Confidentiality in mental health services: negotiating the negotiated order?

Evans, Tony (2007) Confidentiality in mental health services: negotiating the negotiated order? British Sociological Association Mental Health and Human Rights symposium, Warwick, UK. 22 Jun 2007.

Abstract

Confidentiality is identified by mental health service users as a centrally important right. This paper looks at confidentiality within mental health services through the prism of the negotiated order perspective. The negotiated order perspective developed from the study of informal practices in a mental health hospital. Since the original study was published, mental health care has been transformed, with a move to de-institutionalised care and an increasingly managerial approach within human services organisations. The paper examines the confidentiality practices of professionals in contemporary mental health services from the point of view of service users. Eighteen service users were interviewed to ascertain their experience of confidentiality practices in their encounters with health and social services, and to identify their evaluation and response to these encounters. The study points to the continuing relevance of the negotiated order perspective in understanding the operation of fundamental information rights within mental health services. It also points to the need to understand negotiation not only in relation the practices of professionals, but also in terms of the active role of service users in assessing and negotiating the confidentiality practices they encounter.

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