Regulation and Law

Duty to Protect and Warn Laws

Duty to warn gives doctors, counselors and therapists the right and obligation to breach confidentiality if they believe a client poses a risk to another person.

Regulation

Requirement To Report

Example: Wisconsin.51.17, States Warning of dangerousness. “(a) Any healthcare provider that reasonably believes and individual has a substantial probability of harm to himself or herself or to another person…”

  1. Contacting a law enforcement officer regarding the individual and disclosing knowledge of potential evidence of a substantial probability of harm…
  2. Contacting the country department that the healthcare provider  reasonably believes is responsible for approving the need for emergency detention of the individual

Which Staff have the Duty?

Healthcare Providers, Mental Health Professionals including General Physicians, Psychiatrists, Psychologists, Psychotherapists, Nurses, Social Workers, Marriage Counselors, data collectors, employees under supervision, and their secretaries, clerks, and stenographers.

This information does not constitute legal advice and should not be relied upon as a substitute for seeking legal counsel.

Patient Case

“this is an emergency, hang up and call 911”

Our primary care telehealth practice has been seeing a patient for the past year.  Late January she told her psychiatrist over telehealth she was going to kill herself.  The psychiatrist said this was an emergency and told the patient to “hang up and call 911” to receive in-patient care. They hung up and the patient did not call 911. A few days later she called her psychologist, said she was going to kill herself by taking pills, and again was told to “hang up and call 911.”   The patient hung up.  The patient didn’t call.

On Tuesday afternoon the next week, she took a whole bottle of hydroxyzine pills and OTC pills. A few minutes later she called our telehealth practice in Little Falls, NJ and told us she had “done something stupid.”  She is normally in Bergen county but this week she was in Toms River many hours south.  We have emergency telehealth protocols and were able to activate 911 in Toms River.  She became altered to the point she could not open the front door, so our providers coordinated with police and EMS to enter and identify the pills.  She made it to the emergency department and survived.

The psychologist and psychiatrist had no idea what happened until we called them a few days later.  The psychiatrist does not track how many patients she asks to go to the ER or call 911 and does not follow up to find out what happened.

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