Behavioral Health Referral

CONFIDENTIALITY NOTE
STATEMENT OF CONFIDENTIALITY
Note: ALL SOCIAL WORKERS, COUNSELORS, OR CLINICIANS MUST REVIEW LIMITS OF CONFIDENTIALITY WITH OUR STUDENTS PRIOR TO IMPLEMENTING THEIR BEGINNING SESSIONS WITH THE STUDENT.

Building 21’s Behavioral Health Department will offer a variety of services including assessment, counseling, treatment and psycho-education. These services include, but are not limited to, trauma, stress, anger management, fear/anxiety, adjustment issues, teen pregnancy, behavioral issues, self-esteem and depression.

All services are personal and confidential. The information shared with us will only be discussed within the Behavioral Health Department, unless consent is given by student to share confidential information with other individuals or parties. However, as mandated reporters, there are certain circumstances where the Behavioral Health Department can and will breach confidentiality without the student’s consent:

1.To protect the student or someone else when the student intends to carry out violent, harmful, or dangerous actions.
2.To protect the student when they themselves are victims of violent, harmful, or dangerous actions.
3.When a court of police officer orders the release of certain information.

In the event that there will be a breach of confidentiality, the student will be notified.

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