[SheHulk07]

At the community mental health center that I'm a client at, it's on their admission form to put an emergency contact. I had my husband, but with everything going on I switched it to my cousin. In the 4 years I've been going there, they have never once contacted them.

Well I went to our weekend walk in center yesterday to get extra support...basically an extra session with a therapist that's on call that day. I've gone several times, and never had a problem until yesterday. I went in, just said that my husband did something that morning, that I had self harmed earlier and that I've been having some passive SI. That's all I said...I didn't say I had a plan, didn't say I've been researching ways, didn't say I wanted to SH later, etc. When I was leaving, he mentioned that it's protocol that when a client comes in for SI/SH that they call their emergency contact so that there's someone else that knows what's going on. I told him that it's unnecessary to call, and asked him not to. When I left, he ended up calling my cousin and leaving a detailed message on her voicemail that I was feeling suicidal and that I had SH!

My cousin freaked out, and was super worried even though she knows what's going on. I feel like that was a total breach of confidentiality as I specifically said I didn't have a plan or anything. What's your thoughts on this? Have you had this happen or am I right in this situation and should file a complaint?

[Electric76]

Originally Posted by SheHulk07

At the community mental health center that I'm a client at, it's on their admission form to put an emergency contact. I had my husband, but with everything going on I switched it to my cousin. In the 4 years I've been going there, they have never once contacted them.

Well I went to our weekend walk in center yesterday to get extra support...basically an extra session with a therapist that's on call that day. I've gone several times, and never had a problem until yesterday. I went in, just said that my husband did something that morning, that I had self harmed earlier and that I've been having some passive SI. That's all I said...I didn't say I had a plan, didn't say I've been researching ways, didn't say I wanted to SH later, etc. When I was leaving, he mentioned that it's protocol that when a client comes in for SI/SH that they call their emergency contact so that there's someone else that knows what's going on. I told him that it's unnecessary to call, and asked him not to. When I left, he ended up calling my cousin and leaving a detailed message on her voicemail that I was feeling suicidal and that I had SH!

My cousin freaked out, and was super worried even though she knows what's going on. I feel like that was a total breach of confidentiality as I specifically said I didn't have a plan or anything. What's your thoughts on this? Have you had this happen or am I right in this situation and should file a complaint?

I'm so sorry! Sounds like a new therapist, and one who didn't pay attention in class! Do you know if they were a trainee or intern? Filing a complaint sounds harsh given they were doing what they understood was right...maybe have a chat with their supervisor, or your regular therapist who might be able to clarify suicide/self harm risk assessment to them? (Now I'm waiting for you to say they've been practicing over 10 years lol!!) Hope you're taking care of yourself!

One more thing: they should have told you they were going to call your emergency contact. Its not a requirement but definitely a courtesy. Would have been nice if you could call your cousin right after and not leave them worrying after a terrifying message

[DelusionsDaily]

If they've never done that before, something set off bells for them that they felt they needed to make a contact like that. I wasn't there so I'm not sure what that would be. I don't think a complaint is gonna do ANYTHING. I mean it might make you feel better but I think the regulating body is probably gonna err on the side of caution in terms talk of suicide. I guess might force the agency to reveal why they felt the need to make the contact and whether that was legit enough to warrant it. You may never know their answer complaint or not but based on the governing body's response you'll know if it was truly justified.

[ThisWayOut]

Wow. I'm sorry that happened. I would be livid... can you read over their confidentiality forms again? I've only had my emergency contact called when I was being hospitalized and not in a state to make the call myself. There was one time the clinician told me they would call my wife and I denied them permission. At that point, they couldn't make the call anymore...
I'm not sure how likely you are to speak to that particular counselor again, but perhaps you can speak to the supervisor? I would probably approach it in a way that acknowledged how helpful the walk-in had been, but the call to the emergency contact made it feel unsafe to return (or something like that)...
:/
I'm glad your cousin is supportive though... I hope this call from the crisis Center didn't mess with that.

[ScarletPimpernel]

If this person has never dealt with you before and was concerned, they had every right to contact your emergency contact. That's kind of why it's an "emergency contact".

