should medical records of clients be sealed at age 18

[MNBrant]

If you strangled a kitty at age 2 because you were hugging it to hard. Does this information really need to be available to everyone who has access to your medical file for the rest of your life? I don't see how this is theraputic or healthful. No I did not strangle any kittys. I vote for sealing the medical records of minors.

[MatildaGage]

Are you talking about criminal records?

Medical records are destroyed after a period of time. If you don't keep telling it to your healthcare providers now, it won't keep getting into your new records.

[the PC apeman]

This sort of thing is in medical records? Was there an incident in the news that prompts you to ask?

[Dinwar]

I had a few medical conditions before I could walk that can potentially impact medical treatment I recieve. There IS a great deal of theraputic and medical data that would be lost for me if you sealed my pre-18-year-old records, including heart conditions, allergies, chronic diseases, and fractured bones. Not all medical conditions go away after the age 18, nor do they necessarily show up on subsequent check-ups.

[MNBrant]

I am refering to psych records. It seems like everyone has a waiver to hand you, and you never know where a page or two might wind up. If it was cut and dried that everyones psych records are sealed at age 18 there might be a lot less of this floating around.

[The Norseman]

How is this philosophically related?

[the PC apeman]

I am refering to psych records. It seems like everyone has a waiver to hand you, and you never know where a page or two might wind up. If it was cut and dried that everyones psych records are sealed at age 18 there might be a lot less of this floating around.
I don't know about most psychologists and psychiatrists, but the ones I'm familiar with are hesitant to write much down of that sort, and even more hesitant to ever divulge whatever they do write down.

[Qeidx]

How is this philosophically related?

If I slaughter fluffy and my family isn't around to hear it, did fluffy scream?

[slingblade]

MN is possibly going through some stuff just now. A light hand and a kind approach might be best. And some caution about flippant advice. Thanks.

[Alan]

I am refering to psych records. It seems like everyone has a waiver to hand you, and you never know where a page or two might wind up. If it was cut and dried that everyones psych records are sealed at age 18 there might be a lot less of this floating around.
I volunteer at a mental health support service and asked a worker. This is what she said:

Children's records expire when they are 25. Adult records are kept for 7 years (maybe she means 7 years after they leave? I'm not sure). Information can be shared only with people who the client consents to. Consent is given and can last a maximum of 12 months, at which time the client renews it (or not) and consent can be withdrawn at any time. The client is also made aware that records must be provided to coroners and police and such if required.

Other people within the organisation are able to access data as it is stored on a network, but we are tracked when we do so.

[Smackety]

A prior suicide attempt is the single greatest predictor of future suicide attempts - regardless of if the attempt occurred at age 17 or 19. Doctors need to know this information when someone comes in complaining of a stomach ache or insomnia. Something like 15% of completed suicides visited the ER less than a month prior to their death. While I support rigorous and tough enforcement of HIPAA violations, I don't think records should be "sealed" if that means doctors won't be able to see them, including psych records.

[JJM 777]

I vote for sealing the medical records of minors.
You have a theory that what psychologically happens before 18, be it anything whatsoever, has no effect or informational value for understanding the person after 18?

[Cuddles]

I vote for sealing the medical records of minors.

This would not make sense as a blanket policy, since it would mean sealing necessary records of ongoing cases, and even cases where past history is relevant. For example, what if someone is diagnosed with cancer aged 17? A year later, all their records are sealed. Except they still have cancer and the doctors still need access to those records. Or what if someone has a serious head injury aged 10. They appear to recover, but aged 20 they start having recurring headaches. Again, it wouldn't be a good idea to have sealed the records. And that's without addressing mental illness at all, which tends to be an ongoing problem where having access to the full history is often important.

That's not to say all notes should always be kept forever. The hospital I worked at had a policy of destroying unused records after 10 years, although they weren't exactly efficient at it and there were much older records still around. And things like maternity and neonatal records would be kept separate from others and only kept if there were issues specifically related to them, so they could still be destroyed even if the person turned up in hospital for some other reason.

The important point there is the "unused" part. If you strangled a kitty aged 2, then never saw a doctor again until you broke your leg aged 20, then sure, get rid of those old records. But if you strangle a kitty aged 2, then have long history of mental illness with constant contact with doctors over the next 18 years, those old records could be quite important in documenting the onset and progression of the illness.

As for the problem with notes getting lost or misplaced, sealing or destroying them won't really do anything to help. The thing is, records only get lost when they're used. If they're filed away somewhere, they'll stay there. Paper doesn't tend to move on its own, and people don't go hunting through room full of files looking for random ones to hide. It's only when people actually need to go and find them, then accidentally put them in the wrong place, drop them and lose some bits, or whatever, that problems can arise. Getting rid of old notes in ongoing cases won't do anything to change that.

