We recognize there is still work to be done to overcome implementation obstacles to achieve compliance if these regulations are to appropriately serve the needs of the American people. At the same time please know that any delay in the implementation date is contrary to the health needs of the American people. Regrettably, it is often overlooked that confidentiality is an essential element of high quality health care. Some patients refrain from seeking medical care or drop out of treatment in order to avoid any risk of disclosure of their records. And some patients simply will not provide the full information necessary for successful treatment.
Patient privacy is particularly critical in ensuring high quality psychiatric care.
Both the Surgeon General's Report on Mental Health and the U.S. Supreme Court's Jaffee v. Redmond decision conclude that privacy is an essential requisite for effective mental health care. Accordingly, the APA recommends at the close of the comment period you move forward with the publication of the regulations and not delay the implementation date but rather you use your regulatory authority to respond appropriately in the public interest to protect the privacy of the medical record to the comments received. And we suggest this notwithstanding our concerns hereinafter expressed that we believe changes in the provisions on mental health records are critically needed to ensure the delivery of effective mental health care, or other comments that may be submitted. The Administration's efforts seeking comments are commendable, and while the regulations need to take these additional steps, delayed implementation would be more harmful.