Release of Psychiatric Patient: Hospital Must Warn About Threats To Children

Release of Psychiatric Patient: Hospital Must Warn About Threats To Children

Legal Eagle Eye Newsletter for the Nursing Profession

October 1998

Quick Summary: A mental health professional must take steps to protect the person when a patient verbalizes a threat of harming a person who is readily identifiable.

   Professionals working in the mental health field have legal responsibilities not just to their patients.

   A mental health professional may have to warn the intended victim, or warn others to warn the victim, or notify the police where the victim lives or where the patient lives, or do anything else reasonably necessary for the person’s protection.

   This state hospital knew the mother had verbalized threats toward her children during therapy.

   The grandmother had the children while their mother was involuntarily hospitalized.

The hospital had a responsibility to warn the grandmother that the mother had verbalized an intent to harm her children. The hospital also should have warned that she was about to be released. SUPREME COURT OF SOUTH CAROLINA, 1998.

The Supreme Court of South Carolina ruled recently that it would join the majority of U.S. states that now follow the groundbreaking 1976 California Supreme Court case Tarasoff v. Regents of the University of California.

There is now a huge exception to the rule of medical confidentiality which says that mental health workers must take steps to protect any identifiable person against whom a patient has verbalized a threat or intention to do bodily harm.

In this case, during her involuntary psychiatric stay a patient verbalized an intention to harm her children after her release. Nevertheless, the state hospital did not contact the grandmother who had the children to warn her of the mother’s threats. Nor was the grandmother warned of the mother’s impending release.

Having found fault with the hospital, however, the court refused to enter a judgment against the hospital on behalf of one of the children in the civil lawsuit the grandmother filed for the child against the state department of mental health.

The mother went to the grandmother’s home and asked to see her three year-old child. The grandmother let her into her home, let her see the child and left her alone with the child. The child’s body was marked up with a felt-tip marker, including the vaginal area, but no medical evidence of sexual violation could be detected.

The court dismissed the suit. Without any specific warning from the state hospital, the grandmother knew anyway that the mother was a danger to her child, the court ruled. The grandmother was negligent to leave the child alone with her mother, and it was solely the grandmother’s negligence that caused harm to the child, the court said. Bishop v. South Carolina Department of Mental Health, 502 S.E. 2d 78 (S.C., 1998).