MANAGEMENT OF THREATS OF VIOLENCE UNDER CALIFORNIA DUTY-TO-PROTECT STATUTE

Objective: This is the first study to assess clinical practices under one of the new duty to-protect statutes, some version of which has bee n passed in many states. In 1985, California enacted a statute enablin g psychotherapists to limit their liability when a patient makes a ser ious threat of violence by I) making reasonable efforts to warn the vi ctim of the threat and 2) notifying local police. Method: The authors examined all duty-to-protect notifications over a 5-year period in San Francisco by reviewing police and court records. Results: Police rece ived only 337 notifications, typically made by nondoctoral staff membe rs at public facilities such as psychiatric hospitals and crisis clini cs. Patients most commonly directed their threats toward family member s. Of the patients who made threats resulting in notifications, 51% ha d prior arrest records, and 14% had subsequent arrests. Only 52% of th e patients who made threats were civilly committed. Conclusions: The f indings suggest that 1) clinicians rarely discharge the duty to protec t in the manner specified by the law, 2) many patients whose threats r esult in notifications have extensive involvement with the criminal ju stice system, and 3) family intervention may have clinical relevance i n many duty-to-protect situations.