For some service members, concern about the confidentiality of their discussions with their mental health providers is a barrier to care. They may worry that a provider will share their information with command, which could impact their career. The military does provide some protection of information that is shared with a mental health provider. Department of Defense Instruction (DoDI) 6490.08, Command Notification Requirements to Dispel Stigma in Providing Mental Health Care to Service Members, states that only the minimum amount of mental health information can be provided, and only under certain circumstances. Commanders cannot access service members’ mental health care information without meeting certain criteria, including:
- Threats to personal or public safety (harm to self/others), harm to mission, or deployment readiness
- Acute medical conditions that interfere with duty, including inpatient psychiatric hospitalization and substance abuse treatment
- Judicial, law enforcement, and administrative proceedings; special sensitive personnel; or specialized government functions
- Personnel accountability
In contrast to the limited confidentiality of mental health providers, military chaplains have a much higher level of confidentiality. As Dr. Jennifer Tucker discussed in a previous blog, “Chaplains and Confidentiality of Suicide-related Communication”:
Rule 503 of the Military Rules of Evidence states that communications made as a “formal act of religion or as a matter of conscience” to either a chaplain or a chaplain assistant while serving in the capacity of spiritual advisor are considered confidential and are not to be shared with third parties. There are no exceptions listed to this rule, which means that any suicide-related information communicated to a chaplain is protected as confidential. This confidentiality also applies to inquiries from the command; chaplains cannot be compelled by the command to share information about service members or others seeking their services.
The absolute nature of chaplains’ confidentiality leads to many questions from service members, commanders, mental health providers, and even chaplains themselves. In September 2020, the Psychological Health Promotion (PHP) branch of PHCoE hosted a webinar to answer some of these questions regarding confidentiality. The presenters were Dr. Tim Hoyt, PHCoE deputy division chief and PHP branch chief, and Chaplain (Lt Col.) Valeria Van Dress, command chaplain at the U.S. Army Medical Center of Excellence. Some questions addressed in the webinar include:
- What should a chaplain do if a service member says that she is suicidal?
- What if a service member admits to physically abusing his kids or spouse?
- Does the “duty-to-warn” apply to chaplains?
Mr. Evans is a public health analyst at the Psychological Health Center of Excellence. He has a master’s degree in economics and a master of divinity.
The views expressed in Clinician's Corner blogs are solely those of the author and do not necessarily reflect the opinion of the Psychological Health Center of Excellence or Department of Defense.