Law & psychiatry: Can a psychiatrist be held responsible when a patient commits murder?
Explore the source record for details and available documents.
SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
OBJECTIVE: This study assessed the extent to which clinical characteristics, psychiatric status, and use of mental health services explain incarceration for technical violations of probation or parole rather than incarceration for new offenses. METHODS: A total of 250 clients of an urban psychiatric probation and parole service were screened for psychiatric diagnoses and monitored with a 12-month data collection protocol. Longitudinal analysis was used to explain incarceration on new charges, incarceration on technical violations of probation and parole, or absence of incarceration. RESULTS: Eighty-five individuals (34 percent) were incarcerated during the follow-up period. Forty-four (18 percent) were incarcerated for a new offense, and 41 (16 percent) were incarcerated for a technical violation. Participation in mental health treatment was associated with a lower risk of incarceration for a technical violation. Intensive monitoring by mental health providers, such as through case management and medication management, were significant risk factors for incarceration for a technical violation. Clients who were incarcerated for a technical violation were more than six times as likely to have received intensive case management services. CONCLUSIONS: The role of mental health services in reducing the risk of incarceration remains mixed. Providing services that emphasize monitoring tends to increase the risk of incarceration for technical violations of criminal justice sanctions. However, any participation in treatment and motivation to participate in treatment appears to reduce the risk of incarceration.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
OBJECTIVE: Theories of perceived risk state that when people feel threatened, they will react more strongly than they would otherwise. This study tested the hypothesis that evaluations for involuntary psychiatric hospitalizations that were initiated by law enforcement personnel in Florida increased in the weeks after the attacks of September 11, 2001. METHODS: The authors applied interrupted time-series designs to determine whether there was a relationship between the number of involuntary psychiatric examinations initiated by law enforcement officials and the attacks of September 11, 2001. They examined the number of psychiatric evaluations of men and women who were considered to be mentally ill and harmful to others by law enforcement personnel in Florida during seven-day periods ("areal" weeks) that began with Tuesday, July 6, 1999, and ended with Monday, December 31, 2001 (because September 11, 2001, fell on a Tuesday). RESULTS: Over the 130 weeks of the study, law enforcement officials initiated examinations of an average of 25.96 men and 13.47 women per areal week. Law enforcement officials initiated examinations of approximately 14 more women than expected in the areal week that began with September 11, 2001. During the three areal weeks that began with September 18, 2001, a total of 34 more men than expected were presented for evaluation. These findings cannot be attributed to trends, seasonality, other cycles, or the tendency of the examination time series to remain elevated or depressed after high or low values in the series. CONCLUSIONS: Perceived general risk in a community may increase the likelihood that law enforcement personnel and the persons who summon them perceive persons with mental illness as imminently harmful. The public health response to any future terror attacks should include efforts to alert psychiatric service providers to the possibility of lower community tolerance for mental illness in the aftermath of an attack.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
There are many potential causes for malpractice actions in outpatient psychotherapy. Pertinent cases are reviewed, their implications discussed, and means by which practitioners can avert malpractice are described.
Psychiatrists, clinical psychologists, and family practitioners very rarely receive serious injuries from assaults by their outpatients or former patients. The rate of significant assault is comparable to that for nonpatient assault (e.g., mugging). No relationship between clinical experience and being an assault victim could be established.
The landmark cases on the "duty to warn" concept are reviewed. Two trends are noted in the court rulings. The first trend narrowly interprets the duty to warn as applying only to situations involving a serious threat to a specific individual. The second trend has broadened the doctrine to include warnings about patients who do not make threats and whose potential victims are unspecified. The authors argue that the original Tarasoff Doctrine is sound both from the perspective of public policy and psychotherapeutic practice, but that its broader interpretation is problematic for psychotherapists.
One hundred and one psychotherapists responded to a survey designed to obtain data concerning beliefs about various ethical issues encountered in psychotherapy. Opinions about ethical standards in many areas were quite varied for the entire sample. Differences also emerged when therapists were compared in terms of orientation and years of experience.
A large number of psychologists from the Division of Psychotherapy and the Division of Psychologists in Practice were surveyed to determine their attitudes about confidentiality. It was found that psychologists reference their personal code to a considerable extent when making decisions about breaching confidentiality and when providing information to their clients about confidentiality. Approximately one-fourth of the respondents believed in absolute confidentiality. These respondents were found to differ from those respondents who did not believe in confidentiality with respect to their actions as therapists, their beliefs about the effects of informing clients concerning limits of confidentiality, and their actually breaching of confidentiality. The two groups differed much less with reference to items that assessed knowledge of matters pertaining to confidentiality, as well as information afforded their clients. Possible stress and conflict experienced by those believing in absolute confidentiality, in light of legal and APA mandates, is discussed along with the need for future research.
OBJECTIVE: This study tested the hypothesis that contraction of regional economies affects the incidence of involuntary admissions to psychiatric emergency services by reducing community tolerance for persons perceived as threatening to others. METHODS: This hypothesis was tested with time-series analyses of the relationship between initial claims for unemployment in Florida between July 4, 1999, and June 28, 2003, and the weekly number of men and women presented by police to be examined for involuntary psychiatric hospitalization because of danger to others. The analyses controlled for admissions presented by mental health professionals because of danger to others and for admissions presented by police because of neglect or disability. RESULTS: When the analyses controlled for autocorrelation and other covariates, claims for unemployment insurance were significantly associated with the number of men presented by police for danger to others. During the study period, police presented 5,897 men for examination because of danger to others. Increased unemployment claims were associated with approximately 309 more men being presented for examination than expected from prior presentation rates and from the number presented by mental health professionals for danger to others and by police for neglect or disability. No such association was found for women. CONCLUSIONS: Consistent with theory, this study found that presentations for involuntary admission to psychiatric services increased after contractions in the labor market. Combining the methods of this study with econometric forecasting may allow providers to anticipate better the need for psychiatric services.