Will my therapist share my information with immigration?

This page is general information, not legal advice. Laws and federal policies are changing. For advice about your own case, talk with an immigration attorney or a DOJ accredited representative. See Free legal help in the Bay Area.

What is the short answer?

Your therapist is not part of immigration enforcement. In California, what you tell a counselor is protected by federal and state privacy law. A provider may not share your medical information for immigration enforcement unless you agree in writing or the law compels it. California also protects your immigration status itself as private medical information.

The protection is strong, but it is not total. A provider must follow certain legal demands, such as an order from a California or federal court or a search warrant signed by a judge. Counselors must also act when someone is in danger or a child is being abused. Below, we explain each case so you can decide with clear eyes.

Who can see my counseling records?

You can. You have a right to see and get a copy of your health records. The provider must act on your request within 30 days, and may take one 30 day extension.

People you allow. You can sign a form that lets your provider share records with someone you choose, like another doctor or a lawyer. You decide what is shared and for how long. You can say no.

Your care team and your health plan. Federal law lets a provider use and share your information for treatment, payment and the clinic's normal operations without your signature (45 CFR 164.506). Psychotherapy notes are an exception (see below). These everyday uses do not appear on the list of disclosures described below.

No one else, in most cases. In California, a provider generally may not share your medical information without your written permission, except in cases the law lists.

Does my counselor need to know my immigration status?

Counseling is about how you feel, not your papers. You can choose what you talk about. Many people find it helps to talk about immigration fears, and that is welcome. But you decide.

If a form asks about status and you are not applying for Medi-Cal or another benefit, you can ask why it is needed and whether you can leave it blank.

If you do share it, California law treats your current or past immigration status and your place of birth as medical information once a health provider knows it. That gives it the same protection as the rest of your health record.

Can immigration agents get my records?

California law says health providers, health plans and their contractors may not share medical information for immigration enforcement. There are three exceptions:

1. You give written permission.
2. The law compels it. The main examples are an order from a California or federal court, and a search warrant signed by a judge. Providers may not follow court orders from other courts unless a California court orders it.
3. Another listed exception applies. The law has a short list of other permitted disclosures.

Federal privacy law (HIPAA) sets a minimum. It allows some sharing with law enforcement, including in response to some administrative requests. But federal law does not override a state privacy law that gives you stronger protection. In California, the stronger state rule on immigration enforcement applies.

What are psychotherapy notes?

Some therapists keep private notes about what was said in a session, separate from your main record. Federal law gives these "psychotherapy notes" extra protection. In most cases, a provider must get your written permission before sharing them with anyone. The law does have narrow exceptions, such as some legal proceedings and oversight of the therapist.

These notes are also one of the few things you may not have a right to see yourself. The rest of your record is still yours to see.

When does a counselor have to share?

These rules apply to everyone, with or without papers. They are about keeping people safe.

• A serious threat of violence. If you tell a therapist you will seriously hurt a specific person, California law says the therapist must make reasonable efforts to warn that person and the police. Federal law also allows sharing to prevent a serious and imminent threat to someone's health or safety.
• Child abuse or neglect. Psychologists, marriage and family therapists, clinical social workers and professional clinical counselors are mandated reporters in California. They must report suspected child abuse or neglect.
• A court order or judicial warrant, as explained above.

Talking about stress, fear, sadness, your past, how you came here, or your immigration worries does not by itself trigger any of these. If you are unsure, ask your counselor before you share: "If I tell you this, would you have to report it?"

Can my records be used in court?

In California courts, you have a privilege to keep your private conversations with a psychotherapist from being revealed, and to stop others from revealing them. The privilege has exceptions. In federal courts, the U.S. Supreme Court recognized a similar privilege for licensed psychotherapists and licensed clinical social workers in 1996.

We did not find an official source that says whether this privilege applies in immigration court. If you are thinking about using counseling records or a psychological evaluation to support your own immigration case, such as asylum, talk with your immigration lawyer first about who will see them and how they will be used.

