September can bring about lots of changes, especially for college students. The National Alliance on Mental Illness (NAMI) released a guide for departing college students and their families on mental illness, including navigating certain privacy laws.

Health privacy and confidentiality laws protect your health records, including mental health records. The laws safeguard information and prevent colleges from contacting parents if a student facing significant challenges or a serious mental health condition.

Parents are legally permitted to share information about a student with the school or mental health professionals. This one-way communication can help parents who are worried about a student or have important information regarding mental health, including medications, successful treatment approaches, co-occurring medical conditions or special needs.

Health privacy and confidentiality laws require an emergency or an imminent threat of harm to self or to other people before parents may be contacted and health information shared. While many people believe that parents would be contacted in a serious situation, this is not always the case. The interpretation of “emergency” or “imminent threat of harm to self or other people” can vary, and identifying when someone is experiencing a mental health crisis is not always easy. Further, a mental health provider may believe that the family is a major source of conflict or distress and could worsen the situation. In assessing difficult situations, providers often choose to protect health information.

Two federal laws regulate when information included in student education records and health information may be shared with family or others. The Family Educational Rights and Privacy Act (FERPA) protects information in student education records. The Health Insurance Portability and Accountability Act (HIPAA) protects health information.

Laws and Rules on Health Privacy

Family Educational Rights and Privacy Act (FERPA)

What does FERPA apply to? FERPA applies to student education records including records kept in college counseling and health clinics
What protection does FERPA provide? FERPA prohibits colleges from sharing information in student records with parents, with narrow exceptions such as:

· 7 In a health or safety emergency

· If parents document that the student is claimed as a tax dependent

· With written authorization from the student

Can a student sign a FERPA authorization form allowing their parents or others to access education records? Yes, FERPA authorization forms are offered by most colleges online or through the office of the Academic Dean.
Are there state laws and other rules that protect records kept in the campus counseling center? Yes, mental health providers working in campus counseling centers may also be subject to state laws and professional licensing rules that are more restrictive than FERPA.

Health Insurance Portability and Accountability Act (HIPAA)

What does HIPAA apply to? HIPAA applies to health information kept by health care providers outside of the campus community, such as:

· community psychiatrists

· therapists and counselors

· campus-based university hospitals

What protection does HIPAA provide? HIPAA prohibits the sharing of student health information with their parents except:

· In a health or safety emergency

· When an individual presents a threat of harm to self or others

· With verbal or written authorization from the student

Can a student sign a HIPAA authorization form allowing their parents or others to access their health information? Yes, by an authorization form. Psychotherapy notes are generally not disclosed.
Are there state laws that cover my health information? Maybe; some states have laws that are more restrictive than HIPAA. However, a signed authorization should permit disclosure. Unlike FERPA and student education records, parents are not permitted to access health information by showing that they claim a student as a tax dependent.

Student’s Choice

If a student is over age 18, he/she can decide whether or not to authorize the sharing of health information with their parents or a trusted adult and, if so, what information they are willing to share. Consider completing an authorization form before the student leaves for school so that parents or a trusted adult can help if a mental health challenge occurs. If a student has an existing mental health condition and value their parents’ or another trusted adult’s support, it is especially important to consider completing an authorization form. And remember, a student retains the right to revoke authorization at any time.

For more information please view the guidebook.

*DWT assisted NAMI with drafting the guide through a pro bono effort