RN concerned about disclosing psychiatric treatment to state board

By | 2021-05-07T15:08:44-04:00 October 11th, 2017|Tags: |26 Comments

Nurse upset by request to disclose psychiatric care history

An RN submitted a question about needing to apply for a license in another state because, as a case manager, her employer requires all RNs to have licenses in the states in which they provide case management.

The state board she applied to asked her to disclose information about any psychiatric treatment and history. The RN said she was quite upset about this request, stating that she had sought treatment voluntarily, went on disability for one year, was successfully treated and returned to work taking her medication.

Moreover, she continued, isn’t one’s psychiatric history confidential unless a complaint is lodged with the state board?

First and foremost, it is important to point out that, generally, a person’s psychiatric history is confidential. States and the federal government assure this with legislative statutes, such as mental health confidentiality laws and through HIPAA provisions. As a result, a treatment facility, for example, cannot share any information about your treatment, such as its outcome or if you are still under treatment, unless you give that facility consent to share that information.

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However, the confidentiality we enjoy under these laws is not absolute. For example, if you are thinking of harming another person and you share that information with your therapist, the therapist is required to take steps to ensure, insofar as possible, that the harm does not happen. These steps could include discussing your comments with your psychiatrist, evaluating whether you intend to act on your feelings and, if necessary, notifying law enforcement and/or the person you thought to harm.

In the RN’s situation, however, her treatment facility and those who treated her were not asked to share her history with the board. Rather, the board is asking the RN directly about her psychiatric history. She, then, is the one who would disclose this information, so no breach of confidentiality under any law would be taking place.

As you know, the obligation of any state board of nursing is to protect the public by ensuring that those who are licensed are competent and safe practitioners. As a result, they have the authority to ask applicants, and those who renew their licenses, a great deal of information, including if the applicant has any criminal convictions and has had psychiatric care.

Such questions in and of themselves do not necessarily mean that an applicant or one who is seeking a renewal of their license will not be granted a license. Rather, the information is sought in order to carefully evaluate whether you meet the criteria established by the state board to practice competently and safely.

Often, a board may want to meet personally with an applicant if it has questions about the information provided by the RN.

Because integrity and honesty are essential qualities of a nurse, it is vital that your application for licensure be truthful and complete. Providing all requested information is critical so that your situation can be evaluated with the attention it needs, and the right decision about licensure can be made.

If you are asked about your psychiatric history when you apply for a license in any state, your approach should be to:

Respond honestly and factually to the question(s) asked.

 Attach letters from treatment personnel who can honestly support your success with treatment.

• Attach a letter of recommendation from your current employer discussing your nursing practice and your success at work.

• Attach your latest performance evaluation from your immediate supervisor.

• Remember that if you falsify or intentionally omit information requested, you may be denied the license you are applying for.

• Consult with a nurse attorney or attorney in your state who can help you formulate any required statements, responses to questions asked and documents that are required to be included with your application.

Courses Related to ‘Rights and Responsibilities’

CE513: HIPAA and Confidentiality (1 contact hr)
The federal Health Insurance Portability and Accountability Act was implemented in 1996 and has been revised since then. HIPAA can refer to guidelines that protect your ability to maintain your health insurance as you move from job to job or place to place (“portability”). HIPAA can also refer to efforts to simplify the administration of health insurance. These efforts include the creation of national standards for diagnostic terms, insurance forms and provider identification. Perhaps the most common use of the term for healthcare professionals, however, involves protecting the confidentiality and privacy of healthcare information. In this module, you will learn about parts of HIPAA, especially as they concern nursing and other health professionals and the protection of healthcare information. Because you play a key role in the production of healthcare information, you play a key role in its protection.

CE548: Protect Yourself (1 contact hr)
Nurses have an obligation to keep abreast of current issues surrounding the regulation of the practice of nursing, not only in their respective states, but also across the nation, especially when their nursing practice crosses state borders. Because the practice of nursing is a right granted by a state to protect those who need nursing care, nurses have a duty to patients to practice in a safe, competent and responsible manner. This requires a nurse licensee to practice in conformity with their states statute and regulations. This course outlines information about nurse practice acts and how they affect nursing practice.

