Clinicians at Beth Israel Deaconess Medical Center, Boston, are conducting a pilot program in which notes they write about patients' mental health treatment is shared with those patients.

Writing for “A Piece of My Mind,” appearing in the Journal of the American Medical Association (JAMA), lead author Michael Kahn, M.D. and colleagues urged mental health clinicians to begin sharing the visit notes they write with their patients.

Reflecting the impact of the OpenNotes initiative, more than 2.5 million Americans, including patients at MD Anderson, Mayo Clinic, Cleveland Clinic, the Department of Veteran’s Affairs (VA), and BIDMC now have access to their medical notes. But, with the exception of the VA, medical institutions and systems do not share notes written by psychiatrists, psychologists and social workers.

“We believe that such exclusions are unnecessary,” the authors wrote.

Kahn and colleagues acknowledged that offering access to mental health notes presents new challenges. “Inviting patients to read what clinicians write about their feelings, thoughts and behaviors does seem different from sharing assessments of their hypertension or diabetes,” and that for some patients, access could carry more risk than benefit. Still, they suggest, for the vast majority of patients, reading mental health notes could have an overall positive impact on their health and health care.

“Patients’ self-evaluations are often more negative than those of their clinicians,” they wrote. They say access to the notes has the potential to help patients feel less alone and diminish the shame patients can experience with a mental health diagnosis.

Outpatient medical notes have been available at BIDMC since July 2013. Patients are invited to read their notes using a secure, confidential website. The medical center began piloting access to mental health notes in March 2014.

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