When service members feel ready to make mental health-related appointments, there are many variables that may affect their ability to seek care. Access to care, long wait times, and wondering whether treatment is confidential or will negatively affect their careers are among the many concerns. Deciding when to seek help can be tough, but knowing what ethical practices, policies, and guidelines protect our health information can help you make better choices for yourself and the care of your loved ones.
What Does Confidentiality Mean for Service Members?
Your health information is kept private and not released unless authorized by your informed consent via a release of information, or under certain military-related exceptions, contained in policies below.
Department of Defense health care providers are required to report information about your care, providing only the minimal information required, to commanders when certain circumstances involve safety concerns or impact mission. To learn more about the exceptions to confidentiality, see the following fact sheets for:
What Ethical Practices Do Your Providers Follow?
As part of their training and licensure, health care professionals like physicians, psychologists, social workers, and counselors are bound by ethical and professional standards of conduct. Moreover, providers are required to abide by their professional code of ethics and privacy guidelines to safeguard confidentiality. Like non-military providers caring for civilians, each state’s guidelines and rules must be followed by military providers, unless superseded by federal requirements. According to federal law and DOD policies, providers must also follow the Health Insurance Portability and Accountability Act guidelines, or HIPAA.
During your initial intake appointment, you should be fully informed, via an informed consent, of all your confidentiality rights and the limitations to confidentiality. This is an excellent time to ask questions and ensure you understand all aspects of your confidentiality before sharing your information. For more tips about questions to ask and the standards to confidentiality, check out this Real Warriors Campaign infographic: Five Things To Know About Mental Health and Confidentiality.
What Guidelines Does Your Chain of Command Follow?
The DOD has issued instructions establishing policies, procedures, and assigning responsibilities in the evaluation and treatment of service members. See DODI 6490.04 for more information.
Line leaders are expected to familiarize themselves with the Defense Health Agency policies related to the protection of health information. Leaders are allowed to consult a service member’s health care team regarding health or mission concerns. To learn more about the conditions or circumstances under which providers are required to notify command and when mental health information may be shared, see DODI 6490.08.
Leaders can support service members seeking care by normalizing mental health treatment and highlighting the benefits to self, team, and mission.
Stigma and Changing Your Mindset
Mental health stigma can be a roadblock to reaching out for help. Stigma refers to judgements that we make about ourselves (self-stigma), attitudes held by family members, or judgements by society (public stigma). To combat stigma, it is helpful to change your mindset and view self-care to better care for your loved ones and battle buddies. A healthier and more resilient self may also improve mission readiness.
Additional Resources:
Relevant Policies:
- DODI 6025.18, March 13, 2019
- DODI 6490.04, "Mental Health Evaluations of Members of the Military Services," March 4, 2013; Incorporating Change 1 on April 22, 2020
- DODI 6490.08, "Command Notification Requirements to Dispel Stigmas in Providing Mental Health Care to Service Members," September 6, 2023
Sources:
- American Psychological Association. (2018). Rules and procedures of the ethics committee. https://www.apa.org/ethics/committee-rules-procedures-2018.pdf
- American Psychological Association. (2019). Protecting your privacy: Understanding confidentiality in psychotherapy. https://www.apa.org/topics/psychotherapy/confidentiality
- Cornish, M., Brenner, R., Vogel, D., & Wade, N. (2019). Evaluation of an online help seeking stigma-reduction intervention for military personnel. Stigma and Health, 4, 480-486.
- Correll, D. N., Engle, K. M., Lin, S. S., Lac, A., & Samuelson, K. W. (2021). The effects of military status and gender on public stigma toward posttraumatic stress disorder. Stigma and Health, 6(2), 134-142.
- Joseph, D. I., Goldstein, M. M., & Onek, J. (2021). Confidentiality. In S. Bloch & S. Green (Eds.), Psychiatric ethics (5th ed., pp. 237–277). Oxford University Press.
Updated August 2024