Who has access to confidential disclosures at the NHS?

[BellaBooHoo]

I am so so stressed and upset about this and would love someone to put me right. (Have named changed for this).

I made a disclosure a couple of weeks ago to a practitioner at my local NHS mental health services on an assessment initial call. The disclosure was about historic sexual childhood abuse which has never been known by anyone. I also disclosed the relationship with the person, who is a family member who I still have contact with.

I had NO IDEA that my disclosure would lead to the practitioner referring the fact onto their team. Yes, she briefly mentioned safeguarding at the start of the call but I took this to mean whether my current mental state posed any danger to my own children. Which it doesn't. Nothing specific was mentioned to give me warning of anything else.

When she called me back a couple of days ago I was told that my disclosure has been discussed with their team and due to safeguarding they were encouraging me to report it. Which I absolutely have no desire to do, never have, never will. I was hoping to have therapy for current challenges I'm facing and to hopefully work through past issues confidentially with someone supportive. I had no clue that this would suddenly become an issue that might threaten my entire family's stability.

Anyway, I now have to face the face that my disclosure is now permanently on my medical file and I am deeply concerned and stressed about this. I don't know who could access it, who could discover my personal information, or whether they might decide to pass on details about the abuser without my consent. I have a relative who works for the NHS - could she now view this information? If I go to the doctors for anything, will he see it on my file?

I've basically thought of little else since Thursday and am deeply stressed by it. Can anyone reassure me?

You don't have to report if you don't want to. They still have me therapy without reporting him. I did feel.a bit of judgement for not doing so, but as I said to them it was so long ago and no evidence and said it would affect my MH worse than it already was.
I'm sorry you are worrying heavily about this. I know.its.hard, but try to have a good.nights sleep, take some.deep breaths x

Bless you Someone xx

@BellaBooHoo

Does anyone know? Is my statement that there's no danger or threat to any children now sufficient to stop safeguarding taking further action? I want no further action but is that no longer up to me?

I'm so sorry you're going through this. The person you spoke to should have made clear that if you told them anything about a child being at risk of harm they would have a duty to take it further.

It's not up to you any more I'm afraid as the practitioner will have to decide if there is a risk to your children (or social services will). They can't make you report anything to the police though - a safeguarding issue isn't necessarily a criminal issue.

A safeguarding investigation can't go ahead without your consent UNLESS there is an immediate, serious risk to others. If there is no reason to think such a risk exists then there won't be any

Breaching your confidentiality is very serious and would not happen without informing you and not unless there was a serious danger to others. It is a high barrier.

You cannot have info retracted from your notes but it would not be shared outside the team you shared it with. If you make it very clear you don't want that info shared then I'm sure great care would be taken that it wouldn't be.

The therapy is so vital to you. It will have its own confidentiality and you can talk this through at the beginning so you understand what they will and won’t do.

As for the safeguarding Mental health might pass it onto safeguarding at Children’s services. It will be a discreet enquiry from them to offer support if you need it and check you are being a protective parent ( not allowing access to children unattended etc)

No one can make you report this to the Police.

There won't be continued pressure to report in therapy. Definitely not. It absolutely should not stop you going ahead with therapy.

They do have a duty to any child who could be suffering now to ask the question but having asked and been assured there's no risk that's the end of it.

"A safeguarding investigation can't go ahead without your consent UNLESS there is an immediate, serious risk to others. If there is no reason to think such a risk exists then there won't be any"

This is reassuring, thank you. I told them that this person sometimes sees my children (never alone, no reason for that) but I assume they won't consider this a serious risk. So hopefully that means no further action will be taken and we will all be left alone.

"They do have a duty to any child who could be suffering now to ask the question but having asked and been assured there's no risk that's the end of it."

So so so good to hear this. Thank you xx

If I was unsure on what the balance of risks was I would ask advice from a safeguarding practitioner anonymously without mentioning any names. I would likely feel I had to do that in this scenario but I can't see it going any further than that unless there was a reason to doubt your account.

There is an absolute obligation on practitioners in regard to child safeguarding risks. Much as I as the practitioner might want to prioritise the risk to your mental health and keep it a secret I am not allowed to if there is a risk to children. It's really uncomfortable and it's hard to warn people specifically because you can't know in advance what they are going to say.

When you were the child being abused you would have wanted it that way I guess?

Please don't let this stop you seeking therapy.

Op, they have to write down what you've disclosed in their medical notes. Generally this will only be accessible by that team. Its not a massive file that everyone can read.

