Most of what you share with a psychiatric provider is kept private, so you can feel safe being honest.
There are only a few situations when a psychiatrist may break confidentiality to protect someone’s safety, and they should explain these to you.
You have the right to ask questions about confidentiality and speak up if you ever feel like your privacy hasn’t been respected.
When you see a psychiatric provider, it’s normal to wonder about psychiatrist confidentiality. Most of the time, what you share stays private, which can allow you to feel more comfortable being honest. However, there are only a few situations when a psychiatric provider must share information to keep someone safe.
Confidentiality is important because it builds trust. When you know your private thoughts are protected, it’s easier to open up and get the help you need.
How psychiatrist confidentiality works
When you see a psychiatric provider, what you say is private. This is called psychiatrist confidentiality. It means your psychiatrist must protect your personal information and not share it without your permission.
Confidentiality is important because it helps you feel safe and allows you the space to be more honest about what you’re going through.
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What laws and ethical codes protect you
Psychiatrists follow strict privacy laws and professional rules. In the U.S., the Health Insurance Portability and Accountability Act (HIPAA) protects your medical information. Psychiatric providers also follow ethical codes from groups like the American Psychiatric Association (APA). These guidelines require them to keep your information private unless you give written permission or there’s a safety concern.
How are your psychiatric records protected?
Your records are stored in secure medical systems. Only people involved in your care are allowed to see them. Psychiatric providers and their staff are trained to protect your privacy. They can lose their license if they break confidentiality.
Will your employer know if you use your insurance?
No, your employer won’t see the details of your sessions. They might see that a claim was made, but they won’t know what you talked about or why you went. Your personal mental health information stays private between you and your psychiatrist.
Will your parents know if you use their insurance or are younger than 18?
If you use a parent’s insurance plan, they may see a billing statement showing that you had a psychiatry appointment. But it won’t include what you said in your session.
If you’re younger than 18, your psychiatric provider may need to share limited information with your parent or guardian. This is especially true if there’s a safety concern, like thoughts of harming yourself or others. Most of the time, what you share stays private. Your psychiatric provider should explain what will and won’t be shared before you start.
Online vs. in-person psychiatry confidentiality
Confidentiality works the same way online and in person. Psychiatrists must still follow HIPAA rules during virtual sessions. And reputable online platforms use secure video systems to keep your information safe.
When may psychiatrists break confidentiality?
Almost everything you tell your psychiatrist stays private. But there are a few situations when a provider must share information to keep people safe.
For example, your psychiatrist may break confidentiality if:
You’re in danger of harming yourself.
You’re planning to harm someone else.
A child is being abused or neglected.
An older adult or a person with disabilities is being abused.
A court orders your provider to release your records.
In these situations, your psychiatric provider will only share the minimum information needed. Their goal is to protect your privacy as much as possible.
How to talk to psychiatrists about confidentiality
It’s OK — and even helpful — to ask your psychiatrist about confidentiality. You have the right to understand how your private information is protected.
Some questions you can ask at the start include:
“What does confidentiality mean in your practice?”
“Who can see my records?”
“Are there times when you would have to share what I say?”
“How is my information kept safe?”
Asking these questions helps you know what to expect. It also shows your provider that feeling safe matters to you.
If you think your privacy wasn’t respected, you have options. You can try:
Talking to your psychiatrist directly: Sometimes, a simple conversation clears up a misunderstanding.
Contacting their licensing board: Each state has a board that handles complaints about psychiatric providers.
Filing a HIPAA complaint: The Health Insurance Portability and Accountability Act (HIPAA) protects your health information. You can file a complaint through the U.S. Department of Health & Human Services.
You deserve care that respects your privacy. And speaking up is one way to protect your rights.
I think the most common misunderstanding is related to adolescents and confidentiality. For example, as psychiatric providers, we cannot disclose any substance use to parents or guardians. We can only break confidentiality if the adolescent is at risk of being a danger to themselves or others.
Halee Fullerton, PMHNP-BC
Clinical reviewer
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Knowing how psychiatrist confidentiality works can help you feel safer opening up. Most of what you share stays private, with only a few exceptions to protect safety — and you have the right to ask questions about how your information is handled. If you’re ready to seek help, support is out there, and you don’t have to face what you’re going through alone.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
Halee Fullerton, PMHNP-BC
Halee is a psychiatric nurse practitioner with experience treating children, adolescents, and adults. She has worked in outpatient community health with children/adolescents as well as inpatient substance use disorder treatment. She currently sees patients via outpatient telehealth. Before becoming a psychiatric nurse practitioner, she worked in emergency rooms, medical-surgical units, long-term care facilities (including Alzheimer/dementia units) and the intensive care unit.
She chose a career in mental health because she wanted to help people and to contribute to breaking down stigma around mental health. She is especially passionate about working with people who are navigating substance use disorders, depressive disorders, and anxiety/trauma-related disorders. She has three labradoodles that she adores.
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Members of Rula’s clinical leadership team and other expert providers contribute to all published content, offering guidance on themes and insights based on their firsthand experience in the field. Every piece of content is thoroughly reviewed by a clinician before publishing.
