Most states have laws that require or allow psychiatrists to disclose information about patients who may become violent. These laws are receiving increased attention in the wake of recent mass shootings such as those in Aurora, Colorado, and Newtown, Connecticut. A New York law enacted on January 15, 2013, transitions the state`s law from a permissive obligation to one for psychiatrists to report when they believe patients may pose a danger to themselves or others, but protects therapists from civil and criminal liability for failure to report if they act “in good faith.” New York`s new law also allows law enforcement to remove firearms from patients who may be dangerous. (Note: Please refer to the table below for updating.) (a) A health care provider who has reason to believe that a person has a substantial risk of harm to themselves or another person under clause 51.15 (1) (ar) 1, 2, 3 or 4. Complies with any obligation to notify a third party by taking any of the following actions: 4. Take other steps that a reasonable health care provider would consider to be fulfilling the obligation to warn a 3rd party of a substantial likelihood of harm. Opinions on laws differ. The American Psychological Association has advocated that psychiatrists exercise professional judgment on the duty to warn and not unnecessarily expand exemptions for “dangerous patients.” According to some experts, mandatory reporting laws can discourage people from seeking professional help or fully disclosing their intentions; Or, providers may be reluctant to treat potentially violent patients because they fear being held accountable for failing to comply with the duty to warn. According to ethical standards dating back to the Roman Hippocratic Oath, physicians and psychiatrists are generally required to maintain the confidentiality of information disclosed to them by patients in the context of the doctor-patient relationship. With a few exceptions, codified in federal and state law, medical professionals can be held legally liable for breaches of confidentiality.
One exception stems from an effort to protect potential victims of a patient`s violent behaviour. California courts have psychotherapists in Tarasoff v. 1976. The Regents of the University of California. This case triggered the adoption of “duty to warn” or “protect” laws in almost every state, as summarized in the map and in more detail in the table below. (b) If a person is not placed in the custody of a facility referred to in subsection 51.15 (3) and is not voluntarily admitted to an inpatient psychiatric unit, a health care provider who takes any of the measures referred to in clause (a) is no longer required to seek involuntary treatment, emergency detention, emergency stabilization or obligation of the person; tie up or physically isolate the person; prevent the person from leaving the hospital; or to provide treatment or medication without the person`s consent. In this field, you can perform a full-text search or enter the name of the report. * Arizona, Delaware, and Illinois have different responsibilities for different professions.
2. Contact the county department whose health care provider reasonably believes is responsible for approving the need for emergency detention of the person under subsection 51.15 (2) and for disclosing knowledge of potential evidence of a substantial likelihood of harm under section 51.15 (1) (ar) 1st, 2e, 3rd or 4th (2) authorization. Any health care provider, as referred to in p. 146.816(2)(b) 4. or 5., and any enforcement officer may disclose information demonstrating a substantial likelihood of serious bodily harm to another bona fide person in order to prevent or reduce a serious and imminent threat to the health or safety of any person or the public. (4) Liability. Any person or health care provider acting in accordance with this Section shall not be liable under civil or criminal law for acts performed in good faith. In a civil action, the good faith of the actor is presumed. Anyone who claims that the person acting in accordance did not act in good faith bears the burden of proof of that allegation with clear, satisfactory and convincing evidence. (1) Definition. In this section, “health care provider” has the meaning given in § 146.81(1).
Sources: NCSL Staff Research; Edwards, Griffin Sims. State Tarasoff Laws Database, February 2010; Soulier, M., et al. “Status of the psychiatric duty to protect, ca. 2006.” J Am Acad Psychiatry Law 38: 457-73, 2010. Doctors, psychiatrists, psychologists, social workers, professional counsellors or health professionals. Requires others providing services to a psychiatric patient to inform the appropriate health care professional of threats. 1. Contact a law enforcement officer about the person and disclose knowledge of potential evidence of a substantial likelihood of harm in accordance with clause 51.15 (1) (ar) 1, 2, 3 or 4.3. If the health care provider is a representative of the district department responsible for approving the need for emergency detention in accordance with section 51.15(2) and is authorized by that district department to approve or deny the need for emergency detention in accordance with section 51.15(2), emergency detention authorizes the person.