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Confidentiality Preserved at GW

June 22, 2006

Officials at George Washington University confirmed Wednesday that the institution has abandoned a controversial plan that would have required students seeking help at the University Counseling Center to sign a waiver in order to receive treatment. The waiver, which had been mulled for months by administrators, lawyers and counseling center officials, would have allowed information discussed during sessions with students to be shared with administrators.

“At the moment we have no plans to make changes to the waiver system currently in use,” said Tracy Schario, a spokeswoman for the university. “Pros and cons were weighed, and officials ultimately determined that the process isn’t broken.”

Currently, when students seek treatment, they are asked to fill out paperwork that conforms to widely accepted ethical and legal standards, including a consent for treatment form. As is customary at college counseling centers nationwide, students are assured of confidentiality unless they reveal information that suggests that they may harm themselves or others.

Since the plan first came to light in December, mountains of criticism have been heaped on the institution. Many mental health professionals and legal experts said that the waiver would stigmatize students who seek care, discouraging many of them from seeking help, and might conflict with confidentiality guidelines traditionally associated with psychological and psychiatric treatment.  

“It was a wise move to dump it,” Richard Kadison, the chief of mental health services at Harvard University, said upon learning about the tabled plan. “It’s not really informed consent to have a generic form.” If Harvard administrators were to ask him to help adopt such a policy, he said he wouldn’t agree to it and does not believe it would be legal or ethical.

Kadison said that many administrators have felt “pressured” to enact policies that would protect their liability in the event that a student with a mental disorder were to harm himself or others.

Schario acknowledged that the ongoing Jordan Nott case against the university did play a role in the consideration of the proposal. The former GW student claims he was forced to leave the institution and threatened with criminal prosecution after he sought help for depression at the university’s counseling center. The university's lawyers have defended the removal and suggested that Nott’s conduct could have barred his recovery if he remained at GW. 

“It would be disingenuous to say that it was not part of the conversation,” said Schario. “But we have been looking into our policies since before the lawsuit. Once the lawsuit hit, it certainly made us take a look at our procedures.”

Karen Bower, a lawyer for the Bazelon Center for Mental Health, who represents Nott, was perplexed at why his case would have had the institution thinking about making its rules stricter. The point that the lawsuit is making, she said, is that there should be a greater measure of protection between counseling services and administrators.

“I think they overreacted,” said Bower. “Policies should help all students succeed, not punish them for seeking treatment.” Court documents filed in the Nott case indicate that the university responded with disciplinary action by barring the student from the institution after he sought treatment for depression.

“If schools don’t trust the evaluations of the mental health system,” added Bower, “then they should help focus on fixing the system." She said that more community-based services and mental health awareness programs would be helpful for many students.

Jaquie Resnick, director of the Counseling Center at the University of Florida, said that she, too, was pleased to hear that GW had scrapped the waiver idea. “I think it’s important to protect a student’s confidentiality to the degree that’s allowed under the law,” she said. “I think it was presented maybe with the best interests of the students in mind, but ended up being way too blanket, trying to do too much.

“I’m not aware of anyone who has spoken out in favor of it,” added Resnick. “The pendulum tends to swing on these issues, and it was an extreme reaction.”

Kadison believes that many institutions are focusing too heavily on liability issues, which may be leading students to feel stigmatized if they seek treatment. “Each situation has to be looked at separately,” he said. “You cannot break privacy except in very dire circumstances.”

Kadison believes that in “99.9 percent of situations” a student who poses potential harm to himself or others can be spoken to and convinced to leave the institution for a period of time in the course of treatment. “You cannot create monolithic policies,” he added. “It just won’t work.”

 

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