You have called three times. The unit will "neither confirm nor deny." Your child is 24, in a psychiatric hospital somewhere in this county, and you are being treated as a stranger. Some of that is the law. Some of it is a front desk reading the law too widely.
The short answer: California's Lanterman-Petris-Short Act makes "all information and records obtained in the course of providing services" to a psychiatric patient confidential,¹ and an adult patient, with the approval of the professional in charge of their care, designates who is told what. But the same Act carves out the family. On admission to a 24-hour facility, the facility "shall make reasonable attempts to notify the patient's next of kin ... of the patient's admission, unless the patient requests that this information not be provided."² If "the spouse, parent, child, or sibling of the patient" asks, and the patient is unable to authorise a release, "the requester shall be given notification of the patient's presence in the facility," except to the extent federal law prohibits it.² If the patient consents, the facility "shall give the family member ... notification of the patient's diagnosis, the prognosis, the medications prescribed, the side effects of medications prescribed, if any, and the progress of the patient."² Where the patient is unable to authorise the release, the facility must note the attempt and keep asking daily.² And nothing in any statute stops you from giving information to the treating team — the law on holds says the person deciding on custody "shall consider" what family members report about the history of the illness, where it bears on the decision.³
Two laws, one desk
Psychiatric confidentiality in California runs on two tracks at once. The state track is Welfare and Institutions Code §5328, which applies to anyone receiving services under the LPS Act — a 5150, a 5250, a voluntary admission to a designated unit — and which is stricter than the federal rule.¹ The federal track is HIPAA, whose privacy rule permits a provider to share information "directly relevant to such person's involvement with the individual's health care" with a family member or close friend, if the patient agrees, or does not object when given the chance, or — where the patient is not present or is incapacitated — where the provider judges in "professional judgment" that it is in the patient's "best interests."⁴
The desk that says "we can't tell you anything" is applying the state track and forgetting §5328.1. The desk that tells you everything is applying HIPAA and forgetting §5328. The statute in between is short, and it is the one to cite.
What you are entitled to hear
Section 5328.1, in order:²
- That your family member has been admitted. Subdivision (b) is the sentence most desks have never read: on admission to a 24-hour facility, the facility "shall make reasonable attempts to notify the patient's next of kin ... of the patient's admission, unless the patient requests that this information not be provided." The default is that you are told; the patient can switch it off.
- That your family member is there, if they cannot answer. If you are the spouse, parent, child or sibling, and the patient cannot authorise a release — too unwell to be asked, or not yet answered — "the requester shall be given notification of the patient's presence in the facility," except to the extent federal law prohibits it. A unit that refuses that to a parent is wrong on the statute.
- If the patient consents, the substance. Diagnosis, prognosis, medications, side effects, progress — the statute lists them, and says the facility "shall give" them.
- The asking. Where the patient is initially unable to authorise the release, "notation of the attempt shall be made into the patient's treatment record, and daily efforts shall be made to secure the patient's consent or refusal of authorization."
What §5328.1 does not do is override a competent adult's refusal. If your child is able to decide and asks that you not be told, the admission notice is switched off and the presence rule — written for a patient who cannot answer — does not apply. That is the hardest sentence on this page, and it is the law.
What you can always do
Give information. The confidentiality rule governs what comes out of the record, not what goes in. Welfare and Institutions Code §5150.05 requires the person deciding whether there is probable cause for a hold to consider "available relevant information about the historical course of the person's mental disorder" where it has "a reasonable bearing on the determination," and defines that to include information from family members.³ Write it down before you call: what medication they were on and when they stopped, what happened last time, what you saw this week, the name of the outpatient psychiatrist. Ask that it be placed in the chart. A unit cannot promise to answer you; it cannot refuse to listen.
What to say on the phone
"I am the patient's mother. I am asking, under Welfare and Institutions Code section 5328.1, to be told whether my daughter is present in the facility. I understand she must consent before you tell me more, and I am asking that you request her consent and note the request in her record." Then: "I have history that bears on her evaluation. Who takes it?"
If the answer is still no, ask for the patients' rights advocate. Every local mental health director "shall appoint, or contract for the services of, one or more county patients' rights advocates," whose job includes investigating rights complaints and making sure patients are told their rights.⁵ The advocate can carry your information in, and can tell your family member that you are asking.
After the 72 hours
If the hold is extended or a conservatorship is proposed, the picture changes: hearings have notice requirements, and a conservator, once appointed, holds the patient's consent. What happens after the 72 hours → · CARE Court and conservatorship → If your family member is willing, a psychiatric advance directive drawn up between crises can name you in advance as the person the facility talks to. Psychiatric advance directives in California →
If the patient is a minor
The parent or guardian of a minor decides who may receive the minor's records, and may designate people in writing.¹ The consent question runs the other way, and a different page covers it. My parent put me in a hospital →
Q&A
Q: Can they refuse to confirm my son is even there? A: On admission the facility must make reasonable attempts to notify next of kin unless the patient asks it not to; and where the patient is unable to authorise a release, a spouse, parent, child or sibling who asks "shall be given notification of the patient's presence in the facility."² If your son is able to decide and has asked that you not be told, the statute does not compel the unit to tell you.
Q: My daughter said no. Is there anything I can do? A: Give the team your information in writing, ask the patients' rights advocate to tell her you are asking, and ask the team to raise consent again — the statute contemplates daily efforts while a patient cannot decide, and nothing stops a patient who has refused from changing their mind.²
Q: Does HIPAA let them tell me more than the state law? A: HIPAA permits sharing with an involved family member where the patient does not object, or in the patient's best interests when they cannot be asked.⁴ California's LPS rule is the stricter of the two, and HIPAA itself yields to a state privacy law that is "more stringent."¹ ⁶
Q: Can I be told what medication they are giving? A: Yes, if the patient consents; medications and their side effects are on the statutory list.²
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If there are guns at home, the order that removes them does not need a hold or a diagnosis. Can I ask a court to take a family member's guns? →
Sources
Cal. Welfare & Institutions Code §5328 — "All information and records obtained in the course of providing services ... to either voluntary or involuntary recipients of services are confidential," the patient's power to designate persons with the approval of the professional in charge, and the parent or guardian's power to designate for a minor — california.public.law.
Cal. Welfare & Institutions Code §5328.1 — subdivision (b), on admission to a 24-hour facility the facility "shall make reasonable attempts to notify the patient's next of kin ... of the patient's admission, unless the patient requests that this information not be provided"; subdivision (a), notification to "the spouse, parent, child, or sibling of the patient" of the patient's presence in the facility where the patient is unable to authorise a release, except as federal law prohibits; notification of diagnosis, prognosis, medications, side effects and progress on consent; notation of the attempt and "daily efforts" to secure consent or refusal — california.public.law.
Cal. Welfare & Institutions Code §5150.05 — the person making a probable-cause determination "shall consider available relevant information about the historical course of the person's mental disorder," defined to include information from family members — california.public.law.
45 C.F.R. §164.510(b) — disclosure to a family member, relative or close friend of information "directly relevant to such person's involvement with the individual's health care," with the agreement or non-objection of the individual, or on "professional judgment" of the individual's "best interests" where the individual is not present or is incapacitated — law.cornell.edu.
Cal. Welfare & Institutions Code §5520 — "Each local mental health director shall appoint, or contract for the services of, one or more county patients' rights advocates," and their duties — california.public.law.
45 C.F.R. §160.203(b) — the HIPAA preemption exception for a state law that relates to the privacy of health information and is "more stringent than a standard, requirement, or implementation specification" of the federal rule — law.cornell.edu.
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