Prepare for the Psychiatric and Mental Health Nursing (RN-BC) exam with the RN-BC® Certification Review Course.

Nurse.com offers a fully online self-paced prep course.


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About the Author:

Nancy J. Brent, MS, JD, RN
Our legal information columnist Nancy J. Brent, MS, JD, RN, received her Juris Doctor from Loyola University Chicago School of Law and concentrates her solo law practice in health law and legal representation, consultation and education for healthcare professionals, school of nursing faculty and healthcare delivery facilities. Brent has conducted many seminars on legal issues in nursing and healthcare delivery across the country and has published extensively in the area of law and nursing practice. She brings more than 30 years of experience to her role of legal information columnist. Her posts are designed for educational purposes only and are not to be taken as specific legal or other advice. Individuals who need advice on a specific incident or work situation should contact a nurse attorney or attorney in their state. Visit The American Association of Nurse Attorneys website to search its attorney referral database by state.


  1. Avatar
    Carolyn October 15, 2017 at 4:25 am - Reply

    I’m surprised by this. Asking about one’s psychiatrist treatment history is very, very different from asking about a criminal history. And while no confidentiality laws are being broken when you are asked to self-employed disclose your own private health information, it does seem unethical to take away someone’s right to privacy just because he or she has a history or mental illness. If there’s been a complaint or some incident, perhaps, but otherwise it seems discriminatory to collect medical statements or reports about innocent people simply because they received treatment for a mental health condition.

    Unless a nurse behaves unprofessionally or unsafely, there is no reason for his or her BON to ask about any psychiatric records.

    • Avatar
      darren December 7, 2019 at 6:04 pm - Reply

      You must have mental heath issues yourself. Would you take your kid to someone whom is mentally ill?

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        DARLENE Ann NELSON June 5, 2021 at 8:46 pm - Reply

        That was a rather inappropriate reply. Boards both medical and nursing are well documented to take action against a nurse for such as: stable depression or anxiety where controlled substances are not being prescribed, insomnia, reactive emotional crisis that resolves and other conditions that do not make the provider a threat to the public. The stipulations the board will impose are career crippling. Stipulations such as direct supervision, reg random drug and alcohol testing and others. Employers do not want ro hire a provider with stipulations that require special arrangements. The nurse will also be forbidden to work in independent roles such as tele triage, and home health. Compact license will also be revoked. And the charges indicating mental health issues will be posted in detail on the National Providers Databank and Nursys. I’ve seen psych evals done by board hired guns on these searchable sites.

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        Brian July 23, 2021 at 2:04 pm - Reply

        I would have no issues bringing my child to someone who has a mental health issue; but it depends on the severity and the particular issue, itself. If there have been no complaints, that would indicate to me that there is probably no issue to pry about. It means they are functional. Not all mental health issues are the same, and none have the same severity. It’s very sensitive information. Are you a provider? It sounds to me like you haven’t studied up on any mental illness at all. Your question really seems foolish to me. Not saying you are a fool. Just that the question itself implies that you don’t have much perspective on mental health issues.

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    Sarah November 3, 2017 at 12:46 am - Reply

    I agree with Carolyn. If there has been no complaints or cause for concern, I fail to see how a nurse’s mental health history is relevant. State boards would not ask one to disclose other medical information such as their neurological history or if they had diabetes. Mental illness is a treatable condition and need not be disclosed like any other health condition.

  3. Avatar
    Lisa DeBrier December 10, 2017 at 11:11 pm - Reply

    I can understand the importance of making sure a nurse is able to function well on the job. But a person’s psychiatric history is confidential and is NO ONE’S business to know. I agree with both of the comments above. As someone who works in mental health, I know the stigma that is associated with mental illness–this just adds to it. No one asks about someone’s medical history, yet the BON and employers feel that it’s their business to know about someone’s psychiatric history? Confidentiality applies to ALL areas of health–including a psych history.

  4. Avatar
    Cadie Auers May 1, 2018 at 2:18 am - Reply

    I am conducting a research project that dive into the stigma of depression and other mental health issues and the way nurses really do not have a “safe place” to ask for help. Nurses are human, this level for perfection is causing many nurses to deal with stressors in unhealthy ways.

