November 5, 2026 - Xavier Flanagan, Founder

How to get your mental health records in the US

The short answer: yes, in most cases. Your mental health records are health information, and the HIPAA Privacy Rule gives you a right to see and get a copy of the records a provider holds about you. That includes records from a psychiatrist, psychologist, therapist, counselor or primary care doctor, and from a hospital or inpatient unit.

There is one real exception, and it is narrower than many people think: a therapist’s separate “psychotherapy notes”. This guide explains what those are, what is still yours to ask for, when a provider can say no to the rest, and what you can do if you are refused. It was checked against the federal regulations in November 2026. It is general information, not legal advice.

The short version

You can ask. HIPAA’s right of access covers almost everything in your mental health record: diagnoses, medications, treatment plans, test results, progress and visit summaries.
The exception: psychotherapy notes, a therapist’s own notes about what was said in a session, kept separate from the rest of your record, are not covered by the right of access.
Timing: a provider must act within 30 days, with one extension of up to 30 more if it tells you in writing why and when.
Cost: only a reasonable, cost-based fee for making the copy.
Limits: other records can be withheld only on narrow grounds, such as a licensed professional judging that access is reasonably likely to endanger your life or physical safety, or someone else’s. You can have that decision reviewed by another licensed professional.
If you are refused: you should get a written denial. You can complain to the provider, and to the federal Office for Civil Rights within 180 days.

What the law says

The right of access is in the HIPAA Privacy Rule, at 45 CFR 164.524. It gives you a right “to inspect and obtain a copy” of the health information a provider or health plan holds about you in what the rule calls a designated record set: in plain terms, your medical and billing records. It applies to health care providers and health plans covered by HIPAA. Most providers are, but not all: a provider is covered only if it handles certain insurance and billing transactions electronically, so some therapists who take only private payment fall outside HIPAA. If yours does, your state’s law on medical records may still give you a right of access. Our article on your HIPAA right of access covers the general rules in more detail.

The rule names two things that are outside the right of access: psychotherapy notes, and information put together for a lawsuit or other legal proceeding. A provider can also refuse, without a review, information that someone other than a health care provider gave under a promise of confidentiality, where access would be reasonably likely to reveal who gave it. That can include what a family member told your therapist. Beyond those, the rest of your mental health record is yours to ask for.

What psychotherapy notes are, and what they are not

This is the part most people get wrong. “Psychotherapy notes” does not mean your whole mental health file. The regulation, at 45 CFR 164.501, defines them as notes recorded by a mental health professional “documenting or analyzing the contents of conversation” during a counseling session, and only when they are “separated from the rest of the individual’s medical record”.

The same definition then lists what psychotherapy notes do not include. These stay part of your record, and stay covered by your right of access:

medication prescription and monitoring
counseling session start and stop times
the modalities and frequencies of treatment you received
results of clinical tests
any summary of your diagnosis, functional status, treatment plan, symptoms, prognosis and progress to date

So if a provider tells you “mental health records can’t be released”, that is not what the rule says. Your diagnosis, medications, treatment plan and progress are in your record, and you can ask for them. What can be held back is a therapist’s separate notes on the conversation itself. A refusal of those notes is not one you can have reviewed under HIPAA, but nothing stops you from asking your therapist whether they are willing to share or talk them through with you.

When other records can be withheld

For the rest of your record, a provider can refuse access only on a short list of grounds. The ones most relevant to mental health care are where a licensed health care professional has determined, “in the exercise of professional judgment”, that:

access is “reasonably likely to endanger the life or physical safety” of you or another person; or
the record mentions another person (other than a health care provider) and access is reasonably likely to cause substantial harm to that person.

Notice the standard. It is about endangering life or physical safety, not about the notes being upsetting or the provider preferring you not read them. And a refusal comes with protections:

You can have it reviewed. If access is refused on one of these grounds, you have the right to have the decision reviewed by a licensed health care professional, chosen by the provider, who did not take part in the original decision. The provider must follow the reviewer’s decision.
You get the rest. The provider must, “to the extent possible”, give you everything else you asked for, after taking out only the part it has grounds to withhold.
You get it in writing. A denial must be written in plain language, give the reason, explain your review rights where they apply, and tell you how to complain to the provider and to the federal government.

How to make the request

Work out who holds what. Your therapist or counselor, your psychiatrist, your primary care doctor, any hospital or inpatient program, and any clinic you were seen at. Each keeps its own records.
Ask in writing. A provider can require a written request, as long as it tells you so, and many have their own form. Give your name, date of birth and dates of treatment, and say what you want, such as your complete record, or your treatment plans, diagnoses and progress summaries.
Say how you want them. If the records are electronic and you ask for an electronic copy, the provider must give you one in the form you ask for if it can readily produce it. A PDF is usually easiest.
Ask about cost up front. The rule allows only a reasonable, cost-based fee covering the labor of copying, supplies for a paper copy, or for a USB drive or disc if you ask for your electronic copy on one, postage if you ask for it to be mailed, and a summary if you agree to one in advance.
Keep a copy of your request and the date you sent it. The 30 days run from when the provider receives it.

If you are refused, or nobody answers

Ask for the review, if it applies. If the denial was on a safety ground, your written denial should explain how to ask for the review by another licensed professional.
Complain to the provider. Every denial must tell you how to complain to the provider, with the name or title and phone number of who to contact.
Complain to the Office for Civil Rights. You can file a complaint with the Office for Civil Rights at the Department of Health and Human Services. It must be in writing, on paper or online, and filed within 180 days of when you knew, or should have known, about the problem, though that limit can be waived for good cause.

State law can give you more

HIPAA is a floor, not a ceiling. Where a state law gives you greater rights of access to your own health information, HIPAA does not override it, and the provider has to follow the state law. State rules differ, so if you are refused, it is worth checking what your state’s law says about access to mental health records.

The federal information blocking rules, which come from the 21st Century Cures Act, made sharing your electronic health information the expected norm in health care. Their definition of that information also leaves out psychotherapy notes, so the same exception carries over.

A word on reading your own records

Clinical notes are written for clinicians. They can use blunt language, shorthand and diagnostic labels that read very differently on the page than they did in the room. Some people find that confronting. It can help to read them with someone you trust, or to ask your clinician to go through them with you. If reading them brings up something difficult, you can call or text 988, the Suicide & Crisis Lifeline, at any time, day or night.

If you think something in your records is wrong, HIPAA also lets you ask the provider to amend it.

Where exora fits

Once you have your records, you can upload them to exora along with the rest of your health documents. exora reads them and organizes the conditions, medications and history into one record you control, with every detail linked back to the page it came from. You choose what to upload and who, if anyone, it is shared with. How exora handles your information is set out in our privacy policy. exora is free to start, with an optional membership.

exora does not connect to your therapist’s software or your providers’ systems, and does not request records for you. It works with the documents you request and decide to add.