A nurse in an inpatient mental health facility is caring for a client who states, "I do not want anyone to know I am in a mental hospital." Which of the following responses should the nurse make?

A. "We have to notify your insurance company that you are here.": While insurance may require documentation for billing purposes, this statement does not address the client’s concern about confidentiality or privacy. It could increase anxiety and reduce trust in the nurse-client relationship. B. "We have to inform your immediate family members that you are here.": Family notification typically requires the client’s consent unless there is a safety concern or legal mandate. Automatically informing family without permission violates confidentiality and the client’s rights under HIPAA or similar privacy laws. C. "We have to report your admission to the National Alliance on Mental Illness.": Mental health admissions are not reported to advocacy organizations like NAMI. This statement is inaccurate and could cause unnecessary fear or confusion for the client. D. "We have to obtain your permission to discuss your care with others.": Respecting confidentiality is a core ethical and legal responsibility. The nurse should clarify that the client’s consent is required before sharing any information with others, which addresses the client’s concerns and supports trust in the therapeutic relationship.