Michigan Mental Health Records: Understanding Section 748 Confidentiality

When someone receives mental health services in Michigan, information learned during those services is not automatically available to the public, relatives, employers, attorneys, or government agencies. Section 748 of Michigan’s Mental Health Code—MCL 330.1748—sets a state confidentiality rule for a recipient’s mental health record and other information acquired while providing mental health services. ¹

This protection matters because mental health records may contain diagnoses, assessments, medications, treatment plans, safety concerns, family history, trauma disclosures, progress notes, and other highly personal information. Section 748 begins with a broad rule: this information must be kept confidential and is not open to public inspection. It may be disclosed outside the department, community mental health services program, licensed facility, or contract provider holding the record only under circumstances allowed by Section 748 or Section 748a. ¹

What Information Does Section 748 Protect?

The statute covers two connected categories:

• Information contained in the record of a person receiving mental health services, whom the Mental Health Code calls a recipient.
• Other information acquired in the course of providing mental health services to that recipient, even if the information is not simply a page in the formal chart.

The protection is therefore broader than a single diagnosis or progress note. It can include information obtained during evaluation, treatment, care coordination, and other mental health services. The exact application still depends on whether the information and provider fall within the Mental Health Code.

Confidential Does Not Mean “Never Disclosed”

Section 748 creates a strong confidentiality rule, but it also identifies situations in which information must or may be disclosed. A lawful disclosure is not permission to release the entire record automatically. When confidential information is disclosed, the recipient’s identity must be protected unless identifying the person is relevant to the authorized purpose. When practical, other information should also be limited to what is relevant to that purpose. A person receiving the information may disclose it further only to the extent consistent with the authorized purpose. ¹

In practical terms, the questions should be:

1. What legal authority permits or requires this disclosure?
2. Who is authorized to receive it?
3. What specific information is relevant to the authorized purpose?
4. Does another law or a legal privilege impose a stronger restriction?

An Adult Recipient’s Access to Their Own Record

For case-record entries made after March 28, 1996, Section 748 requires disclosure to an adult recipient who requests the information if the recipient does not have a guardian and has not been adjudicated legally incompetent. The record holder must respond as quickly as possible and no later than the earlier of 30 days after receiving the request or, when the person is receiving treatment from that record holder, before release from treatment. ¹

Different rules may apply when the recipient is a minor, has a guardian, has been adjudicated legally incompetent, or seeks material protected by a separate privilege. A provider should explain any denial or limitation and identify the process for challenging it. Michigan administrative guidance also addresses determinations that disclosure may be detrimental to the recipient or others and the recipient-rights complaint process. ²

Disclosures That May Be Required When Requested

Subject to Section 748, Section 748a, and other law, the statute lists circumstances in which confidential information is disclosed when requested. These include:

• Under an order or subpoena of a court of record, or a legislative subpoena, unless the information is privileged by law.
• To a prosecuting attorney when necessary to participate in a proceeding governed by the Mental Health Code.
• To an attorney for the recipient when the appropriate recipient, guardian, or custodial parent has consented.
• When disclosure is necessary to comply with another provision of law.
• To the Michigan Department of Health and Human Services when needed to carry out a legal responsibility.
• To the Office of the Auditor General when needed to carry out its constitutional responsibility.
• In a limited benefits-related situation involving certain relatives of a deceased recipient.

A subpoena is not always the end of the analysis. Section 748 expressly recognizes that information may also be protected by legal privilege. Section 750 of the Mental Health Code separately addresses privileged communications involving psychiatrists and psychologists and identifies specific exceptions. ³ Providers receiving a subpoena or legal demand should follow organizational procedures and obtain qualified legal review rather than assuming that every request authorizes immediate release.

Disclosures With Consent

When valid consent is obtained from the person authorized by law—such as the recipient, a guardian with authority to consent, a parent with legal custody of a minor recipient, or the personal representative of a deceased recipient’s estate—Section 748 allows disclosure to a mental health provider and to certain other people or agencies. In some circumstances, the record holder may withhold information if the holder makes a written judgment that disclosure would be detrimental to the recipient or others. ¹

A valid authorization should clearly identify the person or organization permitted to disclose information, the recipient of the information, the information covered, the purpose, and the time period. Signing a broad release without understanding it may permit more sharing than the recipient expects. A person can ask the provider to explain the form before signing and request a copy.

