Breaching patient confidentiality may be necessary to prevent suicide, experts argue

Breaching patient confidentiality is sometimes necessary to prevent suicide, according to psychiatrists.

Leading psychiatrists have argued against the current position of health services to withhold information from the families of high-risk mental health patients.

Leader of the National Suicide Prevention Strategy for England Louis Appleby and Surrey consultant child psychiatrist Andrew Hill-Smith spoke at the Royal College of Psychiatrists International Congress alongside family members of people who have taken their own lives.

Families should also be seen as potential partners in suicide prevention, they told the event on Tuesday.

Use judgement

Professor Appleby, who is chair of the National Suicide Prevention Strategy Advisory Group, said: ‘Psychiatrists should feel able to use their clinical judgement on where the balance of patient safety and confidentiality lies.

‘Families are devastated when they discover too late that their loved ones had been talking to professionals about suicide.’

Royal College of Psychiatrists president Sir Simon Wessely said courts are ‘exceptionally reluctant’ to rule against doctors who have clearly acted in good faith in the interests of their patient.

‘In my experience, if doctors make well-justified, well-recorded decisions to share information in the best interests of a patient who is in suicidal crisis, consistent with their professional codes of practice, this will be understood, respected and upheld in courts of law,’ he said.

State of mind

Suicide is the leading cause of death among men aged 15-49 in England and Wales.

The Five Year Forward View for Mental Health has set an ambition to reduce the number of people in England taking their own lives by 10% by 2020/21.

In 2014, the National Suicide Prevention Strategy Advisory Group developed a consensus statement which says the duty of confidentiality is no justification for not listening to the views of family members and friends, who may offer insights into an individual’s state of mind.

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