Before exploring through the particular criteria and rules, it’s crucial to know Ontario’s mental health practitioners are bound by strong privacy laws meant to guard private, sensitive medical records. The framework governing this area is comprehensive, involving provincial legislation, professional standards, and technical requirements for digital systems. Mental health practitioners must navigate these criteria carefully to guarantee patient anonymity and deliver efficient treatment in all digital environment.
Disclaimer: This article is intended for informational purposes only and does not constitute legal advice; readers should consult with a qualified legal professional for specific guidance regarding their privacy compliance obligations.
Ontario’s Personal Health Information Protection Act (PHIPA)
Ontario’s primary legislation governing health information privacy is the Personal Health Information Protection Act (PHIPA), which establishes the foundational framework for how personal health information (PHI) must be handled by health information custodians, including mental health practitioners.
PHIPA defines personal health information broadly to include any identifying information about an individual in oral or recorded format that relates to their physical or mental health, family health history, health care providers, payment information, health card numbers, and information about substitute decision-makers according to the IPC’s Health Privacy Guide and COKO’s Practice Guideline on Privacy and Confidentiality. For mental health practitioners, this definition encompasses virtually all client information collected during assessment, treatment, and follow-up care.
Under PHIPA, individuals have significant rights regarding their personal health information, including:
- The right to be informed about the collection, use, and disclosure of their information
- The right to be notified of theft, loss, or unauthorized use or disclosure of their information
- The right to consent to or refuse the collection, use, or disclosure of their information
- The right to withdraw consent by providing notice
- The right to expressly instruct that their information not be used or disclosed for health care purposes without consent
- The right to access and request corrections to their health records
- The right to complain to the Information and Privacy Commissioner about privacy breaches
PHIPA was further strengthened by the Health Information Protection Act of 2016, which amended various provisions to enhance privacy protections, particularly regarding electronic health records. These amendments clarified that even viewing personal health information constitutes a “use” under the Act and expanded notification requirements for privacy breaches.
Obligations of Mental Health Practitioners as Health Information Custodians
Under PHIPA, Ontario mental health professionals who have custody or control over personal health records are classified as “health information custodians”. This classification involves particular obligations for safeguarding patient records.
Privacy Practices and Policies
Mental health practitioners must develop comprehensive privacy practices and policies. According to the Community Mental Health and Addictions Privacy Toolkit, these should include:
- A privacy policy outlining how the organization handles personal health information
- Procedures for accessing, using, and disclosing personal health information
- Technical, administrative, and physical safeguards to protect personal health information
- Clear consent practices that comply with PHIPA requirements
Data Collection and Security Measures
Practitioners must take reasonable steps to ensure personal health information is protected against theft, loss, and unauthorized access, use, disclosure, copying, modification, or disposal as outlined in COKO’s Practice Guideline on Privacy and Confidentiality. This includes securing both physical records and electronic systems.
The Ontario Medical Association emphasizes that physicians (including psychiatrists) must take reasonable steps to protect personal health information in all forms of communication, whether sharing within the circle of care or with patients and caregivers.
Consent Management
PHIPA requires health information custodians to obtain consent before collecting, using, or disclosing personal health information, with certain exceptions. Mental health practitioners must implement systems for obtaining, documenting, and tracking consent, as well as honoring withdrawals of consent as outlined in the IPC’s Health Privacy Guide.
Breach Notification
When personal health information is stolen, lost, or used or disclosed without authorization, mental health practitioners must notify the affected individuals and the Information and Privacy Commissioner of Ontario. The notification must include a statement informing individuals of their right to make a complaint to the Commissioner, as required by the Health Information Protection Act of 2016.
Digital Health Information Systems in Mental Health Practice
The ever digital character of healthcare has brought fresh issues about patient data protection in mental health treatment.
Electronic Health Records
The Ontario Mental Health Reporting System (OMHRS) is one example of a system that collects and reports on information about individuals receiving mental health services in Ontario. This system includes comprehensive data about mental and physical health, social supports, service use, care planning, and outcome measurement.
