In the Military, Different Rules for Patient-Therapist Confidentiality

[Posteritatis]

Pfc. Jeffery Meier, who struggled with post-traumatic stress disorder and drug addiction after two deployments to Iraq, got an appointment in August to see a psychiatrist at Fort Carson, Colo.

But when he arrived for his first session, he was asked to sign a waiver explaining that under certain circumstances, including if he admitted violating military laws, his conversations with his therapist might not be kept confidential. He refused to sign.

Private Meier, who is seeking a medical discharge from the Army, was given counseling anyway. But he says he never opened up to his therapist, fearing that actions taken in the heat of battle might be disclosed to prosecutors. “How can you go and talk about wartime problems when you feel that if you mention anything wrong, you’re going to be prosecuted?” he said in an interview.

He is not alone in his wariness. Many soldiers, lawyers and mental health workers say that the rules governing confidentiality of psychotherapist-patient relations in the military are porous. The rules breed suspicion among troops toward therapists, those people say, reducing the effectiveness of treatment and complicating the Pentagon’s efforts to encourage personnel to seek care.

http://www.nytimes.com/2009/12/07/us/07therapists.html

Interesting article on the state of therapy in the military right now, including some ties to Maj. Hassan's experiences with hearing these sorts of stories from his patients as well as ties to a few other ongoing situations.

It's also surprising at just how recent even this limited form of confidentiality appeared in the military. It's an improvement over what came before, but any situation in which a patient is encouraged, one way or another, to have to lie to anyone treating him for his own protection is a situation that needs improvement.