When is a bad outcome with a psychiatric patient unavoidable and when is it a sign of malpractice on the part of the mental health professional who was treating the patient?
Mental health professionals have a legal and ethical obligation to act when a patient is either suicidal or threatening harm to others. Psychiatric patients may tell their therapist or psychiatrist their plans as a cry for help. When those cries for help go unheeded, people suffer. Here are some of the most common reasons for mental health malpractice claims:
Abuses of the doctor-patient relationship
Therapists hold a special sort of influence over their patients. Patients trust them with their most intimate secrets. They rely on them during their most emotionally fragile moments. Therefore, a therapist has to be careful not to take advantage of that relationship in any way. It is never the patient's responsibility to establish boundaries.
Some examples of inappropriate behavior on the part of the therapist include allowing the patient to pay for services by "working off" the bill (by doing yard work, errands, office work and other tasks), having an affair with the patient, or using the patient's professional skills (like stock tips or tax advice) for personal gain.
Failure to respond appropriately to immediate dangers
When a patient's family contacts a mental health professional to express concerns about a patient's capacity for violence or self-harm, a mental health professional has to be cautious about what they reveal about the patient. That does not mean, however, that the clinician should ignore the family's concerns. They may be in the best position to know if a patient is entering a mental health crisis.
Other failures include dismissing a patient in crisis from the practice abruptly (possibly in an attempt to avoid liability), doing an initial suicide risk evaluation but no follow-up evaluations and not warning a third-party who may be at risk of violence from the patient.
Medical malpractice by mental health professionals often goes unrecognized. Unless psychiatrists and therapists who offer poor care are held accountable by victims and their families, more people may suffer.