No one who knows you personally, even if they are on the team should be accessing your medical records. That is a massive breach of patient confidentiality.

I think given what you have disclosed they do have to take advise from safeguarding, they have a duty of care to your children too and I think this is fairly obvious. But this does not mean there will be an investigation or there will be any repercussions.

Ok, thank you both Covoid and DishedUp. That's what I really wanted to hear - that it's highly unlikely to proceed beyond this point, and I can leave my disclosure alone to 'rip' without fear that one day it will come up and bite me on the backside.

Agree with the others who have advised.

Please though, don’t lost trust in the nhs for this reason. I’m sure you can understand why safeguarding policies are in place. The nhs is a safety net in this regard.

OP I really think you should still give the therapy a try. The person you spoke to can say "we think you should report" but they likely always say that at initial disclosure. When it comes to the actual therapy, it will be about you, and I can 99% say it definitely will not be continually urging you to report. It will be about you.

It's a big, scary thing you've done in disclosing, and now your brain is screaming at you that doing so was wrong, look you've been proved right, that you should never, ever share because terrible things will happen. While it's legitimate to be concerned that info could be shared, it's also apparent to someone who has supported someone through this that this worry is also very much a part of the shame you have been carrying around since childhood.

I know that control of the information is very important and is the only reason you felt able to disclose. I would advise at least going for your first session, which remember is your session, and say at the start that you have no wish or intention to report and you feel concerned you will be pushed to do this. Whoever you see will then know and can reassure you as much as you need.

Your mental health notes will just be on your mental health notes. Your GP can't see them. And when the practitioner talked to the team I imagine it would have been anonymously. They wouldn't have named you.

A family member of mine was in a similar position with her therapy. It changed her life. 22 years after the therapy she felt ready to bring a historic complaint to the police. During that process they promised that a certain other family member wouldn't need to be told, and then insisted in fact they did have to be. It completely knocked her for six and was a terrible time, she felt betrayed and humiliated. But it turned out for the best, allowing her family to become closer and for those she loved to understand her better. It has freed her. I'm not saying you will ever want to disclose to police or share with family members, and that's fine, I'm just recounting this experience because the fear and shame and dread of anyone finding out is very real but at least some the reaction is a symptom of the abuse. What she has found over her now 25 year journey from therapy as an adult to today is that the more light that is let in, the less power and terror there is. Doing the therapy is likely to let a bit of light in for you even if you decide never to take it further than that.

So my advice would be to take the therapy but be very clear with how you feel about information sharing.

Finally I'm a child protection social worker it's very unlikely anyone would make a referral if the person is not left alone with your kids or living in the house. We've had cases where a mum brings a new partner in to live with a conviction for a child sexual abuse offence and we tell her he has to move out and that's it really. So this is even less. If they did unfathomably report it would be triaged and again if the person is never left alone with the kids it wouldn't be taken further. This may be different if he still has children living in his home or works in a profession that brings him into contact with kids - coach, teacher etc. Then it becomes a safeguarding concern to protect others. If none of the above applies there's not much safeguarding concern to act on.

I hope you don't mind me sharing the experience I've seen and you don't take that as any push to make a complaint.

Oh thank you all so much for your replies. You have all been a huge help and the difference in emotion I feel today is enormous.

I am incredibly relieved to read that it's unlikely any further action will be taken. That was never what I sought help for and I know there's no further risk to any child, only the risk of jeopardising my family, which is the only stability I have. The reassurance that my disclosure can remain secret is what will enable me to go ahead with therapy without fear, so thank you all, you may have just saved my sanity (literally!)

Yrneh - I really appreciate your lengthy response. You have gone a long way to reassure me about official procedures and also helping me see that therapy is still a viable option.

Thank you for sharing your personal experience too. Your description of letting the light in sums up exactly what I want, and exactly what I'm sure I need to be happy, but am currently much too scared to do. Maybe a chink of light at a time. Hopefully when I speak to the practitioner again in a few days I will be brave enough to say I want to proceed with therapy. In truth, I've never really linked my adult mental health difficulties to my childhood trauma, but maybe a lot of it actually stems directly from it.

Thank you all for taking the time to reply. You've really helped someone stop crying and stop feeling so flipping scared.

Hi OP, so glad posting on here was helpful for you. Hope you're still feeling a bit better Good luck with everything.

In my personal experience they had to report to police as the person now works with children and I had to give a statement and sign a document saying that I didn't want them to investigate it. They did have to contact his employer though to find out if any other complaints had been raised about his behaviour.