[A study of the relationship between community networking and confidentiality]

Legal and ethical conflicts arise in building a community network for mental health workers with confidentiality. Another ethical problem is encountered by involving mental health volunteers who are not obliged to be confidential. The authors made a questionnaire from the following six points of view: 1) the current attitudes of mental health professionals and workers toward confidentiality, 2) the degree of disclosure of individual information, 3) the relation between collaboration with family and confidentiality, 4) the range of extended confidence, 5) the extent of sharing individual information with volunteers, 6) the guidelines of confidentiality. The questionnaire was delivered to the following objects: 1,471 mental health professionals, 3,400 mentally disabled people and 3,400 of their family members. The returned questionnaires were analyzed and led to the following conclusions. The authors also conducted a bibliographical investigation on this subject. 1) Attitudes toward confidentiality varied among mental health professionals and also among mental health facilities. This created difficulties and confusion among them. 2) Transmission of individual information to the caregiving family members is important to help the mentally disabled, however, mental health professionals varied in the extent to which they informed them. 3) Mental health professionals in the same institute were regarded as an extent of extended confidence by 67.5% of the mentally disabled and 80.5% of family members. The caregiving family members were also regarded as such by 58.4% of the mentally disabled and 69.5% of family members. 4) The methods of transmission of individual information within a facility and/or with other facilities varied among mental health professionals. 5) A contract of confidentiality with volunteers was made only by 8.1% of mental health professionals. However, 34.1% of the mentally disabled and 24.0% of family members refused to transmit individual information to such volunteers. 6) Disclosure of individual information to the mentally disabled or their representatives is inevitable for them to authorize transmission of their individual information to others. Authorization of transmission of their individual information without knowing the content of such records is not valid authorization. 7) It is necessary to establish guidelines on confidentiality, according to 42.1% of the mentally disabled and 44.2% of their family members.