if you feel uncomfortable or unsafe during your sessions. Your provider should be a source of support and security, not someone who violates your rights and boundaries. If you do experience any form of abuse, report these instances as soon as possible.

The Right to Adequate Care

Care that is timely and suitable to a patient’s needs is one of the most vital patient rights during residential and outpatient therapy. The California Department of Health Care Services, for instance, states that all patients should have access to adequate care, such as physical exercise and recreation.⁴

These rights also extend outside of the facility in which you’ll receive treatment. If your mental health professional does not provide adequate care, you have the right to report your concerns and even seek legal advice and action. Situations in which legal action is required in mental health care are rare, but, still, around 3% of psychiatrists face malpractice suits yearly due to issues involving:⁵

Failed duty (to the patient)
Dereliction, meaning negligence, of that duty
Damages caused by this negligence
Direct causation, which means that negligence led to worsened mental health issues or even injury

If you feel your provider has failed to meet their duty of care to you, you can speak up and take action. For instance, if you feel like they have not protected your rights or ignored your concerns in telehealth appointments. Speaking up about your concerns not only ensures that your mental health is cared for in the right way, but it also helps protect future patients from experiencing similar negligence.

2. Right to Privacy and Confidentiality

The Health Insurance Portability and Accountability Act (HIPAA), protects your privacy rights in psychiatric care by making sure your medical records and personal health information aren’t shared with anyone who isn’t directly involved in your care.⁶

Some of the many privacy rules your provider must follow according to HIPAA include:

Obtaining written consent before sharing any personal health information
Limiting access to medical records only to those who need them for treatment purposes
Putting strict security measures in place to protect against sharing of information with anyone not involved in treatment

If you feel your provider is freely giving people, such as your family, access to medical records without your permission it’s important to report this problem as soon as possible.

3. Right to Access Personal Medical Records

The HIPAA also outlines laws and regulations that protect your right to access your own medical records. This means you have the right to view, be given copies of, and request changes or updates to your personal health information, usually within six years of treatment.⁷

Some examples of personal medical records you can access include:

Admission notes
Billing records
Patient profile
Medication records
Referrals to specialists
Discharge and follow-up appointments

Whether you’re curious about a doctor’s notes or assessments, or simply want more transparency, know that you are allowed to see any mental health records about your treatment. If you aren’t allowed access to these, you have the right to free, confidential legal advice.

Informed Consent in Psychiatric Care

Did you know that, as a patient, you also have the right to know and have an opinion on the exact treatment that will be given to you? This is known as informed consent and is one of the most important codes of ethics in the American Medical Association (AMA).⁸Additionally, informed consent doesn’t just apply to residential or outpatient care – it’s also important in telehealth services.

Informed Consent in Telehealth Services

Informed consent can include anything from asking questions about your treatment to being told about any potential medication side effects. In telehealth services, patient rights in outpatient therapy might also include being clued into the potential benefits and risks of receiving therapy through virtual methods.

But are telehealth services as effective as more traditional forms of therapy? For instance, will your provider still be able to provide emergency services if needed? Questions such as these are just as important to ask as other informed consent questions.

Rights to Refuse Treatment and Seek Second Opinions

Informed consent in mental health treatment not only allows you to have a voice in your treatment, but it also gives you the right to refuse treatment and seek second opinions. This means you have the power to weigh other options, explore other providers, and ultimately choose the best route of care for your needs.

We discuss the right to refuse treatment and seek a second opinion next.

The Right to Refuse Treatment

The Supreme Court has ruled time and time again that people have a right to refuse medical care or mental health treatment. Therefore, if you don’t agree with the approaches being taken, you can say “no.”⁹ The exception to this rule is whether someone is considered a danger to themselves or others. Therefore, if you aren’t currently in a psychiatric crisis and simply want to refuse treatment to explore other options, you have the legal right to do so.

The Right to Seek a Second Opinion

Not only do you have the right to refuse treatment, but you also have the right to a second opinion in mental health care. You know your mental health issues and symptoms well – often better than a mental health professional. Therefore, you might not agree with a diagnosis or treatment approach. If this is the case, you don’t have to settle for the first conclusion made about your condition. Additionally, according to the Patient Advocate Foundation, seven states have laws related to second opinions and medical coverage. This means that insurance companies often pay for the majority of second options sought in mental health treatment.^10,11

If you’re concerned about your initial diagnosis and treatment plan, a mental health professional can guide you through finding out whether a second opinion will be covered by your insurance company.

Confidentiality in Telehealth Services

Confidentiality means that you have the right to keep your mental health information private and on a need-to-know basis. Confidentiality is protected in all mental health services by law, whether in-person or through telehealth services.