Since they felt it was okay to let you go home it doesn't make any sense they felt the need to call your emergency contact. I would call and clarify that or find out if that is something you signed an agreement about. It seems strange to me.

[SheHulk07]

I don't have his disclosure statement, but I'm sure I an at least find it and see his credentials. Or bring it up to my new T when I see her. He did say he was going to call, and I said not to and that I would call her and let her know. I had tried calling her as soon as I left to let her know in case he did, but he must have called at the same time.

[SheHulk07]

Originally Posted by puzzle_bug1987

Since they felt it was okay to let you go home it doesn't make any sense they felt the need to call your emergency contact. I would call and clarify that or find out if that is something you signed an agreement about. It seems strange to me.

That's why it doesn't make sense to me. I wasn't an imminent risk to myself which is part of the centers confidentiality agreement so I don't see why he felt the need to call. Not like she could help as she lives across the country. I understand if he put me on a hold but he didnt.

[SheHulk07]

Originally Posted by ScarletPimpernel

If this person has never dealt with you before and was concerned, they had every right to contact your emergency contact. That's kind of why it's an "emergency contact".

I guess that makes somewhat sense, but it seems overkill considering my emerge contact is across the country and can't do anything to keep an eye on me like he said. And he knew that.

[SheHulk07]

Originally Posted by ThisWayOut

Wow. I'm sorry that happened. I would be livid... can you read over their confidentiality forms again? I've only had my emergency contact called when I was being hospitalized and not in a state to make the call myself. There was one time the clinician told me they would call my wife and I denied them permission. At that point, they couldn't make the call anymore...
I'm not sure how likely you are to speak to that particular counselor again, but perhaps you can speak to the supervisor? I would probably approach it in a way that acknowledged how helpful the walk-in had been, but the call to the emergency contact made it feel unsafe to return (or something like that)...
:/
I'm glad your cousin is supportive though... I hope this call from the crisis Center didn't mess with that.

Thank you. I like that suggestion. And thankfully no it didn't mess with my relationship with my cousin. She was just really freaked out after his message.

[SheHulk07]

Originally Posted by DelusionsDaily

If they've never done that before, something set off bells for them that they felt they needed to make a contact like that. I wasn't there so I'm not sure what that would be. I don't think a complaint is gonna do ANYTHING. I mean it might make you feel better but I think the regulating body is probably gonna err on the side of caution in terms talk of suicide. I guess might force the agency to reveal why they felt the need to make the contact and whether that was legit enough to warrant it. You may never know their answer complaint or not but based on the governing body's response you'll know if it was truly justified.

That's understandable what you're saying that it'll probably not have an effect on me or the agency. They have never done it and I've seen a lot of therapists and have talked more about suicidal thoughts and SH than I did with this person, which is why it was weird.

[SheHulk07]

Originally Posted by Electric76

I'm so sorry! Sounds like a new therapist, and one who didn't pay attention in class! Do you know if they were a trainee or intern? Filing a complaint sounds harsh given they were doing what they understood was right...maybe have a chat with their supervisor, or your regular therapist who might be able to clarify suicide/self harm risk assessment to them? (Now I'm waiting for you to say they've been practicing over 10 years lol!!) Hope you're taking care of yourself!

One more thing: they should have told you they were going to call your emergency contact. Its not a requirement but definitely a courtesy. Would have been nice if you could call your cousin right after and not leave them worrying after a terrifying message

I don't know how long he's been practicing besides that he said he usually works with kids. Which might be why he reacted this way and felt the need to contact my cousin. He told me he was going to call and I told him not to, that I could call her and let her know what was up. I tried calling her as soon as I left to warn her that it might happen, but he must have called at the same time.

[ruh roh]

Wow. This is really out of bounds. My understanding about emergency contacts is that they are for notifying your contact there has been an emergency--accident, illness, injury--and where you are located so that your contact can find you. For example, if an employer has an emergency contact for you, they wouldn't call your cousin to tell them you were having problems at work, but they would call if you broke your leg and were taken to the hospital.

In this case, if that therapist felt this was an emergency due to you being at risk of sui, then they should have sought to have you admitted--but the fact is, it was not that kind of an emergency and they knew this and bungled the whole thing. Sounds like an incompetent therapist to me. I'm really sorry.

