Psychiatric treatment is often a difficult process for both doctor and patient. Because of this, strict guidelines have been set out to help doctors make the right diagnoses and prescribe the proper treatments, while providing the best standard of care for patients, and protecting the patient and other individuals from harm.

However, this does not always occur and patients are continually at risk because of errors made by health care professionals. Medical malpractice in the psychiatric fields is as common as other medical fields and often involves more than just the traditional doctor or patient.

Common forms of psychiatric negligence

• Failure to conduct a proper suicide risk assessment. The standard of care requires physicians to conduct a proper risk of suicide assessment on every potentially suicidal patient. If a doctors fails to properly assess the patient considering all the relevant factors such as patient history, age, gender, sexual orientation, employment and living standards, then he is at risk for potential litigation.
• Failure to prevent a patient’s suicide. If a proper suicide risk assessment has been performed and it has been determined there is a legitimate risk of suicide, a doctor must take steps to prevent that suicide from occurring. If he fails in this task, he could be judged guilty of malpractice.
• Improper diagnosis or treatment. While some people believe that many psychiatric diagnoses are ill-defined, this is simply not the case. Any mental health professional should be able to come to a definitive diagnosis assuming the proper patient assessment has occurred. However, if an improper diagnosis is made or if a doctor prescribes the incorrect treatment, a patient or their family have a strong case for malpractice against the doctor or mental health professional.
• Failure to warn. Extending further from the traditional doctor and patient relationship, courts have ruled that if a patient makes threats during sessions against another person, the clinician has a duty to warn this person of the potential threat if they believe it is credible. This can often be a difficult determination for the clinician as he/she must balance doctor/patient confidentiality versus their responsibility for the safety of others. If a patient acts on these threats, the victim’s families have a reasonable malpractice case to pursue.
• Boundary violations. It has been established there must exist a boundary between the healthcare professional and their patients. If the professional violates these boundaries or attempts to use his/her position as a means to, for example, illicit sexual encounters with their patients, he/she are guilty of malpractice and maybe even other felony crimes.
• False repressed memories. One of the most common treatments patients undergo is the process of revealing past memories that have been repressed. Many psychiatric health care professionals believe these memories to be the source of the mental health problems for many patients. If false memories are revealed and it causes irreparable harm to the patient or other individuals, the mental health care professional can be held liable for creating these false memories.

Malpractice case studies

Prosenjit Poddar, a student from Bengal, India, was rebuffed by Tatiana Tarasoff who wanted to see other men.  Poddar withdrew and became increasingly antisocial. Tarasoff left for South America and Poddar began to improve even seeing a psychologist. During his sessions, he confided in his psychologist revealing a plan to murder Tarasoff. When she returned, he stopped seeing his psychologist and carried out the plan he had told him about. Neither Tarasoff or her family received any warnings about the threat.

Tarasoff’s parents later sued the psychologist and other employees of the University of California. The court found that that a mental health professional has a duty to not just the patient, but also any individuals that have been threatened by the patient.

In Syracuse, New York, Joe Mazella, a well respected and popular high school coach, committed suicide after spending three years in the care of physicians and being prescribed antidepressants. After his death, his widow filed a lawsuit against the doctors treating him. Attorneys for the widow argued that Mazella would not have wanted to end his own life and the combination of negligence and low quality of care by the doctors along with three years on antidepressants that are known to cause suicide led to the beloved coach taking his own life.

The Supreme Court of the state of New York found that both doctors who treated Mazella were negligent and held one of the doctors liable for his death awarding the widow $800,000 for the loss of her husband’s income, $200,000 to his youngest daughter and $100,000 to each of his oldest daughters. In addition, $324,000 in interest was added to bring the total to $1.524 million.

Conclusion

Courts are increasingly recognizing the standard of care required for mental health care professionals and, in some areas, their responsibilities can extend far beyond just their patients. These cases represent just a small part of the malpractice cases facing mental healthcare professionals.

It is important for every mental health care professional to provide the highest standard of care possible at all times and to maintain the safety of not only their patients but any individuals that have been threatened by the patient. Failure to provide this type of care is grounds for malpractice and mental health care professionals should and are often held liable for these mistakes.

Image via Paul Matthew Photography / Shutterstock.