Disclosures the Record Holder May Make

Section 748 also permits the holder of the record to disclose information in several defined situations, including:

• When necessary for the recipient to apply for or receive benefits.
• When necessary for treatment, coordination of care, or payment for mental health services, in accordance with HIPAA.
• For outside research, evaluation, accreditation, or statistical compilation, subject to limits on identification and possible harm.
• To a health-service provider or public agency when a compelling need exists because there is a substantial probability of harm to the recipient or another person.
• To a federally designated protection and advocacy system when federal-law conditions are met.

The fact that the law permits a disclosure does not necessarily mean that a provider must make it in every situation. Other applicable laws, professional privileges, ethical duties, and the facts of the request still matter.

Child Abuse and Neglect Investigations

Section 748a creates a specific process for certain Michigan child abuse or neglect investigations. When there is a compelling need to determine whether abuse or neglect occurred or to protect a minor facing a substantial risk of harm, a directly involved MDHHS caseworker or administrator may send a written request to a mental health professional. The professional reviews the records for information pertinent to the investigation and must release pertinent information within the statutory timeframe. ⁴

This is not the same as an unlimited request for every mental health record. The request, review, relevance of the information, other legal restrictions, and protections against improper further disclosure all matter. Mandatory reporting duties may also require a professional to report suspected child abuse or neglect even when the underlying treatment information is confidential.

Confidentiality and Privilege Are Related but Different

Confidentiality generally regulates how a provider or record holder may use or disclose information. Privilege generally concerns whether certain communications can be compelled or used in a legal proceeding. Information may be confidential under Section 748 and also privileged under Section 750 or another Michigan law. The exceptions are not identical. ³

For example, Section 748 includes disclosures under a court order or subpoena but also says “unless the information is privileged by law.” That language is why a provider should not treat every subpoena as automatic permission to release all clinical communications.

How Section 748 Works With HIPAA and 42 CFR Part 2

The same record may be governed by more than one law. HIPAA supplies a federal privacy baseline for protected health information held by covered entities and business associates. Federal law generally preserves a state rule that provides greater privacy protection or privacy rights. ⁵

If the record identifies a patient as having or having had a substance use disorder and was created by a qualifying federally assisted substance use disorder program, 42 CFR Part 2 may also apply. Part 2 can impose additional restrictions, particularly on using records to investigate or prosecute a patient. A disclosure should satisfy every law that applies; permission under one law does not erase a stricter requirement under another.

Practical Examples

A family member calls for an update

Being a close relative does not automatically provide full access to an adult recipient’s mental health record. The provider must determine whether the recipient authorized the disclosure or whether another legal basis applies. The provider may still be able to listen to information offered by the family member without disclosing confidential information in return.

An attorney sends a subpoena

The record holder should verify the type and validity of the demand, determine whether privilege applies, identify any required notice or court order, and limit any authorized release to relevant information. The existence of a subpoena should not be treated as a reason to bypass legal review.

A care coordinator needs information

Section 748 permits information to be shared as necessary for treatment, care coordination, or payment in accordance with HIPAA. The provider should still use appropriate safeguards, verify the recipient, and share only information authorized for the purpose.

There is a serious risk of harm

The statute permits disclosure to a health provider or public agency when a compelling need is based on a substantial probability of harm to the recipient or others. Other Michigan laws, including duties involving threats and mandatory reporting, may also apply. The scope of any disclosure should be connected to safety and the legal purpose.

If You Believe Your Information Was Mishandled

Start by writing down what happened, when it happened, who was involved, what information was disclosed, and how you learned of it. You may:

• Ask the provider’s privacy officer or records department for an explanation.
• Contact the provider’s Office of Recipient Rights if the services fall under Michigan’s public mental health system or a licensed mental health program.
• Use the recipient-rights complaint process described by the provider.
• File a HIPAA complaint with the U.S. Department of Health and Human Services Office for Civil Rights when HIPAA applies.
• Consult a qualified Michigan attorney when a disclosure has affected a legal case, employment, custody, safety, benefits, or another important right.

Ask for the organization’s Notice of Privacy Practices and any applicable recipient-rights materials. Those documents should explain who receives complaints and how to request records, amendments, restrictions, or confidential communications.

The Main Point

Michigan Mental Health Code Section 748 begins from confidentiality: mental health records and information acquired while providing mental health services are not public information. Disclosure must be tied to a lawful purpose, the recipient’s identity and unrelated details should be protected when practical, and a recipient of the information cannot freely reuse it for a different purpose. Because Section 748, privilege rules, HIPAA, Part 2, and mandatory-reporting laws can overlap, the correct answer depends on the particular record and request—not on a blanket rule that mental health information can always or never be shared.