Do I have to disclose mental illness

Davey Do · Mar 19, 2019

I doff my proverbial hat to you, NurseChiaPls, for your candor in discussing your history. I have no experience in a situation such as yours, but please allow me to express my opinion:

Having to deal with the stress of any situation and seeing it through by seeking appropriate treatment is admirable. Following up by continue being treatment compliant shows great fortitude which is also commendable.

I'm thinking out loud here: The term "mental illness" is a general classification which carries a stigma. However PTSD/depression does not imply the same caliber of weight in the ability to function as does psychosis, which is a departure from reality. The diagnosis of PTSD/depression indicates a reaction usually resulting from an intensely stressful situation which can be transient.

From studies that I have read and in my experience, more than one psychotic break usually indicates a need for life-long medication therapy whereas PTSD/depression can be treated with or without medication.

There are different types of brain chemicals involved with the different diagnosis of depression and psychosis; respectively, serotonin and dopamine. I'm speaking in generalities here, but selective serotonin uptake inhibitors (antidepressants) are commonly prescribed for depression whereas dopamine antagonists (antipsychotics) are prescribed for psychosis. However, dopamine antagonists are also useful in treating depressive symptoms of racing thoughts and rumination.

I don't want to imply that an individual diagnosed with psychosis cannot function adequately well and lead a rich, productive life. I have known extremely intelligent individuals diagnosed with psychosis who were treatment compliant and continued successfully working in their field of expertise. For example, one such individual, whose diagnosis was MDD with psychotic features, was a DVM.

I'm hoping that the information I'm giving to you , NurseChiaPls, will help you with your decision on whether or not to disclose your diagnostic history.

But I can say this: If I had been what you have been through and deal with it in the same way that you have dealt with it, I wouldn't have much trouble disclosing. However, I've worked in the mental health field for over 35 years and can see the forest for the trees.

Good luck, and my very very best to you, NurseChiaPls in whatever decision you make!

Jory, MSN, APRN, CNM · Mar 19, 2019

1 hour ago, NurseChaiPls said:
So I just got accepted into nursing school and I was so excited until they asked me to disclose my medical history. I went through a pretty rough time when I was getting out of the Army and was in-patient in a psych facility for about a month a little over a year ago. There were several extenuating circumstances around it, but now that I'm out of the military and don't have manipulative tyrants running my life I've been fine. I'm on meds, I'm doing great in school, and I've never felt more normal. I don't need any academic accommodations or plan on asking for them. I don't want to disclose that I was hospitalized or that I'm on meds for ptsd/depression. Does anyone know if I legally have to? Or if I can get in trouble for lying on the paperwork. This is not how I want to start nursing school.

I don't think this request by your school is appropriate. They can require a physical exam but only relevant aspects of your health history are required to be disclosed. You are still entitled to HIPAA protection.

You may have to disclose the meds, if they are controlled substances. You can send me a PM and I can tell you if they will show up on a drug screen.

The school is in my opinion, crossing a line.

I have had to do three physicals for school...all of which required drug-testing, NONE of which required me to disclose my full health history on any form that went back to the school.

They cannot legally ask you any questions you cannot ask if you were applying for a job.

Kooky Korky, BSN, RN · Mar 19, 2019

Part of the issue is that you lied, it sounds like.

I don't know what the school could and could not ask, but it sounds a little late for you to be deciding.

I think you need to talk to a couple of attorneys to find out what your options are.

I am glad you are doing well with school, but it sounds like your conscience is troubling you or you are worried that someone might learn the truth.

Thank you for serving and I wish you all the best.

Katie Slayton · Mar 19, 2019

Nursing school only has an interest in knowing if you’re capable of completing the program. If you have any injuries or medical problems that could pose a risk they should know that. Otherwise you still have a right to privacy. Even the nursing board cannot go into a nurse’s medical records. As far as I’m concerned all you have to show them as a current physical and you do not need to tell them what meds you’re on. And legally they can only test for potentially illegal ones.

Long Term Care Columnist / Guide · Mar 19, 2019

You say your mental health conditions are well-controlled. I believe you. No reason to open a can of worms and cause your school to be wary of you, which they may very well be if they learn of your diagnoses. Depression is pretty well accepted nowadays, but PTSD still carries a stigma even though it's one of the few mental illnesses that can be cured. Don't disclose it if you can possibly avoid it. You shouldn't have a problem with meds if you're not taking any controlled substances. Best of luck to you.

