JAMA: Let’s Show Patients Their Mental Health Records

NYAPRS Note: A recent article in the Journal of the American Medical Association (http://jama.jamanetwork.com/article.aspx?articleID=1853164) noted that “as electronic medical records and secure online portals proliferate, patients are gaining ready access not only to laboratory findings but also to clinicians’ notes” and asks “should we health professionals encourage patients with mental illness to read their medical record notes?” The article notes that “primary care patients report that reading their doctors’ notes brings many benefits including greater control over their health care, and their doctors experience surprisingly few changes in workflow. While patients worry about electronic records and potential loss of privacy, they vote resoundingly for making their records more available to them and often to their families.”

Let's Show Patients Their Mental Health Records

April 2014 Publisher: American Medical Association Publication: Journal of the American Medical Association

Author(s): Kahn MW, Bell SK, Walker J, and Delbanco T Editor(s): Young R

Patients with easy access to their doctors' notes feel more in control of their care and better understand their medical issues.

The Issue:

With the exception of the Department of Veterans Affairs, medical notes written about “behavioral health” are being excluded from the open records approach. In an opinion piece in the April 2014 issue of the Journal of the American Medical Association, principle investigators from the OpenNotes project and a psychiatrist from Beth Israel Deaconess Medical Center in Boston outline how open access to medical notes can reduce stigma and is beneficial to patients struggling with mental health issues.

Key Finding:

A nonjudgmental approach to describing mental illness behaviors, rather than labeling the issue with complex medical terminology, benefits both the patient and the clinician by altering the clinician-patient dynamic in a positive way.


The ability to read accurate and nonjudgmental notes may help patients address their mental health problems. While sharing a patients’ assessment of hypertension is indeed much different than sharing results about behaviors or feelings, the authors conclude that it’s time to offer fully transparent care to patients with mental illness.

About the Study:

The authors are from the Beth Israel Deaconess Medical Center at Harvard Medical School in Boston. Funding for this work was supported by a grant from the Robert Wood Johnson Foundation's OpenNotes initiative.