[Lauliza]

Since you're an adult, once you told them you would be safe and talk to someone that should have been enough. A more seasoned clinician would have drawn up a safety plan with you, which is more appropriate. Although filing a complaint might not do anything, I still think it's worth telling someone at the clinic what happened. If anything maybe he will be spoken to by a supervisor.

This is why you have to be very careful about what you tell staff in situations like this. There are certain "buzzwords", like SH and sui, that will get a strong reaction of some kind, especially from people newer to the field. So long as the clinician reacts in some way, even over reacts, they didn't do anything wrong.

[ThisWayOut]

Originally Posted by Lauliza

This person didn't break any rules on their end. You With everything you told this person their reaction makes sense, given they didn't know you well. That is why you have to be very careful about what you tell staff in situations like this. There are certain things they hear where if they don't know you well, they will react just like this person did.

To my understanding, due to HIPPA, confidentiality can only be broken with permission in cases like this (unless the person has a guardian)... even a verbal rescinding carries weight. At least, that has been my experience.

[Lauliza]

It gets tricky, because confidentiality can be trumped by safety concerns. I've been in similar situations and would not have done this. Instead a T would have the client contract for safety and come up with a plan before leaving the office. If that's not an option for some reason, however, then the next step could be to contact someone. So, if this T felt there was significant risk then they acted appropriately, at least as far as ethics are concerned. I think the OP is justified in being angry and should say something if she wants to. I just doubt anything will happen to this T beyond a conversation about what to do next time.

If he really thought you were in danger and in an "emergency" it seems really incompetent of him to let you go like that. Sounds like a lot of unclear regulations that you need to clarify

[SheHulk07]

Originally Posted by puzzle_bug1987

If he really thought you were in danger and in an "emergency" it seems really incompetent of him to let you go like that. Sounds like a lot of unclear regulations that you need to clarify

That's what I don't get. If he thought I was unsafe, why not send me to the ER than calling my contact? It's just weird but hopefully I won't run into the same issue again.

[SheHulk07]

Originally Posted by Lauliza

It gets tricky, because confidentiality can be trumped by safety concerns. I've been in similar situations and would not have done this. Instead a T would have the client contract for safety and come up with a plan before leaving the office. If that's not an option for some reason, however, then the next step could be to contact someone. So, if this T felt there was significant risk then they acted appropriately, at least as far as ethics are concerned. I think the OP is justified in being angry and should say something if she wants to. I just doubt anything will happen to this T beyond a conversation about what to do next time.

Yeah, I'm not looking good to get him fired or anything like that. Just maybe have his supervisor talk to him for next time.

Originally Posted by SheHulk07

That's what I don't get. If he thought I was unsafe, why not send me to the ER than calling my contact? It's just weird but hopefully I won't run into the same issue again.

Because it isn't always that black and white. I know there have been times when my pdoc or my T contacted my husband to be sure they were aware that I wasn't doing well, encourage them to keep close watch, and advise them on how to proceed should they feel I might need more intervention. They weren't quite at the point of insisting I go inpatient, but they were on high alert and wanted my emergency contact on high alert.

[SheHulk07]

Originally Posted by Lauliza

Since you're an adult, once you told them you would be safe and talk to someone that should have been enough. A more seasoned clinician would have drawn up a safety plan with you, which is more appropriate. Although filing a complaint might not do anything, I still think it's worth telling someone at the clinic what happened. If anything maybe he will be spoken to by a supervisor.

This is why you have to be very careful about what you tell staff in situations like this. There are certain "buzzwords", like SH and sui, that will get a strong reaction of some kind, especially from people newer to the field. So long as the clinician reacts in some way, even over reacts, they didn't do anything wrong.

He did draw a safety plan, and I had agreed to it and had agreed to come back or go in if things got worse. That's why it's confusing how he responded by calling my cousin after I had agreed to a plan.

Funny thing is that yesterday I went to the crisis Center and talked to a therapist for 2 hours. I told him more than what I told the other therapist and he even read through a few notes from previous sessions. He let me go home even though he was concerned because I didn't have any plans etc.