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Mental Health

Confidental Treatment of Depression

03/12/2008

Question:

My profession is one that unoficially discourages (or at least discriminates against employees) from seeking psychiatric treatment without a very real risk of losing one`s employment or promotion potential. I know that this isn`t supposed to happen, but as a former manager, I know that it does. Here is my question: I have worsening depression that is getting really bad; is there any reason that I can`t see a psychiatrist on a totally confidential basis? I would be a self-pay and it would be the only doctor that I would be seeing, I don`t have any medical conditions, take prescriptions or see a primary care doctor. I have the means to self-pay so no third-party would be involved. I realize that being a John Doe isn`t ideal, but it`s my only choice. I can`t risk my job by seeking help under my real name; is it possible to self-pay and be teated in a totally confidential manner? Thanks.

Answer:

Thank you for your question.

Fundamentally, I think that it is unfortunate that your professional environment is narrow in its view of mental health and the value of treatment. You deserve credit for overcoming this view, recognizing that all is not well, and your openness to a further evaluation.

Privacy and confidentiality are the cornerstones of effective treatment in psychiatry. I take these matters very seriously. You may be comforted to learn that wanting total confidentiality as an outpatient is not a peculiar request.

I recommend that you determine a local, private psychiatrist whose practice is "fee for service." Such a psychiatrist accepts payment for the session and would not involve any insurance company. A trustworthy primary care physician would be a good source for this referral. Otherwise, you can contact the local chapter of the American Psychiatric Association (www.psych.org) and ask for a referral to a psychiatrist whose practice is fee for service.

In calling the psychiatrist, do state that you wish to pay for the sessions outright and not involve any insurance company. You can also ask how confidentiality is treated in that psychiatrist's office.

Again, good for you in considering an evaluation and treatment for yourself.

Best of luck.

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Response by:

Ram Chandran  Kalyanam, MD Ram Chandran Kalyanam, MD
Clinical Assistant Professor of Psychiatry
College of Medicine
The Ohio State University