Are drug and alcohol treatment records different?

Yes. Records from federally assisted substance use treatment programs have extra federal protection under 42 CFR Part 2. These records cannot be used to investigate or prosecute you without your written consent or a court order. A subpoena alone is not enough. The court must first enter a special order under these rules. Programs had to follow updated federal rules by February 16, 2026.

Can immigration agents come into the clinic?

In January 2025, the Department of Homeland Security rescinded its earlier policy that limited immigration enforcement at places like hospitals and clinics. ICE now decides case by case. That is why California's own rules matter.

Under California law since September 20, 2025:

• Health care providers that receive public funds must mark the areas where patients get care or discuss private health information as not open to the public.
• They may not let anyone into those areas for immigration enforcement without a valid judicial warrant or court order that specifically allows it, unless state or federal law requires it.
• Staff must send any request for access to a patient, a site or patient information to a manager, administrator or lawyer right away.

For what to do if agents come anywhere, see If immigration agents come.

What about my Medi-Cal records?

This is a separate issue from what you tell a counselor. The California Department of Health Care Services says a federal court ruled on December 29, 2025 that limited Medi-Cal enrollment information about people who are not lawfully residing in the U.S. may be shared with ICE. That includes immigration status, address, phone number, date of birth and Medicaid ID. The state says sensitive health records remain protected. The lawsuit is still going on. Canceling Medi-Cal does not erase information already sent.

If this worries you, talk with an immigration attorney before you make any choice about your coverage. See Mental health care without fear.

What about teens?

Teens 12 and older in California can often agree to their own outpatient counseling. Parents are usually involved, unless the counselor decides that would be inappropriate. A provider can also deny a parent access to a minor's records in some cases, such as when access would harm the teen's safety or wellbeing or the provider's relationship with the teen. What a student 12 or older tells a school counselor is confidential and stays out of the school record without written consent, with exceptions for safety, abuse reporting and court orders. See Where your child can get mental health help and Where a teen can talk to someone right now.

How can I check who has seen my records?

• Ask for an accounting of disclosures. You can ask for a list of disclosures from up to six years back. The first one in any 12 months is free. The provider must act within 60 days, with one 30 day extension allowed. Routine sharing for treatment, payment and operations is not on the list. In rare cases, law enforcement can ask the provider to delay your list for a time.
• Ask to fix a mistake. If something in your record is wrong or missing, you can ask the provider to correct it. They must answer within 60 days, with one 30 day extension. If they say no, you can write a statement of disagreement that stays with your record.
• Ask for a copy. Many clinics have a simple form for each of these. Ask the front desk.

What if I think my privacy was broken?

Write down what happened, when, and who was involved. Ask to speak with the clinic's manager or privacy office. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, online or in writing. If your immigration case could be affected, talk with an immigration attorney right away.

What should I ask before I start?

Questions people ask

Will my therapist call ICE? Counselors are not immigration agents, and California law bars providers from sharing medical information for immigration enforcement except in the limited cases above.

Can my employer find out? Not from your counselor without your written permission, except in the limited cases on this page.

Is calling 988 private? 988 says conversations are free and confidential. See Calling or texting 988: what happens and privacy.

Who can help

Contact them to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

• Free and low cost immigration legal help: see Free legal help in the Bay Area and How to find a trusted lawyer
• Counseling in San Mateo and Santa Clara counties: see Mental health care without fear
• U.S. Office for Civil Rights, privacy complaints: hhs.gov/hipaa/filing-a-complaint
• 988 Suicide & Crisis Lifeline: call or text 988, or chat at 988lifeline.org. Free and confidential, available 24/7/365. Spanish: dial 988 and then press 2, or text AYUDA to 988. 988lifeline.org

Your story is yours. The law gives you real protection, and you have the right to ask questions until you feel safe. Getting help for your heart and mind is worth it.