[commandlinegamer]

No, in regard to the thread title.

Who should be able to access such records is am important point, though.

[Andrew Wiggin]

If you stop bringing it up, only the most diligent and motivated researchers will ever see it. On the other hand, that might be like not thinking about elephants. After all, you told us.

[gnome]

My understanding is that it is only with your permission that another can see your medical records anyway. Am I mistaken?

[Skeptical Greg]

If you strangled a kitty at age 2 because you were hugging it to hard. Does this information really need to be available to everyone who has access to your medical file for the rest of your life? I don't see how this is theraputic or healthful. No I did not strangle any kittys. I vote for sealing the medical records of minors.

I have no idea why an incident like you describe would be part of a medical record..

[I Ratant]

I desire that my medical records -are- available to all my physicians.
And it's getting that way, with computer data bases and interfacing with the doctor's offices.
Getting files from a doctor you no longer see requires some footwork at the very least, to get the medical history to the new guy.

[mediocrity511]

As someone with a history of mental health problems, I'd vote no. My psychiatric records probably include all manner of embarassing and upsetting things that I'd really rather forget about, but which are relevant to my treatment. If they are in my medical records, then I don't have to go through the trauma of recounting it all, whenever I see a new doctor. Without those records, then if I can't bring myelf to talk about something, then healthcare professionals wouldn't know about them.

[Daald]

It is opt in only. Even the systems that handle the data are monitored very closely. Access is strictly controlled and monitored. The word of a violation will put the entire company on alert trying to squash. My team found a bug in a back end mainframe one time and as soon as we said that it could lead to violations everyone was down our throats to prove it and then on the mainframe guys to plug it.

This leads to a lot of problems getting test data and makes putting new systems up a pain when something that is only in production breaks things.

[MatildaGage]

I have no idea why an incident like you describe would be part of a medical record..
This is a normal thing to include in a behavioral health assessment since it could be indicative of certain psychiatric conditions.

However, every time he gets seen by a new practitioner, they cannot possibly be obtaining copies of his childhood medical records. What's most likely happening is he is or did tell a healthcare professional this bit of info within some recent years and that information is included in his current records.

[Complexity]

I want all of my medical history available to my doctors and healthcare providers.

I don't want any of it available to a damned government.

I've heard that one of the consequences of the healthcare 'overhaul' in the US is that all medical information will be forwarded to the federal government, either directly or through state governments. I don't have a citation - perhaps someone else knows whether this is true.

[Smackety]

I want all of my medical history available to my doctors and healthcare providers.

I don't want any of it available to a damned government.

I've heard that one of the consequences of the healthcare 'overhaul' in the US is that all medical information will be forwarded to the federal government, either directly or through state governments. I don't have a citation - perhaps someone else knows whether this is true.

Well, Medicare/Medicaid has your records if you belong to those insurers, otherwise, nope. The public option that was shot down might have allowed a lot more people to have federally backed health insurance?

[Andrew Wiggin]

I have no idea why an incident like you describe would be part of a medical record..

MacDonald's Triad. Strong correlation between abusing animals, bedwetting, and setting fires and future antisocial behavior. Regardless of the child's excuse for why they wrung kitty's neck, children who torture or kill animals are more likely to grow up to be killers than supreme ruler of the planet. If someone does such things while simultaneously acting out enough to get themselves into the mental health system, they'll be watched.

[cwalner]

Another vote for no here for a lot of the same reasons. I had two heart surgeries when I was a child (5 months and 5 years). Just last year (40 years old) I had an issue that arose directly related to those original surgeries. The treatment that I received was dependent upon whether a particular procedure was used or not in the original surgeries.

I am quite glad that those records were not destroyed.

[Smackety]

MacDonald's Triad. Strong correlation between abusing animals, bedwetting, and setting fires and future antisocial behavior. Regardless of the child's excuse for why they wrung kitty's neck, children who torture or kill animals are more likely to grow up to be killers than supreme ruler of the planet. If someone does such things while simultaneously acting out enough to get themselves into the mental health system, they'll be watched.

I think you missed the part where the child is 2.

[Smackety]

Another vote for no here for a lot of the same reasons. I had two heart surgeries when I was a child (5 months and 5 years). Just last year (40 years old) I had an issue that arose directly related to those original surgeries. The treatment that I received was dependent upon whether a particular procedure was used or not in the original surgeries.

I am quite glad that those records were not destroyed.

I am amazed they were not destroyed - no-one keeps records that long!

[MNBrant]

I think you missed the part where the child is 2.

I think the mcdonalds triad thing is pretty damn close. I don't think it matters to these people (govt) if the kid is 2 or 15. I am still voting no.