Will psychotherapy come back to haunt my friend? (A question about bureaucracy.)
January 3, 2011 6:29 PM   Subscribe

Will psychotherapy come back to haunt my friend? (A question about bureaucracy.)

A friend of mine is going through some tough times and is considering psychotherapy. However, she's worried that having done this - especially if she ends up on some sort of medication - could cause her some trouble in the future. The two examples she brought up to me were if she wanted to adopt a child or to get a government job.

Is my friend being unreasonably paranoid? (I'm using "paranoid" in a colloquial sense here; I'm aware it's a psychological term.) Or is there actually some reason to worry here?
posted by madcaptenor to Health & Fitness (15 answers total) 2 users marked this as a favorite
 
Depends on location. Some countries, and some parts of the US, make it illegal to discriminate on that. And so many people have gone through some kind of treatment that it would be fairly ridiculous to deny anyone a job/a child based on past treatments.

It's better to get treatment and get well than to struggle with depression / anxiety / etc. and get nowhere.

(Oh, and I worked for state and federal governments in the U.S. while actively being treated for mental illness, including psychotherapy, and my employers knew and supported it. Not everyone will be like that, but hey.)
posted by criacow at 6:37 PM on January 3, 2011 [1 favorite]


This is the sort of worry that mental illness likes to throw out there as a barrier to keep you from getting treated and better.

As was pointed out in a recent thread, unless therapy is something you are hiding and thus could be blackmailed over, it doesn't make a difference for a US government security clearance. That also jives with my friend's experiences with high-up security clearances. And while I'm guessing there might be some circumstances where mental illness would make a difference for a super-secure government job, my (low level) clearance asked about any illness as well as any treatment, and the answer didn't make a difference. So your friend would have to disclose the mental illness, having suffered anyway - but without the benefit of treatment.

I'm pretty sure HIPAA covers mental health treatment, too, maybe someone else can touch on that.
posted by ldthomps at 6:54 PM on January 3, 2011 [2 favorites]


I would not be concerned for the government job unless the problem was persistent and was a security concern.
posted by Ironmouth at 6:57 PM on January 3, 2011


For many years, I did my therapy and my consultations with a psychopharmacologist on my own dime so that no record of them would show up on my insurance. Something your friend might want to think about, so that she could disclose as much or as little as she wanted to in future contexts.
posted by Sidhedevil at 6:58 PM on January 3, 2011 [2 favorites]


I am someone who advocates for treatment. I am the poster child for what happens when you have depression, and push and push to get it successfully treated (through psychotherapy and/or meds.) I can't speak to the government job, but I can speak to the adoption issue.

Psychotherapy will probably not matter at all. People seek therapy for everything from short-term stress counseling to grieving help to [fill in the blank here]. If she initiates an adoption within the next ten years, she may be asked to obtain a letter from her therapist that simply states that in their belief nothing that there are no barriers to her being an adequate parent.

Meds will be an issue for some (not all) countries if she is still on them at the time she decides to adopt. I hate that this is true, but it is.
posted by jeanmari at 7:12 PM on January 3, 2011 [1 favorite]


If she initiates an adoption within the next ten years, she may be asked to obtain a letter from her therapist that simply states that in their belief nothing that there are no barriers to her being an adequate parent.

This was our experience with the foster care system. My husband and I are both on psychiatric medication (for ADHD and anxiety, respectively) and the bureaucrats just needed the all-clear from our doctors.
posted by desjardins at 7:26 PM on January 3, 2011


"so that she could disclose as much or as little as she wanted to in future contexts."

Except that in the U.S., in most government jobs situations where they are asking about your prior mental health treatment you are signing a sworn affidavit under penalty of perjury. If you fail to disclose, you can be both fired and prosecuted.

Similarly, until recently, you were attesting to the truth of what you put on your health insurance application and could be dropped if it was later discovered you had failed to disclose.

