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Confidentiality question - Carers UK Forum

Confidentiality question

For issues specific to caring for someone with mental ill health.
My friend is currently on a psych ward having tried to committ suicide numerous times over the last 6 weeks. She has managed to convince the professionals that she didn't plan any of them. After she was admitted (voluntarily) I discovered her suicide notes. I know that she wrote them a little while ago as I saw them a few weeks ago after one of her attempts. At that point they were in sealed envelopes and I didn't read them. This time I was collecting stuff together to take to hospital for her and came across them again, now out of the envelopes. Having read them - which was heartbreaking - I'm fully aware, which I suspected, that she most certainy did plan her attempts. I know what she means - that she didn't plan a day and time, but was obviously planning for it to happen at some point. I also found a bag of empty packets of laxatives.

I was talking to a friend about this and she said I should tell her doctors/someone at the hospital. However I don't want her to know I've found them - especially the letters. I suspect that would make it impossible for her to face me and possibly to come back home eventually. I do think they need to know though as if she can convince them that there was no intention again, then she may be discharged before these things are worked through.

Where do I stand in terms of confidentiality? If I talk to her doctor/psych nurse can they keep my info from her?
Were they addressed to you? If not I think that you will do more damage to your relationship by having opened them and divulging their contents to professionals than having simply opened them. I personally would not have opened them even if they were addressed to me, I would have told her that I had found them and asked her what she wanted me to do with them, an element of depression and of self-harming is often the sense that one has lack of control over one's life, I would be helping her to take more control of her life, handing responsibility for what happens to her back to her, only she can know whether these were attempts to end her life or cries for help and even she may not be sure, making decisions for her is disempowering, doing things behind her back can seem like a breach of trust, your friendship obviously matters a great deal to her, it is something stable and enduring which she can rely on, in your situation I would not jeopardise it.
I agree with a lot of what you said. The letter I read was adressed to me and was on a piece of paper open to view. I wouldn't have opened it if it wasn't. To be honest I feel horribly guilty for having read it, but once I'd seen the first bit of it, which like I say was there staring me in the face (I didn't go searching), I actually couldn't help myself continue to read. It was like a compulsion. In many ways I wish I'd never read it, it's had me in pieces ever since, but it's done now. Still not sure though if I should talk to someone or not.

I completely agree with you about not jeopardising our friendship - that's the last thing I want to do, which is why I'm trying to work out what, if anything, I should do.
this is a hard one to decide on what is best to do. clearly your friend needs help and hopefully is now getting it. but for things to improve she also needs to accept that there is a problem that she cannot deal with on her own, not being 100% honest with her doctors is not going to help her as there need that to treat her. now we hit the hard part do you tell the doctors so that there can really help her, i know from my experience with my partner sometimes you have to take the hard step and tell them what you have found. yes i risked my relationship and if it had end i would have be heart broken but deep down i know that i did the right thing for my partner who is still alive and getting the treatment there need but would'nt admit that there need it.. perhaps try talking to her and try to get her to admit to them about it. i would put her life above the friendship but that is me.. i really feel for you and your friend..
Thank you Paul. You've hit the nail on the head. I value her life above the friendship, but am terrified of losing it at the same time. Stuck between a rock and a hard place I feel!
i know and i know how hard it is as either way you could lose her. i feel that your friendship is strong and if it is then she will understand your reasons for telling as you only want what is best for her and for me that is what is the most important thing.. have you tried taking to her or her parents about it??
I haven't talked to her parents. They are not unsympathetic and really want to support her, but just don't get it. They cannot see past the food issue and it's so much more than that. I also feel that telling them about the letters would involve a conversation about a letter for them and I don't really want to go there. Think it would destroy them and I don't want to be the cause of that. They haven't really taken her suicide attempts seriously, not through lack of caring, just denial and a lack of understanding etc which I can understand.

As for talking to her - I don't want her to think I was going through her things. In reality she'd asked me to get some clothes from her drawers for her and she has 2 sets. The first ones I looked in had the letters in. Didn't know that, but not sure she's rational enough at the moment to see that.
It is extremely difficult, sadly those determined to end their lives will do it whatever anyone, family, friends, the professionals, do to try to prevent it, I have lost friends this way, but your friend may not be determined to end her life, not all suicide attempts, even those accompanied by suicide letters, mean that the individual wants or intends to die, parasuicide, they may be contemplating it but not feel able to act on it or they may be in extreme mental distress and a suicide attempt may be the only way in which they can express their need for help, even the professionals are not good at judging who is at serious risk of suicide and some parasuicides do end in unintended death.

I think that to help your friend and prevent yourself getting hurt you need two-way trust, she needs to trust you and you need to trust her, I personally would still discuss it with her, offer to be with her if she will talk about the way she really feels to the team treating her, and remember, it may be that she is not suicidal at the moment, and then, based on your discussion with her, make your decision whether to discuss it with them without her agreement if she will not tell them herself, I would tell her that this is what I am going to do, you might choose not to but she will, of course, realise that it was probably you whatever you do.
Hello.
You are in a very difficult position. Have you thought about phoning MIND. They support people with mental illnesses, also their Carers.They will have a Carers support worker who will listen to you and may be able to suggest something. They will make no judgements on your or your friend.MIND are open every day of the year, and they are also online.
Good luck.x
MIND will also be confidential, they will not talk to her Drs about what is said.
I understand how difficult this is for you and how much you want to do the right thing for your friend. However if she is determined to commit suicide, she will. At the moment she is in the safest place possible. It may be that after receiving treatment and therapy she will start to feel better. You don't know when she wrote the notes for definite. They may have been there for a long time when she was at her lowest.

If you tell someone you may be raising the alarm without cause and breaking her trust into the bargain. That said, however you may be helping your friend, and she may have asked you to get some things for her knowing full well you would see the letters. Only she knows the answer. I don't think going behind her back will help. Like others have said, it may be worth telling your friend what you have seen then leaving it at that. She went into the hospital voluntarily so she obviously felt she needed help, which isn't really the actions of someone suicidal. I notice you said that "she has managed to convince the staff that her attempts were not planned" but it sounds like you don't believe her.

Sometimes it is easier to talk to a stranger than someone close so it may be that your friend has been able to be really honest with the people looking after than she would anyone else.

Unfortunately however much we want to help, we don't have control over other people's actions. If your friend wants to commit suicide then she will. However, your friend is safe at the moment and will be watched carefully. The staff in the hospital will know what signs to look out for. The fact that she has made several attempts and not succeeded may indeed mean it is a cry for help more than a serious attempt. But of course I cannot know that.

Have you thought about ringing The Samaritans? They are there for people who are worried about someone as well as people who are suicidal. It certainly sounds as though the whole ordeal has taken a toll on you. Who is supporting you in all this?