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Friday, October 19, 2018

Risk Management Considerations When Treating Violent Patients

Kristen Lambert
Psychiatric News
Originally posted September 4, 2018

Here is an excerpt:

When a patient has a history of expressing homicidal ideation or has been violent previously, you should document, in every subsequent session, whether the patient admits or denies homicidal ideation. When the patient expresses homicidal ideation, document what he/she expressed and the steps you did or did not take in response and why. Should an incident occur, your documentation will play an important role in defending your actions.

Despite taking precautions, your patient may still commit a violent act. The following are some strategies that may minimize your risk.

  • Conduct complete timely/thorough risk assessments.
  • Document, including the reasons for taking and not taking certain actions.
  • Understand your state’s law on duty to warn. Be aware of the language in the law on whether you have a mandatory, permissive, or no duty to warn/protect.
  • Understand your state’s laws regarding civil commitment.
  • Understand your state’s laws regarding disclosure of confidential information and when you can do so.
  • Understand your state’s laws regarding discussing firearms ownership and/or possession with patients.
  • If you have questions, consult an attorney or risk management professional.
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