Synopsis
Protect confidential psychiatric information while sharing proportionately with consent, under law or to prevent serious harm, distinguish receiving concerns from disclosing records, and document purpose, recipient, minimum content and patient communication.
- Explain confidentiality and its limits early, including care-team sharing, safeguarding, legal requirements and prevention of death or serious harm.
- Seek explicit consent for disclosures outside direct care, clarify recipient and purpose, and respect granular preferences where safe and lawful.
- Within direct care, share relevant information with professionals who need it, while checking the person understands ordinary information flows whenever practicable.
- Listen to family, employers or others who offer risk information without confirming diagnosis, attendance or treatment in return.
- Without consent, ask whether disclosure is required by law or justified in the public interest because non-disclosure exposes someone to death or serious harm.
- Assess specificity, imminence, severity, affected people, credibility, available alternatives and which recipient can actually reduce the danger.
- Use the minimum necessary content, secure route and verified identity; protect third-party information and avoid forwarding whole notes by default.
- Tell the person about disclosure unless that would increase danger, reveal a confidential source inappropriately or obstruct a lawful investigation.
- Document consent, capacity, facts, advice, balancing, information shared, recipient, timing and plan for review or patient notification.
Key red flags
A specific threat, target, method, access and timeframe requires active consideration of protection and cannot be managed by promising secrecy.
Children, partners, carers and employers do not gain automatic access to psychiatric information through relationship, concern or responsibility alone.
Refusing to hear information from a relative because consent is absent confuses receiving a concern with disclosing confidential patient details.
Sharing an entire record when a focused factual disclosure would meet the purpose breaches data minimisation and can expose unrelated trauma or third-party information.
There is no single universal UK Tarasoff-style formula; clinicians must apply GMC guidance, statutory duties, common law, safeguarding and jurisdiction-specific advice to the actual danger.
Investigation priorities
Identify why information is requested, who will receive it and what action the disclosure could enable.
Management branches
The patient wants a relative, employer, service or other recipient to receive information.
- Clarify purpose, recipient, content, duration and communication route and assess capacity when there is a genuine concern.
- Share accurate minimum necessary information within the authorised scope and distinguish fact, opinion and uncertainty.
- Record consent and disclosure and revisit permission when circumstances, recipient or purpose changes.