By law, you have the right to keep your medical history secret. The best medical and psychiatric care demands it if a patient is to reveal intimate details about her life and illness.

Certain realities of modern life make it vital that your medical history remains confidential. The lack of understanding and fear of mental illness that still exists in today's society can result in loss of jobs, promotions, health care benefits, and insurance coverage for a person whose private medical history is not protected.

If you care for someone who is being treated for schizophrenia or another mental illness, ask your psychiatrist and other mental health care providers how they protect your confidentiality. Find out what they disclose to insurance companies and others when they share information.

If a present or prospective employer or an insurance company requests information from your doctor, it can only be released if you sign an authorization form. The American Psychiatric Association Guidelines on Confidentiality state that you should be told clearly who wants to see your medical records and why. The guidelines also say you should not be forced or threatened in any way to give permission for others to see your records; your permission should be given freely. Nevertheless, there is an unavoidable implied threat in such requests: unless you sign the form, there is a good chance you might not get the job or the money from the insurance company.

If you are looking after the interests of someone with schizophrenia, make sure you know the identity of the third party asking for medical records, why it wants them, and what it is going to do with them. Find out how the third party is going to protect your privacy and whether or not it intends to share the records with any fourth parties.