Know Your Clients' Rights

Mental Health Providers are an oasis of privacy and trust in an increasingly information-hungry environment. 

This is especially true for issues of immigration. 

If you haven’t over the past year, it’s time to familiarize yourself with some of the basic rules and rights you and your clients have when questioned by law enforcement, Immigration and Customs Enforcement (ICE) or Border Patrol. 

The National Immigration Law Center has a useful 5 minute primer on this: https://www.nilc.org/resources/healthcare-provider-and-patients-rights-imm-enf/

It might be clinically relevant to understand your client’s immigration story. 

But it is probably not clinically necessary to chart whether they (or their loved ones) are here legally. In fact, determining their status for certain is outside of most therapists’ scope of competence. How much continuing education do you get in immigration law?

Me checking my grad school books for information on immigration law...

Furthermore, in 2025, prioritizing nonmaleficence (doing no harm), means understanding that harm can come from collecting more than the necessary information.

Over-documentation can reduce a client’s desire to share, reducing the clinical efficacy of the treatment. 

It can also put them or their loved ones at risk if their notes are brought up in court.

At one point, it was the standard of practice to document sensitive identity issues in the intake process. 

But again, in 2025, in America, the definition of good care needs to take multiple risk factors into account. 

Do not record immigration status. Again, unless you are specifically trained in immigrants issues and rights, this is probably outside of your scope to determine anyway.

And while we’re at it, give your clients the option to skip gender-identity questions on your forms. 

I hope, one day, these concerns will be irrelevant, but for now, let’s do our best with what we’ve got.

Good luck this week!