Violence by Mental Patients

The Therapist’s Job to Protect People from the Therapist’s Patient

Before the 1970s, mental health professionals had no personal legal responsibility if their patients turned violent against some outsider. Such outbursts were thought to be unfortunate and regrettable, yes, but subject to legal accountability, no. That changed with a shocking case in Berkeley, California. Since then, courts in a variety of states have said that mental health therapists can be subject to malpractice lawsuits for failing to protect certain foreseeable victims from violence by the therapists’ own patients.

The California case involved a graduate student at UC-Berkeley who became infatuated with a young woman named Tatiana Tarasoff. When she rebuffed him, the young man sought counseling with a psychologist at the university health service. He told the therapist he wanted to kill Ms. Tarasoff. The therapist reported this to campus police and the police warned the young man to stay away from Ms. Tarasoff. When she returned from a summer away, he stalked and fatally stabbed her. Her parents then sued the university. They claimed the therapist should have directly warned Ms. Tarasoff. The trial court threw the case out on the ground that the therapist owed a duty only to the patient, not to any outsider. Then the California Supreme Court ruled twice, in 1974 and then on a rehearing in 1976, that a mental health therapist did have a duty to protect an outsider under some circumstances. The court said:

“When a therapist determines, or pursuant to the standards of his profession should determine, that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. The discharge of this duty may require the therapist to take one or more of various steps. Thus, it may call for him to warn the intended victim, to notify the police, or to take whatever steps are reasonably necessary under the circumstances.”

The rules that apply to mental health professionals vary all over the map depending on the individual state and the court. At least 23 states have passed laws on the subject, and these also vary widely. Here is an article that reviews 76 court decisions relating to so-called Tarasoff liability. Some states now say that a therapist has a duty only to a specific identifiable victim who has been threatened by the patient. Others say the therapist’s duty applies to any foreseeable harm to any outsider.

Next: What Reasonable Therapists Need to Do to Protect The Public (and Protect Themselves from Legal Liability) when they have a Potentially Violent Patient

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