Limits to Confidentiality in U.S. Army Treatment Settings

A number of reports detail ethical concerns of behavioral health providers in the U.S. Military regarding limited confidentiality. This article provides a review of limits to confidentiality in behavioral health settings as outlined by U.S. Army regulations and Department of Defense directives. Specific limits are discussed under seven categories, including: medical treatment and oversight, command notification, threats to safety, public health purposes, judicial or administrative proceedings, law enforcement investigation, and specialized personnel programs. Specific attention is given to war crimes reporting, special duty, and command involvement. Lessons learned for best practice across service branches are provided as a collaborative model for resolving perceived conflict between the APA Ethics Code and military regulations.