国际紧急心理健康和人类复原力杂志

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Tarasoff vs Threat: Considerations for Mental Health Providers Navigating Legal, Ethical and Practical Variables Associated with Preventing Mass Acts of Violence

Daniel C. Holland, Mark Newmeyer, Jamie A. Holland, Amber Quaranta-Leech 

Protecting patients and communities is a serious concern for counselors and the rest of the mental health community. The process of violence must be interrupted before events occur. Every day, mental health workers must navigate complex ethical territory regarding confidentiality and their Duty to protect potential victims from targeted violent acts. Federal agencies responsible for ensuring privacy and other professional organizations provide guidance to assist in this critical process. A review of multiple factors significant during the application of these standards provides insight to the mental health community tasked with navigating ethical and logistical concerns during critical moments when working with potentially lethal patients. Through a stronger understanding of the differences between general threat and targeted threat assessments, state and ethical limitations and expectations regarding threats, elements present in imminent threats and the power of collective intelligence gained by collaboration, inter-disciplinary care and the reduction of siloed mental health care, and increased community connections, the mental health community can increase its effectiveness at managing potential targeted threats, interrupting the process of violence and decreasing lethal actions.