39. The balance between legal responsibility and patient rights IN mental health care

Abstract Background Psychological health care has gradually become a way for most people to relieve social pressure and treat mental disorders. Although the current Civil Code stipulates that psychological caregivers and therapists have confidentiality obligations towards patients. However, in some special psychological disorders, patients may be at risk of self harm or harming others. Should therapists continue to maintain confidentiality in the face of multiple complex situations, or should they break their confidentiality obligations and upload reports for the sake of patient rights and the social rights of others? There is a lack of clear provisions for exceptions in current laws, so research is being conducted to investigate the attitudes of therapists and the public towards confidentiality obligations in mental health care. The purpose of the study is to identify potential challenges that psychotherapists may encounter during their practice and provide corresponding improvement suggestions. Methods A questionnaire was distributed to 36 psychotherapists in medical institutions and 620 members of the general public to investigate their perceptions and attitudes towards confidentiality, as well as their perceptions and attitudes towards confidentiality exceptions, measures, and recommendations. Simultaneously select legal professionals and hospital managers who have participated in the questionnaire survey and are interested in conducting semi-structured interviews for in-depth interviews. After the investigation, the data was organized using SPSS software and analyzed using t-test method. Results The experimental results showed that the average approval rating of the psychological therapist group for the confidentiality provisions in the Mental Health Law was 4.78 ± 0.49, and the average approval rating for the confidentiality exception provisions in the Physician Law was 4.67 ± 0.63. The attitude of the psychotherapist community towards exceptions to confidentiality obligations is as follows: for behaviors that pose a threat to national security and public safety, seriously endanger the personal safety of others, or abuse minors, the average attitudes of the psychotherapist community towards patient reporting are 4.72 ± 0.97, 4.72 ± 0.85, and 4.50 ± 1.08, respectively. The average evaluation of reporting patients' secret behavior by the general public is 4.66 ± 0.91, 4.60 ± 0.93, and 4.46 ± 0.98, respectively. It can be seen that the attitudes of the general public and psychotherapists towards confidentiality obligations and exceptions are generally consistent on most issues. Discussion A study conducted research on psychotherapists and the general public, and found that different groups have similar perceptions and attitudes towards the confidentiality obligations and exceptions of psychotherapists. In response to the issues identified in the research, it is recommended to establish systematic provisions at the legislative level regarding exceptions to the confidentiality obligations of psychotherapists, in order to clarify the situations where the confidentiality principle can be violated in specific circumstances. At the same time, it is recommended to list specific exceptions to confidentiality for psychotherapists, and to enhance their professional competence, including legal and medical literacy, to ensure that they can balance confidentiality and disclosure correctly. In future research, questionnaire questions will be expanded to focus on legal rights issues in the practice of mental health care.