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Protecting third parties: a decade after Tarasoff.

M J Mills, G Sullivan, S Eth

    The American Journal of Psychiatry
    |January 1, 1987
    PubMed
    Summary
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    Psychiatric patient treatment policies require updates. Current laws may lead to overly restrictive clinical practices and less informed legal decisions regarding potentially violent individuals.

    Area of Science:

    • Forensic Psychiatry
    • Mental Health Law
    • Clinical Psychology

    Background:

    • Current public policy on managing potentially violent psychiatric patients is examined.
    • Legal and ethical precedents shaping these policies are outlined.
    • The evolution of therapeutic interventions concerning patient violence is discussed, particularly in light of the Tarasoff decision.

    Purpose of the Study:

    • To analyze the impact of current public policy on the treatment of potentially violent psychiatric patients.
    • To compare therapeutic approaches before and after the landmark Tarasoff decision.
    • To propose improvements for clinicians, legal standards, and legislative interventions.

    Main Methods:

    • Policy analysis of legal and ethical precedents.
    Keywords:
    Analytical ApproachLegal ApproachMental Health TherapiesProfessional Patient RelationshipTarasoff v. Regents of the University of California

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  • Comparative analysis of therapeutic interventions pre- and post-Tarasoff.
  • Review of clinical interpretations of legal standards.
  • Main Results:

    • Clinicians often interpret laws regarding patient violence too restrictively.
    • Existing liability standards in legal decisions lack clinical insight.
    • Legislative measures intended to absolve psychotherapists of liability may encourage reactive rather than thoughtful patient management.

    Conclusions:

    • Clinicians should be encouraged to apply a more nuanced interpretation of laws.
    • Courts must develop liability standards that are better informed by clinical practice.
    • Legislative changes specifying liability absolutions for warnings could inadvertently promote less effective patient care strategies.