Student mental health: appendix 2


This is an appendix to the Student mental health policy.

These guidelines have been drawn up by UCL in order to clarify the issue of confidentiality. They are intended for all staff at UCL who come into contact with students.

Recent changes in the law have reflected an increased sensitivity in society at large about sharing information, particularly of a personal nature. For example, The Human Rights Act, 1988, addresses issues of privacy and areas where an individual's right to privacy may be in conflict with a responsibility to a wider public. The Disability Discrimination Act, 1995, sets out the responsibilities for addressing the needs of individuals with a disability, some of which can conflict with an individual's wish for privacy.

The Data Protection Act, 1998, regulates the management and confidentiality of written information. These guidelines therefore refer to verbal communication. Their objective is to offer a framework of agreed standards, in order to establish transparency about sharing information that will lead to improved trust and openness. They should benefit students and staff, by informing them of the importance given to confidentiality and how verbal information should be treated.

A number of professionals, such as doctors, psychotherapists and clergy follow a strict code of practice on confidentiality. This assumes that any information they receive in their professional role (and often outside it) is confidential, unless they have been given permission to divulge it. Such permission may be implicit, for example when a patient's solicitor requests a medical report on a patient's behalf. Such codes are extremely strict and it is assumed that they will in most cases over-ride what is set out below. However, the underpinning principles are similar.

These guidelines are intended to be practical, realistic and sensitive. They are not intended as a set of rules, since staff need to be able to formulate decisions on when to share information, what information to share and with whom dependant on individual circumstances. However, it is also important for everyone to be aware of the implications of breaking confidentiality, which may only be implicit.

Framework for dealing with confidentiality

The following questions should always be considered:

  • is the information intended to be confidential?
  • is it appropriate to treat it as confidential?
  • who else should it be discussed with?

Information that is intended to be confidential

This is apparent if a student makes it explicit. It is assumed that most people will recognise whether a student wishes confidentiality to be protected or to have information shared. Often, this will apply to only part of the information. However, raising awareness of this issue should lead to individuals erring on the side of caution and, if there is any doubt, this should be clarified with the student. Circumstances that should alert someone to this include hearing about personal or family details, medical information and criminal behaviour.

When it's appropriate to treat information as confidential

It is usually correct to simply respect a student's autonomy and accept the need for confidentiality. However, there are occasions when this will feel extremely uncomfortable. This may be because of concern about the student's physical or mental health or because the student is sharing information about criminal activity. It can sometimes be very difficult to balance a respect for an individual's autonomy against one's responsibilities to society or other people. If the breaking of confidentiality is being considered, a member of staff must talk over the issue with a senior colleague who has experience in these matters, such as the Head of Student Psychological Services, the Director of Student Support and Wellbeing, or the Head of Department. This can be done without necessarily revealing the identity of who the discussion is about. If it is decided that breaking confidentiality is justified, every effort must be made to inform the student concerned of this decision and why it has been reached. The student should also be encouraged to inform the appropriate person themselves, or at least to agree to this course of action.

There are two situations that require special consideration.

Information provided by a third party

The member of staff should ascertain whether the student concerned is aware of the information being provided by the third party, whether they know that the member of staff is to be informed and whether they gave permission for this to happen. What the informant wants the member of staff to do with the information should be clarified. It would often be appropriate to discuss the possibility of the informant communicating directly with the student concerned, if they have not already done so. Failing this, if the information has been given in confidence, for example a medical or legal report, permission to share this with the student should be sought. Such decisions can be extremely complex and it is generally best to discuss them with a senior colleague, as described above.

Dealing with a crisis

It is usually possible to defer making a decision, however much pressure may be felt. This will allow an opportunity to consult, as described above. In those exceedingly rare situations which have to be treated as an emergency an individual will always be supported if they have considered the implications of breaking confidence, if they have attempted to discuss this with the student and if they are too worried to carry the responsibility of secrecy.