Tarasoff Murder Case | Duty to Warn vs. Duty to Protect

welcome to my scientifically informed insider look at mental health topics if you find this video to be interesting or helpful please like it and subscribe to my channel well this is dr. grande today's question is what is the duty to warn so when I say duty to warn I'm talking about the obligation in most jurisdictions that mental health professionals have if they're treating a client and that client makes a threat to another person or they have some reason to believe that client is going to harm another person a lot of times when we think about the duty to warn we think about a particular legal case Tarasov versus the Regents of the University of California and this is really the dangerous intersection between mental health and the wall I've talked about this before in other videos we're combining the responsibilities of a mental health clinician to treat a client and help that client with this idea of protecting other people protecting the public from the client so it gets into an area that a lot of counselors feel uncomfortable with and there are actually a lot of reasons to feel uncomfortable with it because the law the duty to warn law or the duty to protect law is different in each state so I'm gonna start with talking about Tarasov and then kind of move into the implications of the Tarasov case so it's interesting because when we talk about the Tarasov case we're really actually talking about two cases there was a Tarasov ruling in 1974 that provided this duty to warn right so a therapist had a duty to warn intended victims but Tarasov one as I'll call it the 1974 case was actually vacated by Tarasov two in 1976 and this changed the duty to warn over to a duty to protect so in essence this increased the options for the therapist a little bit so now it was the duty to protect and not necessarily a duty to warn but therapists could still warn depending on the circumstances so the key finding in this case Tarasov - was that the protective privilege of therapy ends where public peril begins so this element of course is shared with Tarasov one this was the finding in 1974 as well this idea that there is a limit to confidentiality when the public is in danger so now I'm going to get into the facts of this case it's a fascinating case and I think that a lot of times as mental health counselors we hear a shortened actually incorrect version of the Tarasov case and it really kind of leaves us a little bit confused as to what happened and why we have this law today the short version that's incorrect that we hear a lot of times is there was a student who went to a Counseling Center at university and he indicated he was going to harm somebody he followed through with that and murder a young woman and during his time in therapy the counselor didn't do anything therapists didn't do anything to try to stop him in any way and you'll see from the facts of this case that yes there was a murder and there was a person who expressed an interest in committing a murder but in terms of the actions of the therapist there were a lot of actions taken in order to stop this individual so this is really interesting because again it diverges from what we hear so often about the Tarasov case so we see if this case begins with a man named person Jeet hadar and Poddar was a 35 year old student at the USC California at Berkeley and he started there in 1967 he was an exchange student from India in the fall of 1968 he started a folk dancing class and he met Tatiana Tarasov and she's also known as Tanya Tarasov she was 19 years old they met weekly and on New Year's Eve 1968 they kissed now Poddar thought that this meant that they had kind of serious relationship that this indicated the start of a serious relationship but Tarasov was not interested and she was actually involved with other men and she indicated this 2-part are Poddar took this rejection pretty sure he became severely depressed and he would meet her still occasionally and during these meetings he recorded her and played the recordings back trying to figure out why she didn't love him or what her feelings were in general so Tarasov went to Brazil on vacation during the spring of 1969 and during this time Poddar improved he actually went to a hospital that had an agreement with the University and he was treated by a dr. Gould at that time he was diagnosed with paranoid schizophrenia and dr. