Tarasoff/duty to warn

[AlmostaPhD]

Hi all-
A situation recently came up at my workplace in relation to duty to warn about threats made by patients. Colleagues and I determined that the threat was credible and specific enough that we ought to make a report (we are in a state where we MAY report but not MUST report). Law enforcement was called. Because the patient claimed to not have the intended victim's phone number or exact address (city and street, but not number) we have no way of notifying the potential victim (that I can think of) and I'm frankly not confident that the police will do so as they said they'd need the street address to notify the potential victim but would talk to the patient and see if they could get it from them.

I have not yet been updated (and don't know if I will be) but I am wondering if there is more we can/should do. I obviously can't provide a lot of details on here but the basic gist is that I am concerned about this patient who has access to lethal means and apparent desire to harm this third party. The patient denied a specific plan currently but seemed cagey about this. They noted that the most recent time of elevated intent was yesterday. Has anyone had to deal with this? This is my first time actually getting to the point where we had to report something like this. Any advice?

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[deleted343839]

Does your employer have legal counsel? I'd start there. Also see if your state psych association has a legal consultant you can contact.

 

[foreverbull]

A Matter of Law: Psychologists’ Duty to Protect

When a therapist determines, or pursuant to the standards of his profession should determine, that his patient presents a serious danger of violence to another [person], he incurs an obligation to use reasonable care to protect the intended victim against such danger.

www.apaservices.org

The statutes vary by state, and this issue is such a huge gray area that I would be hesitant to offer any advice other than consult, consult, consult and document. Whomever your employer’s malpractice insurer/risk management company is should be able to speak to this and/or legal counsel, etc. I would also stay in consultation with your colleagues at work about the situation.

This is definitely one of the most complicated and anxiety-provoking ethical issues to have to face in practice, so I feel for you. Make sure that whatever the consultants encourage and you do to cover your bases, you remind yourself that you’ve done your best in following appropriate protocol.

 

[PsyDr]

In the case of emergencies, I tend to do what I think is most ethical. And I consider how to phrase it so the headline would be on my side.

“I’d prefer to make a patient uncomfortable than a citizen dead. Maybe the state disagrees but I think saving someone’s life is the right thing to do.”

Phrasing like that forces the trier of fact to answer the question. The board is then faced with justifying which position it takes.

Read: When The Headline is You