    • Avatar
      misunderstood June 14, 2018 at 1:15 am - Reply

      that sounds wonderful. I was misdiagnosed with substance use disorder due to ONE bad LSD trip that left me in the hospital, and I’m terrified because I will have to report this to the BON.

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      MAB February 15, 2019 at 4:55 pm - Reply

      I would be interested in seeing your research. That is exactly the problem I am running into. I currently have a suspended license because of mental health problem. So now I have to say only the right things in therapy risk a negative thing being put in my medical record. My medical record that the state board of nursing might see. There is nowhere that I can be honest and get help. There is so much other stigma. Nursing are not allowed to have a personality flaw or risk getting their license, their livelihood, their financial security taking away. I am so lost and frustrated to find someone that can help me, which adds to the mental health problems.

      • Avatar
        emma August 31, 2019 at 9:55 pm - Reply

        can you email me please

  5. Avatar
    Via June 16, 2018 at 3:54 am - Reply

    I’m applying for a license in a state after being inpatient several months ago due to work-stress/ultimate burnout and needing to decompress. I requested my mental health records from my primary therapist and never received them (my request was intentionally ignored). When I had my interview with the licensing board, I informed them that I was unable to obtain my records. They stated they would subpoena them. Meanwhile they were aware I was getting a psychological evaluation at a separate facility and they were requiring a new one anyway. I’m not sure if they requested or subpoenaed these records as well, but I never signed a release or consented to their being released. The licensing board has received them. This makes me so uncomfortable. The records were released before I even received the results, and once I did I became aware of the inaccuracies contained within the evaluation. I’m feeling so violated and overwhelmed. I want to give up.

    • Avatar
      sueann July 26, 2018 at 10:43 pm - Reply

      what occurred after your evaluation. I have been ordered to take a evaluation after I received a DUI and another misdemeanor which isn’t on the senate bill . I have never had medical issues .

      • Avatar
        Indi December 21, 2018 at 2:31 am - Reply

        Did you find an approved psychiatrist?

    • Avatar
      emma August 31, 2019 at 9:52 pm - Reply

      please email me [email protected]

  6. Avatar
    Holly October 14, 2018 at 8:57 pm - Reply

    A nurse’s mental health history is none off their business, just like the rest of a nurse’s medical history. Mental health is NOT a separate part of someone’s medical history, it is PART of it. Nowhere on any applications or other documents for licensing boards are there questions about what your last A1C was, or your cholesterol, or what your last chest CT showed, or if you have any orthopedic conditions. Licensing boards have become way too intrusive & have been given WAY TOO MUCH power & control over a professional’s license. Forcing licensees into substance abuse treatment & 5 year monitoring programs for 20 year old DUI’s or a petty theft charge when someone was 18 years old is beyond ridiculous. The licensing board has no right to control what someone with a professional license does away from work. If they can practice safely, that’s what matters. If a nurse with a history of depression or some other mental health disorder has been stable for 15 years, on the same medication & regularly seeing a mental health professional, why should the Board of Nursing have anything to do with it? While substance abuse & addiction are the biggest topics in health care today, with the main focus on destigmatizing it & making treatment available without judgment, it is highly ironic that the BON treats nurses with these issues like lepers, turning a genuine healthcare/mental health problem into a major character flaw. Legislation must be brought forward limiting the BON’s power when it comes to mental health & license discipline. Asking about any mental health problems on an application for a nursing license violates the Americans With Disabilities Act. Why are licensing boards permitted to bypass the standard laws that everyone else has to follow?

  7. Avatar
    Cindy October 26, 2018 at 1:59 am - Reply

    I’ve never had a patient complaint or incident in 15 years. I misscarried, lost my father, friend, and fiance within 4 years. I was hospitalized for severe depression. Now I cannot get a job despite having every certification in my field, educating new employees, and always going above and beyond at work. I am disgusted with this unfair practice. If you steal narcotics, You agree to rehab and then you can get a job! This a profession that kills you.

    • Avatar
      Kiki March 4, 2019 at 9:39 am - Reply

      I was involuntarily hospitalized for severe depression last year. I’m about to start an RT program and they’re asking for psychiatric history along with the health history. Will this hold me back? Should I just withdraw?

