Behavioral health providers' perspectives on supporting patient decisions in sharing treatment information in substance use and mental health settings: a qualitative study.

Abstract

Privacy and confidentiality are particularly important for individuals receiving care for behavioral health (BH) conditions. This study aims to explore BH service providers' experiences when they introduce and discuss consent to share BH treatment information with patients. BH providers participated in virtual focus groups (FGs). 100-120 min discussions were recorded, transcribed, coded using both a priori and open coding and analyzed for themes. Participants (n = 12) from 9 U.S. states participated in the FGs. Participants emphasized that discussing consent is an educational process and highlighted stigma, mistrust, and confusion as common patient experiences. Participants indicated difficulty with keeping up with changing laws, time constraints, and have concerns that discussions can feel coercive. Participants recommended that well-trained staff should facilitate patient-centered conversations and requested skills-based trainings, resources, and job aids, particularly for complex cases. This study elucidates BH service providers' experiences and recommendations with navigating conversations about consent, an important first step in fostering patient trust. There is a need to couple existing training focused on health privacy laws with how to practically apply that knowledge during the clinical encounter, ensure providers can seek guidance, and understand that consent is an ongoing, educational, and patient-centered process.