Providing mental health care in the context of online mental health notes: advice from patients and mental health clinicians

Maura Pisciotta, Lauren M. Denneson, Holly B. Williams, Susan Woods, Anais Tuepker, Steven K. Dobscha

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background: The OpenNotes initiative provides patients online access to their clinical notes. Mental health clinicians in the Veterans Health Administration report a need for guidance on how to provide care, write notes, and discuss them in the context of OpenNotes. Aim: To provide mental health clinicians recommendations identified by patients and clinicians that help them effectively practice in the context of OpenNotes. Method: Twenty-eight mental health clinicians and 28 patients in mental health care participated in semi-structured interviews about their experiences and perceptions with OpenNotes. A rapid review approach was used to analyze transcripts. Results: Analysis of interviews identified three domains of advice for mental health clinicians: writing notes that maintain the therapeutic relationship, communicating with patients about their notes and utilizing clinical notes as a patient resource to enhance care. Specific recommendations are provided. Conclusion: Findings provide mental health clinicians with guidance from service users and clinicians on how to leverage clinical notes to maintain–and potentially enhance –therapeutic relationships in a healthcare system in which patients are able to read their mental health notes online.

Original languageEnglish (US)
Pages (from-to)64-70
Number of pages7
JournalJournal of Mental Health
Issue number1
StatePublished - Jan 2 2019


  • Health information technology
  • mental health
  • patient portal
  • veterans

ASJC Scopus subject areas

  • Psychiatry and Mental health


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