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    Optional Mental Health Disclosure

    The Student Optional Disclosure of Private Mental Health Act, 110 ILCS 74/1 et seq. requires that institutions of higher learning maintain a policy that provides all students the opportunity to authorize, in writing, the disclosure of certain private mental health information to a designated person. A designated person is defined by this Act as a parent, guardian, or other person over the age of 18 designated by a student to receive disclosure of certain private mental health information. The choice to designate a contact person is at the student’s discretion.

    What information will be disclosed?
    Under the Student Optional Disclosure of Private Mental Health Information Policy, Triton College may disclose a student’s mental health information to the student’s designated person if a physician, clinical psychologist, or qualified examiner who is employed by Triton College makes a determination that the student poses a clear danger to himself, herself, or others. In order to protect the student or other person(s) against a clear, imminent risk of serious physical or mental injury or disease or death being inflicted upon the person(s) or by the student on himself, herself, or another, Triton College may disclose the student’s mental health information as set forth herein. The information by the qualified examiner will be disclosed to the designated person as soon as practical, but in no more than 24 hours after making the mental health determination.

    Who is a qualified examiner?
    A qualified examiner is defined by 405 ILCS 5/1-122 of the Mental Health and Developmental Disabilities Code Act as a clinical social worker, a registered psychiatric nurse, a licensed clinical professional counselor or a licensed marriage and family therapist.

    If you wish to designate a contact person, please click HERE to complete the Student Optional Disclosure of Mental Health Information Form.

    THIS INFORMATION WILL BE STORED CONFIDENTIALLY AND SECURELY. ONLY TRITON COLLEGE COUNSELORS, THE DEAN OF STUDENT SERVICES, AND THE DEAN OF ENROLLMENT SERVICES MAY ACCESS THESE FORMS.

    This form will remain valid until the student revokes authorization by notifying the College in writing that s/he is withdrawing this authorization. Additionally, students wishing to change the name for the designated contact person may do so by submitting a new Optional Disclosure of Mental Health Information Form.

    FOR MORE INFORMATION ABOUT THIS ACT AND DISCLOSURE, PLEASE CONTACT A TRITON COLLEGE COUNSELOR AT 708-456-0300, EXT. 3588.