Calls for service dealing with attempted suicide or a mental health complaint. Sometimes a family will call 911 for law enforcement response for a family member in a mental health crisis. Other times, a business owner or a bystander calls to report unusual behavior (which often is an individual in crisis) and responding officers would benefit from knowing if the individual has a mental health condition. This type of information may enable officers to employ crisis intervention and de-escalation techniques that could reduce the likelihood of injury to both officers and individuals in a mental health crisis.
HIPAA permits a health care provider to share PHI with law enforcement, in conformance with other applicable laws and ethics rules, in order to “prevent or lessen a serious and imminent threat to the health or safety of an individual or the public.” 45 CFR 164.512(j). For example, if an individual makes a credible threat to inflict serious and imminent bodily harm, such as threatening to commit suicide, a provider may share with law enforcement the information needed to intervene. The provider may rely on a credible representation from a person with apparent knowledge of the situation or authority, such as a law enforcement official, when determining that the disclosure permission applies.
Other general calls: An officer is trying to determine whether an individual has a mental illness, substance abuse problem, or both, and needs to gain information about his or her condition in order to decide whether jail, emergency room, or some other program is needed.
If the individual is in lawful custody, a health care provider may disclose PHI to law enforcement pursuant to 45 CFR 164.512(k)(5) if the official represents that the information is needed to provide health care to the individual or to provide for the individual’s health and safety or the health and safety of the officers.
If the individual is not in lawful custody (see 45 CFR 164.512 (k)(5)), nor is a threat to self or others (see 45 CFR 164.512(j)), these provisions would not apply and the provider would need to obtain an authorization from the individual before disclosing PHI to law enforcement, unless another HIPAA provision applies (e.g., escaped inmate, apprehension of an admitted perpetrator of violent crime, etc.). n.
We note that substance use disorder treatment information may be subject to additional protections under 42 CFR part 2.