Management of Threats of Violence Under California's Duty-to-Protect Statute

Abstract

The findings suggest that 1) clinicians rarely discharge the duty to protect in the manner specified by the law, 2) many patients whose threats result in notifications have extensive involvement with the criminal justice system, and 3) family intervention may have clinical relevance in many duty-to-protect situations.

The Relationship Between Command Hallucinations and Violence

“…If a patient reports that voices are giving commands to harm specific individuals, the patient's communication about such experiences may be on a continuum with threats. Consequently, a patient's report of command hallucinations to harm other people may prompt the clinician to consider various actions to protect the victims from the danger associated with the threatened violence (27).…”

Untitled

“…Some in psychiatry believe, "It is difficult if not impossible to envision a clinically realistic situation requiring a warning in which involuntary commitment is not also called for, as the levels of danger that are conditions for the two actions are indistinguishable" (Gutheil, 1995). However, one study showed that about half of the clients were hospitalized after the Tarasoff II notification for protection occurred (McNiel, Binder & Forrest, 1998). These findings suggest that a different interpretation was made by clinicians for civil commitment and for a Tarasoff II duty to protect third parties (p. 1100).…”

Assessment and management of acute risk of violence in adult patients.

“…Throughout the treatment, clinicians must remain aware of their legal duty to protect potential identifiable victims. The Tarasoff decision (Tarasoff v. Regents of the University of California, 1974California, , 1976 and subsequent court decisions and legislation established in many jurisdictions that when a patient makes a setious threat of physical violence, the psychotherapist has a duty to protect the intended victim (McNiel, Binder, & Fulton, 1998). To determine whether a threat is serious, the clinician needs to undertake a risk assessment for violence.…”