Embracing the new age of transparency: mental health patients reading their psychotherapy notes online

@article{ONeill2019EmbracingTN,
  title={Embracing the new age of transparency: mental health patients reading their psychotherapy notes online},
  author={Stephen O'Neill and Hannah Chimowitz and Suzanne G. Leveille and Janice Walker},
  journal={Journal of Mental Health},
  year={2019},
  volume={28},
  pages={527 - 535}
}
Abstract Background: Though patients’ access to clinicians’ visit notes may improve patient engagement and strengthen patient–clinician relationships, it is unknown whether these benefits extend to mental health settings. Aims: Examine patients’ attitudes and experiences reading their psychotherapists’ notes online. Methods: Using a mixed methods design, we conducted telephone interviews and an online survey of patients at an academic medical center who had opened ≥1 of their psychotherapy… 
Sharing Psychotherapy Notes with Patients: Therapists' Attitudes and Experiences.
Evidence suggests that the practice of sharing clinicians' notes with patients via online patient portals may increase patient engagement and improve patient-clinician relationships while requiring
Preparing Patients and Clinicians for Open Notes in Mental Health: Qualitative Inquiry of International Experts
TLDR
The results of this study point to the need for further refinement of exemption policies in relation to sharing mental health notes, guidance for patients, and curricular changes for students and clinicians as well as improvements aimed at enhancing patient and clinician-friendly portal design.
The Benefits and Harms of Open Notes in Mental Health: A Delphi Survey of International Experts
TLDR
This iterative process of survey responses and ratings yielded consensus that there would be multiple benefits and few harms to patients from accessing their mental health notes, and questions remain about the impact of open notes on professional autonomy.
Sharing Clinical Notes in Psychotherapy: A New Tool to Strengthen Patient Autonomy
TLDR
It is proposed that open notes may provide an important new strategy to strengthen patient autonomy and improve clinical outcomes without sacrificing professional autonomy.
The benefits and harms of open notes in mental health: A Delphi survey of international experts
TLDR
There was consensus that offering online access to mental health notes could enhance patients’ understanding about their diagnosis, care plan, and rationale for treatments, and that access could enhance patient recall and sense of empowerment.
Patient and Provider Experience of Electronic Patient Portals and Secure Messaging in Mental Health Treatment.
TLDR
The implementation of electronic access to mental health notes requires a transition from viewing the medical record as the exclusive tool of providers to that of a collaborative tool for patients and providers to achieve treatment goals.
Patients, clinicians and open notes: information blocking as a case of epistemic injustice
TLDR
It is argued that patients’ access to their health information exemplifies a form of epistemic exclusion, one with practical and ethical consequences including for patient safety, and that patients are vulnerable to (oftentimes, non-intentional) epistemic injustice.
Sharing Clinical Notes and Electronic Health Records With People Affected by Mental Health Conditions: Scoping Review
TLDR
PAEHRs in MHC may strengthen user involvement, patients’ autonomy, and shift medical treatment to a coproduced process and further research is needed to examine the clinical effectiveness, efficiency, and implementation of this sociotechnical intervention.
Patients’ Access to Their Psychiatric Notes: Current Policies and Practices in Sweden
TLDR
The results show that regional differences concerning sharing psychiatric notes persist, despite Swedish regulations and a national policy that stipulates equal care for everyone, and there is evidence that the regions are moving toward increased transparency for psychiatry patients.
Patient Access to Mental Health Notes
TLDR
Key empirical questions are identified that must be pursued to inform ethical practice guidelines into opening mental health notes to patients, particularly among persons with serious mental illness and those accessing psychological treatments.
...
...

References

SHOWING 1-10 OF 25 REFERENCES
Trust in Mental Health Clinicians Among Patients Who Access Clinical Notes Online.
TLDR
It is suggested that ensuring consistency between what occurs during appointments and what appears in clinical notes, as well as highlighting patient individuality and strengths in notes, may help engender patient trust and avoid negative consequences of OpenNotes in mental health care.
What Patients Value About Reading Visit Notes: A Qualitative Inquiry of Patient Experiences With Their Health Information
TLDR
A patient feedback tool linked to OpenNotes was developed as part of a pilot quality improvement initiative focused on patient engagement, finding aspects of what patients like about using both notes as a feedback tool highlight personal, relational, and safety benefits.
Inviting Patients to Read Their Doctors' Notes: A Quasi-experimental Study and a Look Ahead
TLDR
Patients accessed visit notes frequently, a large majority reported clinically relevant benefits and minimal concerns, and virtually all patients wanted the practice to continue, with doctors experiencing no more than a modest effect on their work lives.
Impacts of a web-based educational program for veterans who read their mental health notes online
TLDR
Findings suggest that this educational program may help empower mental health patients who read their notes online to be active participants in their care, while also providing information and tools that may facilitate better relationships with their clinicians.
VA OpenNotes: exploring the experiences of early patient adopters with access to clinical notes
TLDR
Initial assessment of the patient experience within the first 9 months of availability provides evidence that patients both value and benefit from online access to clinical notes.
Patient Access to Online Visit Notes
TLDR
The findings suggest that HIV clinic patients and doctors are ready to share visit notes online, and doctors were less likely than primary care doctors to change the level of candor in visit notes.
When doctors share visit notes with patients: a study of patient and doctor perceptions of documentation errors, safety opportunities and the patient–doctor relationship
TLDR
Tritionally more vulnerable populations—non-white, those with poorer self-reported health and those with fewer years of formal education—may be particularly likely to feel better about their doctor after reading their notes, according to the findings.
Patient access to electronic psychiatric records: A pilot study
OpenNotes After 7 Years: Patient Experiences With Ongoing Access to Their Clinicians’ Outpatient Visit Notes
TLDR
In this first large-scale survey of patient experiences with a broad range of clinicians working in practices in which shared notes are well established, patients find note reading very important for their health management and share their notes frequently with others.
Online Access to Doctors' Notes: Patient Concerns About Privacy
TLDR
When considering online access to visit notes, approximately one-third of patients had concerns about privacy at baseline and post-intervention, suggesting that the benefits of onlineAccess to medical records may outweigh patients’ perceived risks to privacy.
...
...