How to Protect Your Privacy When Seeking Mental Health Treatment at School
Colleges and universities often offer mental health counseling as a free service, but school counselors are not always required to keep your information private. Here are your options and what you need to know if you want to ask for help in confidence.
School Counselors
Services provided by a mental health center are often free and may be the most affordable option. If someone on campus directs you to the center, that fact may become part of your study documentation. So even if you didn’t say anything to the therapist, there might still be documents to prove that someone was worried about you.
Education records are usually protected by a law called FERPA (Family Education Rights and Privacy Act). According to the Jed Foundation , FERPA allows school staff to share information about you as needed.
The information you provide to the therapist is not automatically transferred, so you respect some confidentiality. But as soon as you ask for an adjustment due to a mental disorder, or talk about a vacation, or if your therapist sees a safety issue and speaks to someone else on campus, school officials can legitimately pass that information on and this falls under the rules FERPA.
FERPA states that information can be shared with your parents if you consider them a dependent for tax purposes. If you do not – including if your parents do not live in the United States and do not pay taxes in the United States – the school may share information with your parents in an emergency. They can also tell your parents about alcohol or drug policy violations.
Find your school on U Lifeline to see what resources are available to students and the school’s privacy practices. If your school is not listed, see the student guide.
Off-campus healthcare providers
Mental health is considered part of health care, and once you are off campus, your records will be subject to HIPAA, the Health Insurance Portability and Accountability Act. This provides more privacy and more control over your records.
Under HIPAA, you decide who can view your medical records. If you are over 18 years old, your parents will not have automatic access. If you are under 18, state law can come into play, but if you agreed to treatment (and not your parent agreeing for you), then you are the one who can control who sees your records .
If you are enrolled in your parent’s insurance program, they may end up getting a bill for your care. But in many states, you can call your insurance company and ask them to send your EOB — an itemized bill also known as an explanation of benefits — to your own address, not your parents. Whether they can do this, or must do so upon request, depends on state law. Ask as many clarifying questions as you need so you can understand if the company will send any information to your parents.
Bedsider, a sexual health resource, has scripts for this conversation and tips on how to make sure you get all your questions answered. After all, you can also keep your sexual health services confidential.
Emergencies and statutory reporting
Regardless of which law applies, your therapist can notify others about your mental health if they think you are a threat to themselves or others. This could include your parents if they feel that notifying your parents will help keep you safe. And that could include law enforcement.
If you tell your therapist about ongoing child abuse, domestic violence, or elder or disabled abuse, the therapist may need to report it .
Other options
You have more options than just therapists on and off campus. You can video call a physician from telemedicine services such as Teladoc and Amwell, just like you would call for a sore throat consultation.
You can also get help through a variety of apps, chatbots, and mental health subscription services , each with its own privacy policy. Some of them may not obey HIPAA regulations and may not even be required to report abuse. This can be a plus or a minus, as it can mean that you will not be helped in an emergency. Therefore, do not forget to think about how you feel about the rules of the service you have chosen.
There are also other groups that may not be relevant to your school but may provide free or readily available counseling. For example, you can find a support group or ask a church for advice. And you can check the various hotlines and groups that are available to help you get through a crisis or find a way to a more permanent solution. These include the National Suicide Prevention Line and Trevor’s Project for LGBTQ + Young People (ages 13 to 24).