Misteighbloo, BSN, RN · Mar 19, 2019

4 hours ago, Kooky Korky said:
Part of the issue is that you lied, it sounds like.
I don't know what the school could and could not ask, but it sounds a little late for you to be deciding.
I think you need to talk to a couple of attorneys to find out what your options are.
I am glad you are doing well with school, but it sounds like your conscience is troubling you or you are worried that someone might learn the truth.
Thank you for serving and I wish you all the best.

My understanding was not that this person has lied... they just now got accepted to nursing school and the school is now asking for medical information and they are trying to determine if it will be required to disclose this information or not. The “doing well in school” comment likely is in reference to the pre-requisites or finishing up a first degree.

FolksBtrippin, BSN, RN · Mar 19, 2019

No, you do not have to disclose this information. I would not.

If you are drug tested, you must disclose your meds to whoever drug tests you. But that company can't tell your school what prescribed meds you are on.

I would not disclose this information to anyone, not because you have anything to be ashamed of, but because it's none of their business.

EDNURSE20, BSN · Mar 19, 2019

I’m surprised. I personally would tell them. Maybe not every last detail, like being hospitalised. But that you’ve had issues in the past, it’s well controlled and what you have in place to keep everything controlled.

It can work in favour as well, if you struggle with you mental health at any point during your schooling, the school will probably be more supportive and accomodating if they know about your history.

I learnt that the hard way. I have endometriosis, that really got in the way in my first year. I failed a paper because I didn’t tell anyone or ask for help/extensions. Then last semester of nursing school things got bad again, so I told them BEFORE it effected my grades and they were able to help and I got to graduate on time.

RNNPICU, BSN, RN · Mar 19, 2019

49 minutes ago, Newgradnurse17 said:
I’m surprised. I personally would tell them. Maybe not every last detail, like being hospitalised. But that you’ve had issues in the past, it’s well controlled and what you have in place to keep everything controlled.
It can work in favour as well, if you struggle with you mental health at any point during your schooling, the school will probably be more supportive and accomodating if they know about your history.
I learnt that the hard way. I have endometriosis, that really got in the way in my first year. I failed a paper because I didn’t tell anyone or ask for help/extensions. Then last semester of nursing school things got bad again, so I told them BEFORE it effected my grades and they were able to help and I got to graduate on time.

Except, Mental Health is not viewed in the same way as other Medical conditions. Mental health diseases are treated with much more stigma. A medical diagnosis is treated much differently. In Nursing school, any hint of a POTENTIAL sense that something may not be right is like painting a huge target on your back.If the past mental health diagnosis is not a currently active disease, there is no need for disclosure.

To the OP, provide a physical exam as that is what is typically required.

allnurses Guide · Mar 19, 2019

Sometimes schools want to know these things because they are looking for potential barriers to licensure. In California the application for licensure specifically asks if you have been treated for a mental illness (psychosis) or been prescribed antipsychotic medication or been treated for a addiction in the past 10 years. If you answer yes to these questions you can still sit for the NCLEX but your first years as a nurse could be done under monitoring which in my opinion is not conducive to a successful launch into a nursing career.

So if you hospitalization did not include psychosis or addiction with a legal record I would keep it to yourself. Depression and PTSD that is in remission and well controlled is no one's business but your own.

Hppy

brownbook · Mar 19, 2019

7 minutes ago, hppygr8ful said:
Sometimes schools want to know these things because they are looking for potential barriers to licensure. In California the application for licensure specifically asks if you have been treated for a mental illness (psychosis) or been prescribed antipsychotic medication or been treated for a addiction in the past 10 years. If you answer yes to these questions you can still sit for the NCLEX but your first years as a nurse could be done under monitoring which in my opinion is not conducive to a successful launch into a nursing career.
So if you hospitalization did not include psychosis or addiction with a legal record I would keep it to yourself. Depression and PTSD that is in remission and well controlled is no one's business but your own.
Hppy

I don't know why a school would need to know? Is this a public or private school?

I don't know exactly what the Board of Nursing application asks. But if it's just, have you been treated for a mental illness, don't lie. You may simply need to provide a letter from your therapist with a brief description of your diagnosis and treatment.

I think this is a good "Ask the Lawyer" question.