Such systems must adhere to strict data quality and privacy standards. As noted in the OMHRS metadata documentation, “CIHI ensures that the quality of the information in our data holdings is suited to its intended uses and that data users are provided with accurate information about data quality”.
ConnectingOntario ClinicalViewer
For health care organizations providing mental health services, the ConnectingOntario ClinicalViewer offers a secure, web-based portal for accessing digital health records, including mental health care information. This system provides real-time access to comprehensive patient health information while requiring only one username and login.
Systems like these must implement robust security measures to protect sensitive mental health information while still allowing appropriate access to those within the circle of care.
Requirements for Digital Tools in Mental Health Practice
Website Content Management Systems (CMS)
Any system gathering or keeping personal health information must follow PHIPA. This implies keeping audit logs, using suitable security policies, and guaranteeing only authorized access.
Mental health practitioners should select CMS platforms that:
- Apply encryption for private information.
- Supporting role-based access restrictions
- Keep comprehensive access logs.
- Allow for secure communication
- Respect privacy rules.
Online Booking Systems
Online booking systems are increasingly common in mental health practice. Examples from various institutions like Ontario Tech University, University of Toronto, and Queen’s University demonstrate the prevalence of these systems.
For online booking systems, mental health practitioners should ensure:
- The system securely collects and stores only necessary information
- Privacy notices are clearly displayed
- Consent for information collection is obtained
- Secure access mechanisms are implemented
- The system integrates with existing privacy practices
Ontario Health has developed a Virtual Visits Verification Standard that helps health service providers make informed decisions about the procurement of virtual care solutions, including booking systems. This standard ensures that solutions meet requirements for privacy, security, technology, and functionality.
Virtual Care Considerations
The COVID-19 pandemic accelerated the adoption of virtual care in mental health practice, introducing additional privacy considerations.
Ontario Health’s Virtual Visits Verification Standard helps mental health practitioners select appropriate virtual care solutions. Solutions that meet this standard are verified against mandatory requirements and published on a Verified Solutions List.
This verification process ensures that:
- Privacy and data protection safeguards meet minimum standards
- Solutions comply with relevant legislation
- Technical security measures are adequate
- Functionality supports appropriate clinical practice
MindBeacon, a provider of digital therapy services, notes that their practices are “compliant with PHIPA, PIPEDA, FIPPA and the health custodian regulations set out by the College of Psychologists of Ontario”. This demonstrates the importance of ensuring that any third-party digital service used in mental health practice meets all relevant regulatory requirements.
Best Practices for Mental Health Practitioners
Based on the search results and the requirements of PHIPA, mental health practitioners in Ontario should follow these best practices to protect patient data:
- Develop and implement a comprehensive privacy policy specific to mental health practice
- Conduct regular privacy impact assessments when implementing new systems or processes
- Provide privacy training to all staff with access to personal health information
- Implement appropriate physical, technical, and administrative safeguards
- Establish clear procedures for obtaining and documenting consent
- Create a breach management protocol that includes notification procedures
- Regularly review and update privacy practices to reflect changes in technology and legislation
- Select digital tools and services that meet privacy and security standards
- Document all privacy-related decisions and actions
Conclusion
Ontario’s mental health professionals work under a thorough privacy framework anchored around PHIPA. While professional norms and technical factors offer more layers of protection, this legislation lays out rules for safeguarding personal health information.
Practitioners have to make sure that all facets of their work—from electronic health records to online booking systems—meet the required privacy and security criteria as mental health treatment progressively uses digital tools and services. Understanding and using these criteria can help mental health professionals deliver efficient treatment while preserving the confidentiality and trust required of the therapeutic relationship.
Mental health practitioners should regularly consult with privacy professionals, stay informed about regulatory changes, and leverage resources such as the Community Mental Health and Addictions Privacy Toolkit to ensure ongoing compliance with privacy requirements. The protection of sensitive mental health information is not just a legal obligation but a fundamental ethical responsibility in mental health practice.
Disclaimer: This article is intended for informational purposes only and does not constitute legal advice; readers should consult with a qualified legal professional for specific guidance regarding their privacy compliance obligations.