Mostly nobody cares if you've had treatment -- they care if you fail to disclose, or if you fail to get treated and thereby create some sort of liability.
posted by Eyebrows McGee at 7:30 PM on January 3, 2011


As mentioned, private therapy is really off-the-record (if you pay for it out of pocket).
posted by ovvl at 7:39 PM on January 3, 2011


As some have said in earlier threads, therapy won't cause her nearly as many troubles in the job seeking process as untreated mental illness.
posted by pickypicky at 8:22 PM on January 3, 2011 [1 favorite]


If she's being referred to a psychiatrist for the purpose of being prescribed something, doesn't that imply that there is a problem? Ignoring the problem and not seeking treatment seems like a much larger barrier to entry than taking a certain medication would be, in a situation where such a thing might matter.
posted by Sara C. at 9:55 PM on January 3, 2011 [1 favorite]


I'm a private practice-based therapist. There is no legal way that any agency or person could obtain information about private, out-of-pocket therapy unless your friend signs a release of information specifically to allow them to do so. There's no way the government will find out about it without her knowledge, because the records are 100% confidential under HIPAA unless subpoenaed by a court for some reason (if someone wanted to sue her and knew she was in therapy, then thought subpoenaing her records would be helpful to their case for some reason? I can't really imagine how it might come into play for her), and even then, a therapist you can try to fight the subpoena in the interest of privacy.

It's going to be totally safe if she gets private therapy that doesn't involve her insurance company or going to a community mental health/Department of Mental Health agency where they might need to do reporting to the county for stats reasons or something (and even in that case, I'm not sure the information would pop onto some kind of permanent government record for her name or something).
posted by so_gracefully at 10:41 PM on January 3, 2011


Within the United States, run-of-the-mill anxiety and depression are extremely common and not a big deal. More significant mental illness, if it is under control, would be protected under the ADA which protects Americans With Disabilities.

This doesn't rule out encountering individual prejudices, especially in sub-cultures where psychotherapy is not as accepted as it is in mainstream American society. I have also heard that the Chinese government is discriminating against almost any mental illness (even minor or well controlled cases) in adoption. However, these don't seem like good reasons to avoid treatment that would make her life substantially better.

One other thought. There are many reasons that people seek therapy - not all of them qualify as mental illness. If the primary cause of her problems are external or relational, then she might honestly seek therapy without diagnosis of mental illness. (This would be something to discuss with a therapist - I have no idea how bad her problems are.) If you check out the DSM-IV (the manual for diagnosing mental health problems) there is a section of "V codes" (diagnositic codes that have a "V" before the number) that are explicitly not mental illnesses.
posted by metahawk at 10:59 PM on January 3, 2011


Seconding metahawk, for what it's worth. I see a gestalt therapist and the notion of diagnosis/pathology has never even come up between us. No idea how that relates to the OP's friend - obviously a weekly chat with a well-meaning counselor is not going to cure schizophrenia.
posted by Sara C. at 11:03 PM on January 3, 2011


I have a top secret clearance and I work in a federal agency in a job with a fair amount of responsibility and authority. I got where I am even though I have gone through therapy numerous times and at one time or another I’ve been prescribed pretty much every antidepressant, sleeping pill, and antianxiety medication out there. I am still taking a couple of them. Your friend has nothing to worry about as long as her condition is manageable with therapy and meds.
posted by Gringos Without Borders at 3:59 AM on January 4, 2011


Except that in the U.S., in most government jobs situations where they are asking about your prior mental health treatment you are signing a sworn affidavit under penalty of perjury. If you fail to disclose, you can be both fired and prosecuted.

Yes. The thing is that saying "I saw a shrink in $dates to deal with general issues of adjustment" is one thing, and having the detailed records of one's treatment available is another. Being off the books gives one the opportunity to be selective in how much one chooses to disclose.

Now, obviously, I have changed my tune on discretion about my personal history since then, but at the time I was considering some possible career choices in which I didn't necessarily want to discuss all of my experiences with mental illness.
posted by Sidhedevil at 12:12 PM on January 4, 2011


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