In case you have been ordered to comply with AOT, and you believe that it’s the wrong decision, you can challenge the order via the legal process.

HIPAA Compliance in Telehealth Services

The U.S. Department of Health and Human Services Office for Civil Rights has made it clear that all telehealth services, including emotional and behavioral health, must comply with HIPAA laws.¹² Confidentiality is a top consideration in these laws.

For example, telehealth providers must ensure the confidentiality of all patient information shared online or electronically. Therefore, if your therapist uses a secure platform to communicate with you, they must inform you about the risks of sharing information electronically, confirm your identity, and get your consent. If they do not take these steps, it may be wise to consider another mental health provider.

Data Protection Measures in Telehealth Services

The Office of the National Coordinator for Health Information Technology also outlines tips for providers to use to make sure they protect your health information.¹³ Some of the measures mental health professionals should take include:

Conducting third-party audits of their telehealth systems to ensure they are secure and in line with privacy regulations
Routinely review telehealth privacy and security policies
Regularly deleting sensitive files on mobile devices
Backing up data and putting recovery processes in place in case there’s a data breach

Never be afraid to ask your provider about their policies and practices regarding telehealth security. Doing so ensures your health information is protected and that you can feel secure enough to open up in therapy.

Access Telehealth and Outpatient Mental Health Care Today

Your right to privacy is just as important as your right to high-quality mental health care. At Mission Connection, we believe in not only providing the best mental health treatments for peoples’ needs but also combining these therapies with state-of-the-art security.

We take our patients’ information seriously, while also knowing how valuable flexible outpatient therapy and virtual mental health treatment are. If you have questions about our security measures, the types of mental health treatment we offer online, or any other concerns, please do not hesitate to reach out. We are here to support you in your mental health journey and make sure that your privacy is protected every step of the way.

References

1. Ahad, A. A., Sanchez-Gonzalez, M., & Junquera, P. (2023). Understanding and Addressing Mental health stigma across Cultures for Improving Psychiatric Care: A Narrative review. Cureus. https://doi.org/10.7759/cureus.39549
2. United Nations & Human Rights Office of the High Commissioner. (1991). Principles for the protection of persons with mental illness and the improvement of mental health care. https://www.ohchr.org/. https://www.ohchr.org/en/instruments-mechanisms/instruments/principles-protection-persons-mental-illness-and-improvement
3. Department of Consumer Affairs, State of California. (n.d.). Therapy never includes sexual behavior – California Department of Consumer Affairs. https://www.dca.ca.gov/publications/proftherapy.shtml
4. California Department of Health Care Services. (n.d.). HANDBOOK rights for individuals in mental health facilities admitted under the Lanterman-Petris-Short Act. In California Department of Health Care Services. https://www.dhcs.ca.gov/services/Documents/DHCS_Handbook_English.pdf
5. Frierson, R. L., & Joshi, K. G. (2019). Malpractice Law and Psychiatry: An Overview. FOCUS the Journal of Lifelong Learning in Psychiatry, 17(4), 332–336. https://doi.org/10.1176/appi.focus.20190017
6. U.S. Department of Human and Health Services. (2024, September 27). The HIPAA privacy rule. https://www.hhs.gov/hipaa/for-professionals/privacy/index.html
7. Tariq, R. A., & Hackert, P. B. (2023, January 23). Patient confidentiality. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK519540/
8. Informed Consent | AMA-Code. (n.d.). https://code-medical-ethics.ama-assn.org/ethics-opinions/informed-consent
9. Library of Congress. (n.d.). AMDT14.S1.6.5.1 Right to refuse medical treatment and substantive due process. Constitution Annotated. https://constitution.congress.gov/browse/essay/amdt14-S1-6-5-1/ALDE_00000903/
10. Patient Advocate Foundation. (2008). Second opinions: Know your rights and options. In A Greater Understanding. https://www.patientadvocate.org/wp-content/uploads/Second-Opinions-Know-Your-Rights-and-Options.pdf
11. Molina Healthcare, Inc. (2024). Member initiated second opinion: Benefit Interpretation Policy Version 3.0. In Molina Healthcare. https://www.molinamarketplace.com/marketplace/ca/en-us/Providers/-/media/Molina/PublicWebsite/PDF/Providers/common/BI/2024/2024-Member-Initiated-Second-Opinion.pdf
12. Legal considerations. (2023, November 7). telehealth.hhs.gov. https://telehealth.hhs.gov/providers/legal-considerations
13. Office of the National Coordinator for Health Information Technology. (n.d.). Telehealth privacy tips for providers [Press release]. https://telehealth.hhs.gov/documents/Telehealth+Privacy+Tips+for+Providers.pdf