I worked in the field of mental health for 25+ years, and the
requirements for patient confidentiality are essentially the
same as in the medical field. A large proportion of those who
have a diagnosis of mental illness are 'dual-diagnosed', or
also have a diagnosis of drug or alcohol use. This information
is highly confidential, and the only concern of a professional
in the medical field is the possibility of assisting the patient
in becoming rehabilitated.
As for the military, this is evidenced by the language of the
this directive from the Department of Defense, titled,
'Rehabilitation and Referral Services for Alcohol and Drug Abusers':
"Personnel who are to be discharged for drug and alcohol abuse
may be referred for rehabilitation to a VA facility when
mutually agreed upon by the referring Agency and the VA facility.
Within the legal requirements of patient confidentiality and
release of information, the VA facility shall be provided
appropriate records, such as a copy of the member's Military
Service record, and the nature of the member's discharge.
The member shall be informed of this opportunity for
rehabilitation. Alcohol or drug-dependent Service members
who are evaluated as not having potential for further useful
service, if discharged, are to be evaluated by a physician,
provided with appropriate care to include detoxification if
needed, and referred to a VA facility for further rehabilitation"
Their only real concern is rehabilitation. Also notice the
reference to "legal requirements of patient confidentiality and
release of information".
An entire page is devoted to outlining these requirements on
this page from the AMA website, prepared by the American Medical
Association, Office of General Counsel, Division of Health Law:
"Physicians have always had a duty to keep their patients'
confidences. In essence, the physician's duty to maintain
confidentiality means that a physician may not disclose any
medical information revealed by a patient or discovered by
a physician in connection with the treatment of a patient."
This allows for trust between the patient and the treatment
provider which allows the patient to be confident in offering
full disclosure of all information which might impact the
outcome of treatment. This benefits both the patient and the
"There are exceptions to the rule, such as where a patient
threatens bodily harm to himself or herself or to another
These exceptions refer to suicidal or homicidal intentions,
and do not leave room for judgmental perceptions that clients
are harming themselves by the use of drugs or alcohol.
All information that is shared with others, which is usually
limited to other treatment providers, must be accompanied by
a "release of information" or ROI, which is signed by the
patient, and includes the following:
- Patient's name and identifying information;
- Address of the health care professional or institution
directed to release the information;
- Description of the information to be released;
- Identity of the party to be furnished the information;
- Language authorizing release of information;
- Signature of patient or authorized individual; and
- Time period for which release remains valid.
And, in summary:
"Any breach in confidentiality - even one that seems minor -
can result in mistrust and, possibly, a lawsuit and/or
Much more on the page:
So, generally speaking, healthcare professionals are likely to
be much more vigilant than most of their patients in seeking
to preserve the confidentiality of the information which is
disclosed by the patient or discovered in the process of
treatment. It's an integral part of the ethics and legal
requirements of their jobs. Healthcare professionals working
at the VA are no different than those working at other facilities,
in that regard.
Also, you'll be doing your doctor, the healthcare system, and
yourself a favor by providing full disclosure. It will save
everyone the expense of unnecessary tests, and give your
treatment providers a much better overall picture of your
Additional information may be found from further exploration
of the links provided above, as well as those resulting from
the Google searches outlined below.
Searches done, via Google:
"patient confidentiality" "veterans administration" discharged
patient confidentiality law