I will introduce open notes in the USA, and the new federal laws on sharing patient access that come into effect in April 2021. Taking a deep dive into mental health notes, I will ask: Is it ethical to share mental health notes? After reviewing the practice dilemmas in the context of mental health care, I will describe existing (and very recent) patient and clinician survey research from the USA. Throughout the presentation, I will identify a wide range of knowledge gaps that now require further empirical research.