EMRs for mental health?

I’ve been wondering, has anyone in mental health truly had success with an EMR? I can’t imagine any psychotherapist sitting at a computer typing notes while there’s a patient on the couch. That would be particularly bad for a patient with self-esteem issues.

I imagine that tablets like the iPad may make this a little easier, but what psychotherapists really need is something like a pen tablet (with a stylus rather than touch-screen) or digital ink to mimic taking notes on a pad of paper.

The other issue related to EMRs in mental health is the exchange of notes with other physicians. Will an electronic note from therapist back to the primary care physician wind up in the electronic chart that might get sent, say, to an orthopedist or gastroenterologist? The only thing other specialists really would need to know is the patient’s medication list, not a psychiatric diagnosis or treatment history, right? Segmenting out sensitive parts of an EMR like treatment for mental health and sexually transmitted diseases is something vendors and CIOs have struggled with for years, and I believe continue to struggle with.

In both cases, I’d love to hear your anecdotes here.