Healthpathways Spotlight: Responding to Family Raised Mental Health or Drug And Alcohol Concerns

13th December 2017

Voluntary disclosure of drug and alcohol use or mental health concerns in the general population is low, and reported levels of drug use and mental health symptoms are often minimised by the patient. Often the presence of a drug and alcohol or mental health issue is raised by a partner, family member, or parent.

To further complicate matters, the raised concern may also include:

  • A request that the GP act upon the information
  • A request that the GP does not disclose who gave them the information
  • Indications that the children of the index patient are at risk of harm
  • A risk that the information provided would put that person in danger if the index patient found out (such as in the case of domestic and family abuse and violence)

A family-raised concern about a patient’s drug and alcohol use or mental health state, without the index patient being present, represents an ethical challenge for general practitioners, regarding:

  • duty of care to the index patient
  • duty of care to the family member raising the concern
  • confidentiality
  • breach of privacy.

During the HealthPathways Drug and Alcohol Workgroup, this issue was raised and a new pathway was suggested to provide GPs guidance in this area. The HealthPathways team liaised with the RACGP and a medical defence association to develop the pathway to ensure that the recommendations are consistent with recommended practice. The Responding to Family Raised Concerns provides guidance on how to support the family member who has raised the concern, support the index patient for whom the concern was raised and maintain appropriate ethical standards.

To review this and more than 340 other localised clinical and request pathways, go to

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