Privacy and Confidentiality in Mental Health Care Edited by John J. Gates & Bernard S. Arons. Baltimore, MD: Paul H. Brookes. 2000. 242 pp. US$34.00, £37.50 (pb). ISBN 1 55766 426 9

Privacy is a tenet of individual liberty in the USA. To understand this in the particular context of mental health information, the inquisitive must enter a complex legal and ethical labyrinth, featuring a patchwork of amorphous state laws, a dearth of controlling federal law, the Code of Ethics of the American Medical Association and many case-law precedents. The weary traveller will likely emerge with the conclusion that privacy and confidentiality rules affecting mental health information in America are inadequate and incomplete.

Vast technological changes in the USA pose a continuing challenge to the privacy of mental health information. The individual right to privacy must be continually reasserted against competing, larger societal pressures. The need for ongoing, informed discussion in this vital (and contentious) area is obvious.

The contributors to this volume deserve congratulation for injecting a healthy, salutary dose of good, solid scholarship into the strident debate relating to the privacy and confidentiality of mental health information in the USA. It is to be hoped that its call for informed debate in this unsettled area will galvanise such discussion.

Much of the volume is work originally presented at the 1997 13th Annual Rosalynn Carter Symposium of the Carter Center Mental Health Task Force (Atlanta, Georgia). Contributors come from varied academic and professional backgrounds, including psychology, psychiatry, social work and law.

Ten illuminating chapters tackle thorny issues associated with the privacy of mental health information from various perspectives, including those of consumers, family members and clinicians. In critical but constructive discourses the expert contributors draw readers' attention to the legal aspects of the privacy of mental health information. Attention is focused on the limits of confidentiality for HIV patients and on mental health information and confidentiality in the context of substance misuse.

The academic worth of this book is enhanced by numerous references and a succinct appendix, which summarises US state provisions for mental health confidentiality.

Although written in an academic style, the volume is not esoteric. In an incisive, sobering way it offers an abundance of informed views and advice which will be of value to all those interested in reshaping the existing laws on the privacy and confidentiality of mental health information in order to benefit both the individual and society. For such prospective readers, the volume is heartily recommended.