I read with great interest the article in the October 15 issue about the breach of confidentiality of psychiatric records by the New York Times.

I would like to share a few thoughts on the subject. I worked in several mental hospitals in New Jersey and Virginia. I observed that in all those institutions patients’ records were located in the nursing station and were accessible to all who were making entries. All the personal information about the patient’s past and current status was available to all those people. No secrets.

When I worked in a mental hospital in my native Poland, the situation was different. The patients’ records were kept in my office locked in a drawer. No one had access to a patient’s record but me. No one made entries in the record but me. Nurses and other ward personnel reported to me about the patient but not to the record, and I summarized the information in the patient’s record. The diagnostic conference (if any) in which the patient was presented, the record was reviewed, and the case discussed was attended by psychiatrists only. In my opinion the system assured complete confidentiality of the record.

Michael J. Rostafinski, M.D.

Petersburg, Va.