Ikenna DISCUSSION WEEK 2COLLAPSE The article I chose is “Confidentiality in the Age of HIPAA: A Challenge for Psychosomatic Medicine.” In this article the author examines the challenges confronting


The article I chose is “Confidentiality in the Age of HIPAA: A Challenge for Psychosomatic Medicine.”  In this article the author examines the challenges confronting consultation–liaison psychiatrists as they strive to maintain trust between patient and physician while managing conformance with the increasing complexities of confidentiality with the provision of sufficient information to our medical colleagues for good clinical practice. 

HIPAA (Health Insurance Portability and Accountability Act) is a federal law in the United States that establishes data privacy and security safeguards for medical information (Mermelstein & Wallack 2008). The law has gained attention in recent years because of the numerous breaches of health data related to cyber threats and cyberattacks on healthcare insurers and providers. 

U.S Congress Passed the federal statute into law on Aug. 21, 1996. HIPAA takes precedence over state laws governing the security of health information, unless the state law is deemed to be more strict(Edemekong, et al.,2018). I will address the legal and ethical implications of the Information Portability And Accountability Act (HIPAA) and how this law impacts adolescents and adults in a clinical setting.  

The therapeutic relationship is predicated on trust between the patient and practitioner. According to several studies, confidentiality, or the protection of an individual’s privacy, has been a precept of the medical profession. Confidentiality is founded on the concept that it is advantageous for patients to speak freely with their clinicians to receive the finest medical treatment possible and that it is desirable for citizens to have access to and use such care. Confidentiality is required in no other branch of healthcare but psychiatry. We want our patients not just to describe their symptoms, but also to express their most private thoughts and feelings to us. Additionally, the issues that motivate people who seek mental health care may include substance misuse and addiction, schizophrenia, child exploitation, assault, attempted suicides, family conflicts, and cognitive difficulties, among others. These folks are extremely vulnerable and rely on doctors to safeguard the very “shameful secrets” that had to be disclosed for treatment to occur. 

It is critical to understand that HIPAA regulations permit the sharing of clinical records in the interest of treating patients and protecting them or the public unless the release is specifically requested. Even so, in certain emergency cases (e.g., suicidality), disclosure against the patient’s choice may be permitted. Until certain problems are resolved, however, these judgments should be made based on the requirement of patient care, the expected impact of the communication, the benefit-risk ratio, and the efficacy of any other means that may exist (Mermelstein & Wallack 2008). 

According to Mermelstein and Wallack (2008), Adolescent patients witnessed multiple scenarios of medical visits with differing degrees of confidentiality promises. The desire of an adolescent to seek medical care, to be cooperative with the clinician, and to come for follow-up visits corresponded to the degree to which each encounter showed unconditional confidentiality. When physicians and medical students who scored highly on depression rating scales were asked why they did not seek care, nearly 35% claimed fear of disclosure, resulting in large rates of untreated depression and the associated suicide risk in an already vulnerable population (Mermelstein & Wallack 2008). 

The implications of violating HIPAA can be severe, and it is critical to realize that fines for HIPAA violations can be assessed by the Department of Health and Human Services’ Office for Civil Rights (OCR) even though no exposure of PHI occurs. In Texas, repercussions of violating HIPAA vary according to the degree of carelessness and – if a breach occurs – the volume of material that may have been exposed because of the breach as well as the risk created by the data leakage: For deliberate disregard of the HIPAA Rules, the highest monetary penalty is $1.5 million per infraction category, per year (Cater, 2021). 


Carter, M. H. HIPAA in 2021: Overview and Updates.HIPAA in 2021: Overview and Updates – Optimizing Rural Health 

Edemekong, P. F., Annamaraju, P., & Haydel, M. J. (2018). Health Insurance Portability and Accountability Act. Health Insurance Portability and Accountability Act – PubMed 

Ford, C. A., Millstein, S. G., Halpern-Felsher, B. L., & Irwin, C. E. (1997). Influence of physician confidentiality assurances on adolescents’ willingness to disclose information and seek future health care: A randomized controlled trial. Jama, 278(12), 1029-1034.Influence of physician confidentiality assurances on adolescents … 

Mermelstein, H. T., & Wallack, J. J. (2008). Confidentiality in the age of HIPAA: a challenge for psychosomatic medicine. Psychosomatics, 49(2), 97-103.Confidentiality in the age of HIPAA: a challenge for psychosomatic medicine 

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