  8. Avatar
    Board Ordered Nurse November 5, 2018 at 8:09 am - Reply

    The state board posted my mental health information online (for anyone at all to click and review in great detail) because it was disclosed in open court with the BON when I told the board that I had gone to a treatment center (self reported). I was not told that it would be made public, or that everything would be posted, nothing redacted, no privacy, everyone can see

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      Adrienne Milam December 5, 2018 at 7:10 am - Reply

      My jaw is on the floor. I’m so sorry you are going through this. That should never ever happen to anyone. This is definitely not how a nurse should be treated, that has taken the risk to be honest and brave and disclose personal stigmatized information, all in the pursuit of having a career taking care of other people. Please let me know how I can support you. This isn’t okay.

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      mab October 9, 2019 at 8:05 pm - Reply

      I am in the same boat as you. Mental health history is now public record. I can’t get a job at walmart, let alone ever getting a job as a nurse. Were you ever able to get in unpublished?

    • Avatar
      Bo April 18, 2021 at 9:27 pm - Reply

      would you mind emailing me? I have a somewhat similar situation as you, and would really like to get your advice or if may … hear a bit more about your course of action taken.. thank you so very much.

  9. Avatar
    Daphne December 18, 2018 at 9:16 am - Reply

    I applied to a new state (Florida). Have a hx of depression and anxiety. In the new state, I had to pay over 5k for “evaluations.” Have absolutely NO drug or alcohol history. But I am being placed on a 5 year monitoring contract that includes drug AND alcohol monitoring. I cant even have a glass of wine on my wedding anniversary. I’m wondering if I will even be able to find a job.

  10. Avatar
    Mel January 21, 2019 at 2:33 am - Reply

    Pls give me an advice, i was on orientation for months and got probationary terminated due to falsification of employment record of failure to disclose my brother and sis in law to the hospital. Can I lose my RN license? Im worried. Thanks

  11. Avatar
    DeeDee February 26, 2019 at 10:26 pm - Reply

    Nurses have nowhere to go. When we need help. I went to my primary physician for trouble with depression 7 hours later, I found myself admitted to a psych unit against my will. She signed an affidavit saying that she felt I was unsafe and I spent four days in a psych unit. Fighting for my release. I saw her at her office for approximately five minutes before she suggested I go to the ER to talk with a counselor. Once I got to the ER I was informed that she had sent over an affidavit and I was going to be admitted.I never saw an MD or a psychiatrist or anyone from Psych prior to being taken to the psych unit; I never had any psych. evaluation prior to being taken to the unit. Once there, I was surrounded by alcoholic and drug abusers; this hospital thinks psych patients need to be on the same unit as detox, etc. I am pursuing this with an atty., They plan file complaints with the state MD board, dept. of licensing for the e.r. nurses involved, and against the hospital itself. There were HIPPA violations involved, wrongful imprisonment, denial of care bc they would not give me the meds that I have been taking it home for rheumatoid and psoriatic arthritis and trigeminal neuralgia. By the time I got out of there on the following Friday I was in a lot of pain and the trigeminal neuralgia felt like someone had a flamethrower on my face.
    I will never ask for help again.

  12. Avatar
    Tina May 4, 2019 at 11:11 am - Reply

    Wow is all I can say. I guess I won’t be becoming a nurse.

  13. Avatar
    Linda Orman August 22, 2019 at 2:55 pm - Reply

    Actually, it is unlawful to even ask an applicant to disclose any health condition, including mental health and addiction, to the BON. It’s in direct violation of ADA’s disclosure laws. 21 states have already removed or reworded nursing applications to come into compliance with the ADA and HIPAA. Since the BON is a state entity, they are governed by the same rules as any other government employer, which means they have to follow federal guidelines. The fact that state agencies try to bypass federal law is a gross misuse of power on their part. The only time a nurse can be questioned is if they have a condition that currently causes a threat to public health. https://www.ncbi.nlm.nih.gov/m/pubmed/30973613/

    New articles, such as the one listed above are coming out and shedding light on this subject. To be punished for receiving treatment for a condition that is well under control is in violation of individual privacy. The BON is not here to serve nurses, but to safeguard the public. They do not care about nurses.

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