Duty to protect

Confidentiality and Duties to Third Parties

Dr. Katherine Michaelsen, CMHPL core faculty member, contributed to educational modules on confidentiality and duties to third parties, free to access via the Yale website. The modules are designed to teach general psychiatry residents about basic concepts in forensic psychiatry using an interactive, case-based format. Each module takes approximately 20 minutes to complete.

This work was supported by an educational grant from the AAPL Institute for Education and Research.

Confidentiality

Upon completion of the module, you will be able to:

  1. Understand the concepts of confidentiality, privilege, and privacy
  2. Identify common legally allowable exceptions to confidentiality under state and federal law (i.e. HIPAA)
  3. Identify the steps to take when you receive a subpoena to relinquish medical records
  4. Apply your understanding to clinical encounters

Duties to third parties

Upon completion of the module, you will be able to:

  1. Identify the relevant Tarasoff requirements in your state and know how to find them
  2. Distinguish between various types of Tarasoff laws
  3. Know the options available to you when a patient verbalizes a threat to an identifiable victim
  4. Apply your understanding to clinical encounters

Access Modules

Note: These modules were developed for a national resident audience.  They give an overview of mental health clinicians’ duty to warn/protect and discuss national variation, but do not describe the law specific to Washington State. 

Washington law on the duty to protect is currently governed by: 

  • Volk v. DeMeerleer (duty to protect foreseeable victims from a patient’s violent propensities; voluntary treatment settings); and
  • RCW 71.05.120 (duty to warn or take reasonable measures to protect when a patient has communicated an actual threat of physical violence against reasonably identifiable victim(s); involuntary treatment settings). 

Legal Update on Duty to Protect

University of Washington Psychiatry & Addictions Case Conference series

Presenter: Jennifer Piel, MD, JD

September 17, 2020

View slides (no recording of presentation)

Objectives:

  • Understand the legal basis for mental health clinicians’ duty to protect
  • Distinguish legal duties under statutory and common law in Washington state
  • Appreciate how to approach the duty from a clinical perspective

Protection of Third Parties and Assessment of Dangerousness: What Do I Need to Do When My Patient Makes a Threat Toward Someone?

University of Washington Psychiatry & Addictions Case Conference series

Presenter: Jennifer Piel, MD, JD

April 26, 2018

View slides (no recording of presentation)

Objectives:

  • Review legal and ethical obligations
  • Identify risk factors for violence
  • Develop techniques to assess dangerousness