An Ounce of Prevention

Several of us at PRMS were talking the other day about the number of violent incidents in just the past few weeks where the alleged perpetrator was said to be mentally ill. Perhaps it’s our professional sensitivity to news events involving the mentally ill, or it could be that we’re located in Virginia and the negligence trial against Virginia Tech, arising from the mass murder in 2007, is ongoing. Still, one of our society’s continuing dilemmas is how to respect the rights of the mentally ill, while protecting society against violence. That issue is beyond the scope of this blog.

Rather, every time I hear about one of these events, I wonder if one of our customers will soon be calling us to report that he or she treated the accused and wants to report a potential claim. Sadly, sometimes that happens. I would ask you, when you hear of a violent event in your community, do you instinctively wonder whether the suspect might be a particular one of your patients? Do you worry that one of your current patients might become violent?

Over the past 30+ years, almost every state legislature or court has addressed the issue of the psychiatrist’s duty to protect society from the violent mentally ill. The legal/psychiatric shorthand for this obligation is the “Tarasoff Rule,” after the seminal California case in the 1970s. The various states have taken varied approaches to dealing with the issue: some states have held that there is no duty, others say there’s some kind of limited duty, and still others have imposed a very broad duty on practitioners to protect society in general and to warn certain “targeted” individuals.

You need to know that if you’re insured through PRMS, our Risk Management department can get you the assistance you need to determine any reporting obligation you may have. Every day, legislatures amend long-standing statutes, and courts overturn long-standing precedents, so even if you dealt with this issue in the past, you should check with us if you face it again in the future.