Obstacles to Getting Help

Concerns about confidentiality sometimes keep people from getting mental health help. These concerns can be legitimate but are usually outweighed by the benefits of the care received. Many people are worried about whether an employer can learn of any illness if they use benefits provided by their company to pay for their visits. This will vary depending on how your company handles its benefits. You have the choice of discussing the issue with your benefits administrator or, if you are uncomfortable even doing that, paying out of pocket for your mental health care.

Many recent legal changes have been designed to improve the privacy of medical information. However, not every office or company follows the new rules consistently, so you need to be cautious about the individuals and organizations who have access to your information. Ask how confidential information is protected and don’t sign blanket medical record release forms. Only sign time-limited requests to release specific information. For therapy to be as effective as possible, you must be able to trust that sensitive information discussed with your therapist will not be shared with others.

Another concern regarding mental health confidentiality arises when a couple with children is unable to agree on how to handle child custody. In most states, information revealed in counseling can be used by your spouse to show that you might not provide the best care for the children. Judges have generally ruled that determining what is best for the children is more important than the patient’s right to confidentiality. It is usually best for people to get the mental health care they need, because without care, the symptoms they are experiencing could cause poor decision making as well as all sorts of other problems. However, if you are in this type of situation, you need to talk to a lawyer to understand how the law works in your state and consider the pros and cons of getting help. One thing to remember is that mental illnesses, such as depression, are very common and, when treated, may not have a major impact on a judge’s determination of your fitness to parent.

Those who lack insurance or who choose not to use it because of their concerns about confidentiality sometimes fail to get the professional help they need, feeling that they cannot afford it. What they often don’t realize is that they will spend much more on legal fees—making bad judgments and spending time relying on their lawyer for emotional support—than they would have on some therapy, and perhaps medication. It is very short sighted not to use any appropriate solution you can.

Finally, some people, particularly the initiators of the divorce, avoid getting help because they simply don’t perceive that they have a problem. The initiator may not experience the depression common to the noninitiator, but this person still had a marriage that didn’t work out. Usually this spouse believes that the failure of the marriage was entirely the fault of the other spouse. Unfortunately, many people go through multiple failed relationships before realizing they need to get some help. Rather than waiting, they would better off exploring the underlying issues as they engage in the divorce process so as to deal with these issues effectively and have a better chance in future relationships. As we said before, the only way to find the silver lining of divorce is to do the difficult emotional work required for growth and change.

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