Ask Your Adult Child to Waive Privacy Rights Under HIPAA

At 18, when our mentally ill children are no longer minors, it is important to encourage them to waive their privacy rights through the Health Insurance Portability and Accountability Act (HIPAA) and allow parents to participate on their mental health team. To assure that adult children waive their privacy rights, parents need to develop a relationship of trust.

Why the Choice to Waive Privacy Rights Is Important

HIPAA was designed to keep insurance companies and others from sharing a person’s private health information without her consent. Unfortunately, one of the consequences of that law is that it also “protects” adult children with mental illness from having their information shared with their parents unless the child chooses to waive privacy rights.

There are exceptions to this rule and sometimes ways around it in mental health emergencies, but for bread-and-butter experiences, it can be difficult to access your child’s mental health information without permission.

When An Adult Child Does Not Waive Privacy Rights

The irony for parents is that (if not legally then in reality) they are usually still on the hook to pay for this medical care and take care of the fall-out when their children have a mental health crisis, but without the adult child’s choice to waive privacy rights, doctors may not relay information to parents about her treatment or prognosis.

For parents whose children still live at home, or for whom they are paying all the bills—including medical insurance—being subject to privacy laws can be extremely frustrating. Additionally, if parents know that their child, by virtue of her mental illness, is prone to poor decision-making, it can be alarming to be cut out of the loop.

And, if parents have had an adversarial relationship with their teen, too often, new adults will not waive privacy rights to assert their power without ever considering the consequences of banning a parent from their mental health support team.

Get Involved Before Waiving Privacy Rights Becomes an Issue

But, parents can continue to be part of their child’s treatment team several ways:

• Ask to Participate: Depending on your child, staying a part of the treatment team may be as simple as asking your child to waive her privacy rights. Do this with each provider and have your child carry a signed letter that gives permission to contact and talk to you.
• Build Trust: Begin sitting in part of the therapy session before your child turns 18. Rather than listing your complaints, use the time to acknowledge the efforts your child is making towards mental health. Allow your child to take the lead and honor the steps she is taking to improve her life. Create an environment of mutual respect and trust that will carry you into adulthood. Focus on what’s going right or being accomplished by your child. (Save your venting for your own therapy session.)
• Have a One-Way Conversation: If despite your best efforts, your child will not sign a waiver, that does not stop you from talking to her doctor. The doctor just may not talk back. Send an email; write a letter; or call your child’s provider to offer insights into your child’s behavior to her health care providers. Begin your conversation by declaring, “I know you may not talk to me, but there are some things I think you ought to know....” They are allowed to listen.

By employing these methods, both before and after your child turns 18, you will assure that you are as involved in your adult child’s care as possible and will remain a vital part of the decision-making team.

Build Trust Before Asking Your Child to Waive Privacy Rights

Resources:

The Health Insurance Portability and Accountability Act (HIPAA)