CONSENT FOR SERVICE & PRIVACY POLICY

Consent for Service

The process of support and intervention is unique for each individual and is a collaborative process between you and the Mental Health Worker. We will focus on topics of concern that are of greatest importance to you and will proceed at a comfortable pace. By contacting Reach Out we understand that you are experiencing life stressors that are creating challenges in your day to day life and/or are seeking information regarding services. Our Mental Health Workers will work with you to identify the primary issues impacting you today, explore past and current coping strategies, provide education as appropriate and make recommendations for community resources that may be useful to you in achieving your goals for today. All of our Mental Health Workers practice from a person centered trauma informed philosophy.

You can expect your session today to be between 0 - 30 minutes in length.

Consent

Individuals are asked to specifically consent in the collection, use and disclosure of personal health information. Any information collected is confidential. We will not disclose information about you to anyone outside of CMHA Middlesex, CMHA Elgin or CMHA Oxford unless we first obtain your written informed consent, or unless legally required to do so.

Use of Information

Personal information that is collected is used for your mental health care plan of treatment.

Disclosure of Information

Under certain circumstances, we may be required to disclose personal and/or health information. Circumstances where disclosure is required include:
• If there is concern about your personal safety due to risk for suicide
• If there is a concern that you may seriously harm another person
• If there is concern that a child, under the age of 18, is at risk of being abused or neglected
• If you report sexual abuse by a regulated health practitioner and disclose the name of that health practitioner
• If you report abuse and/or neglect, including financial abuse of a resident of a long-term care facility
• If clinical notes or records are ordered by a judge during a criminal or civil trial
• If I and/or my records are subject to review by professional governing bodies

In all cases, you will be informed of the disclosure and encouraged to ask questions.