APA Says Mentally Ill Left Under-Protected by Clinton Medical Privacy Rule
Today the American Psychiatric Association (APA), representing 42,000 psychiatric physicians nationally,responded to President Clinton's proposed medical records privacy regulations by calling on the Administration to strengthen mental health patients' rights to secure, private medical records.
"Confidentiality of medical records is essential to insure the delivery of the highest possible quality health care and protect personal privacy," said Paul Appelbaum, M.D. Vice President of the APA. "The U.S. Supreme Court ruled in Jaffee v. Redmond, that privacy is an essential component of effective mental health care. The Court even went so far as to give mental health care unique protections under law."
"The new regulations proposed by President Clinton do not go far enough to repair the torn fabric of medical records privacy," said Appelbaum. "People with mental illness have witnessed a steady erosion of privacy over the past twenty years, and we in the medical profession have seen first-hand the struggles our patients have had to endure as a result. Some patients have had their medical records used against them by employers and even printed in the newspaper. Clearly this destroys a very valuable and essential doctor-patient relationship that in the end hinders successful treatment of patients."
"The President's proposal is a first step, but during the review period concerns for the mentally ill must have a place at the table," said Richard Harding, M.D., Vice President of the APA and a member of President Clinton's National Committee on Vital and Health Statistics. "Patients must regain and retain the right to decide, without coercion, who can view their personal medical history. This is always the way records have been kept, and it is only recently that so many different third party groups have been able to access private personal medical records."
The APA recommends that before any new regulations are enacted into law they should include increased patient control over both paper and electronic medical records. States should have the right to enact more protective privacy laws that cannot be preempted by the Federal government, which the President's proposal accomplishes. In addition the APA views additional mental health and employees rights protection as essential pieces currently missing from the proposed regulation. Lastly, the APA would like the patients to once again be the primary decision-maker about exactly who has access to their own private medical records.
"As a society we view our privacy as one of the greatest freedoms we enjoy. To allow insurance companies and other entities to have direct access without prior knowledge or consent to medical records should not be an option," said Harding. "Too many patients are choosing to go untreated rather than face the potential of private records made public. In the end this hurts patients, their loved ones and the people who are dedicated to caring for them."
Read an in-depth analysis of Susanna Kaysen.
Read an in-depth analysis of Lisa.
Read an in-depth analysis of Georgina.
Polly - A disfigured patient. Before entering McLean, Polly poured gasoline over her face and upper body and set herself aflame. Polly appears to be at peace, even cheerful, during her first year at the hospital. One day, Polly suddenly becomes aware of the awful extent of her injuries. She is inconsolable. Kaysen notes that although everyone at McLean is affected by sickness, Polly is the only patient trapped forever by the consequences of her illness.
Daisy - A patient who spends the period from Thanksgiving to Christmas at the hospital each year. Daisy lets no one into her room, emerging only for laxatives and the whole roast chickens her father brings twice weekly. Lisa discovers that Daisy’s room is filled with the picked-over carcasses of the chickens. Daisy leaves the hospital to live in an apartment her father has purchased for her. The girls later learn that Daisy committed suicide on her birthday.
Cynthia - A severe depressive on Kaysen’s ward. Cynthia undergoes months of electroshock therapy. The effects of the shock treatments change Cynthia’s personality, leaving her totally unable to assert herself. Cynthia is close to Polly.
Lisa Cody - A patient who becomes fast friends with Lisa, only to be cruelly rejected. Diagnosed, like Lisa, as a sociopath, Lisa Cody emulates Lisa’s behavior. Feeling that her position among the girls is threatened, Lisa turns against her, and Lisa Cody leaves the hospital. Returning from an escape to Boston one day, Lisa tells the other girls that Lisa Cody has become a “real” junkie.
Torrey - A methamphetamine-addicted patient from Mexico. Torrey’s parents, embarrassed by their daughter’s condition, arrive to retrieve her after a short time. Lisa plans to help Torrey escape, but Valerie halts Lisa’s plan.
Alice Calais - A troubled patient who pronounces her last name “callous.” Alice’s mental breakdown results in her transfer to the maximum-security ward. Alice’s appearance and the frightening atmosphere of the ward appall the girls when they visit.
Valerie - The head nurse on Kaysen’s ward. The girls like and respect Valerie for her fairness and willingness to speak up on their behalf.
Melvin - Kaysen’s therapist. Impressed by Kaysen’s intelligence, Melvin begins an advanced program of analysis with her. Kaysen finds the experience unconvincing and discovers that she was Melvin’s first analysis patient.
Mrs. McWeeney - The evening nurse on Kaysen’s ward. Mrs. McWeeney hails from the old school. Her old-fashioned uniform and values alienate the girls.
Dr. Wick - An older female psychiatrist on the hospital staff. Dr. Wick is from Africa and is entirely unfamiliar with the American youth culture of her patients. Vulgarity and frank discussion of sex embarrass Dr. Wick, whose efforts at treatment are not necessarily effective.
James Watson - Nobel Prize–winning friend of Kaysen’s family. Beloved by Kaysen for his unpredictable behavior, he visits Kaysen and offers to help her escape. She turns him down in the belief that she should continue treatment.
Kaysen’s Husband - Introduced to Kaysen prior to her hospitalization, he stays in touch with her throughout her time at McLean. His marriage proposal allows Kaysen to leave the hospital. They are married only a short time.
The English Teacher - Kaysen’s high school teacher and lover. He takes her to the Frick Museum in New York, where she first sees the Vermeer painting titled Girl, Interrupted at Her Music. Their affair is short-lived.
The Diagnosing Doctor - The psychiatrist who encourages Kaysen to enter McLean Hospital. He diagnoses her in a mere twenty minutes. Kaysen believes that his swift diagnosis expresses the psychiatrist’s misguided effort to save her from the wayward youth culture he disdains and cannot understand.