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Alison Gadsby: ‘We need to discuss how we use confidentiality’

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Don’t tell anyone but I want to talk about confidentiality. It all started with an episode of Holby City. Yes, I know I need to get out more but there’s something about it I find very hard to resist.

I’m watching said very realistic medical drama and, amid the unfeasibly steamy plot lines – there’s no doctor and nurse romance à la Mills and Boon going on my way, I can tell you – there’s a shot of a whiteboard with patients’ names on it. There they were, first and surnames together, for all the world to see.

‘So what?’ I hear you ask. Well, here’s the thing. In a previous job, there was a move to display only patients’ initials on the board, which was behind the closed door of the office. There was some talk of putting up a curtain at the window as well, just in case someone was able to rotate their head 360 degrees and glimpse this initialled board from the corner of their eye while passing by at just the correct speed.

Get the picture? Congratulations if you do, because no one who worked there did. Confusion reigned, even more so than is usual in these environments, because it made the already tricky task of memorising new names and locating people worse.

You may have the impression that I’m not a fan of keeping people’s details private. Isn’t having a mental health problem stigmatising enough without having your entire name on display for anyone to see?

Therein lies the problem. Which came first, the problem or the stigma? Why is it OK to have your name on display if you’ve broken your leg but not if you’re mentally unwell and need to be in hospital just the same?

What is it about us as a society, and as a healthcare system, that allows this differentiation on the grounds of the type
of health problem you have?

I know there are differences but it seems that stigma will be around for as long as we continue to allow it to be. While it won’t be possible to change the views of society by writing someone’s full name on a whiteboard, there must be small changes that would begin to make a big difference.

I would never betray someone’s right to privacy for the sake of a cause but I would be happy to bring up the issue of confidentiality in, for example, a group programme on a ward. We use groups for craft and quizzes, so why not use them to explore issues around stigma too?

It’s time we used confidentiality in the way it was intended, not to further stigmatise.

Alison Gadsby is a mental health nurse in Cambridge

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