Study published: Benefits and harms of open notes in mental health


A study recently published in the scientific journal PLOS ONE has investigated potential benefits and harms of open notes in mental health. An expert panel identified a total of 42 potential benefits and 48 potential harms.

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Experts answered questionnaire in three rounds
The expert panel consisted of clinicians, chief medical information officers, patient advocates, and informaticians with extensive knowledge about patients’ access to mental health notes.

The study was a so-called ’Delphi study’, in which the experts answered online questionnaires in three rounds. The experts were provided with a summary of the responses to the previous questionnaire between each round.

Enhanced understanding of diagnosis
There was consensus that offering online access to mental health notes can enhance patients’ understanding of their diagnosis, care plan and the rationale for treatments, and enhance their sense of empowerment. At the same time, experts identified a potential harm that clinicians can be less detailed and/or accurate in their documentation if patients have access to their mental health notes.

Photo of Maria Hägglund
Associate Professor Maria Hägglund.

Maria Hägglund is one of the authors of the study:

– Another potential harm that was identified by the experts is that denying patients access to their mental health notes could lead to increased feelings of stigma.

Read the full article “The benefits and harms of open notes in mental health: A Delphi survey of international experts”. It is written by Charlotte Blease, Anna Kharko, Maria Hägglund, Stephen O’Neill, Deborah Wachenheim, Liz Salmi, Kendall Harcourt, Cosima Locher, Catherine M. DesRoches, and John Torous.

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Last modified: 2022-05-25