Assignment: Duty to Warn and Protect

Your client has told you that he plans to kill someone. You figure out the identity of his intended victim, although he has not specifically told you. What do you do?

This was a predicament that psychotherapist Lawrence Moore faced in 1969. Moore did not specifically warn the intended target, but told the authorities about his patient's threat. The patient was found to be rational and released, but then carried out his threat to kill his intended victim. The resulting case, Tarasoff v. Board of Regents of the University of California, became the most influential confidentiality case in the mental health field when the California state supreme court ruled in 1976 that Moore and his superiors had a duty to warn the intended victim.
The case described above represents one of the most difficult dilemmas for professionals working with people in crisis. Confidentiality and when it is ethical to break it places enormous stress on mental health workers. There are very strict guidelines for breaking confidentiality, and mental health workers can be violating the law if they do not have legal justification for releasing information gathered in a confidential meeting.

Each state has its own regulations regarding this issue; however, the gold standard that most mental health workers abide by is Tarasoff. In this week's Seminar, you will discuss the case, how it changed mental health work, and its benefits for all parties involved.

Why is confidentiality so important for mental health workers and people in crisis? What is the role of the mental health worker in keeping confidentiality? When must confidentiality be broken? If you have any suggestions or alternate approaches to the duty to protect, you are encouraged to provide them.