A fine line to walk: case managers' perspectives on sharing information with families

In the United States, sharing information with families in health care involves competing demands between clients' rights to confidentiality and families' wishes to know. In this article, I explore how community mental health providers share information with families of clients with severe mental illness. I interviewed 24 case managers in assertive community treatment programs. Results show that case managers share information with families to attain treatment goals rather than to support families in providing care. Case managers respect clients' confidentiality and do not release information without client consent. However, the absence of client consent posts an ethical dilemma when families provide helpful information for clients' treatment. Case managers find themselves walking a fine line between adhering to confidentiality guidelines and working for the clients' best interests. The findings suggest the need to expand confidentiality laws to the exchange of information and to develop guidelines for working with families in community settings.