Breaking Confidence: When Silence Kills
Abstract
This article presents the dilemma faced by mental health practitioners whose maintenance of strict confidentiality may result in harm or injury to the client or to others. As a crisis worker, I spent over a decade working with high-risk clients in community mental centers in rural New England and in a major metropolitan area in Virginia. Having gained some distance from my work, I increasingly question the power and authority granted me as a "professional." I am increasingly concerned about illusions of self-determination and true mutuality between client and practitioner and the role that helping professionals play in social control. Narrative accounts exemplifying legal precedents and ethical conflicts are presented using my own professional experiences with mental health and medical involuntary hospitalizations.
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REFLECTIONS:
NARRATIVES OF PROFESSIONAL HELPING
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