Practical guide · England

What is confidential in therapy — and when can information be shared?

What confidentiality usually means in NHS mental-health care, useful questions to ask, and why there are limited exceptions.

Start by asking how confidentiality works

You can ask at the beginning of an assessment or therapy what will be recorded, who can see it, whether information is routinely shared with your GP, and what circumstances could lead the clinician to share information without asking you first.

It is not the same as absolute secrecy

Health professionals have duties to protect confidential information. There are also circumstances where information may be shared for care or because there is a serious safety, safeguarding or legal reason. The exact decision depends on the situation, so ask the clinician to explain the limits that apply to you.

Family and supporters

If you want a partner, friend or relative involved, say what you are comfortable being shared. If you do not want particular information shared, say that too and ask how the service will record your preference.

A useful question

Try: “Before we start, can you explain confidentiality, what goes in my record, who normally receives it, and when you might have to share something without my permission?”

Make the appointment easier to use

Put the things you do not want to forget into one private note before you go.

Open appointment prep →

Trusted source

NHS / NHS England guidance ↗

General information, not a diagnosis or personal treatment plan. Exact pathways and options vary. Reviewed 8 September 2026.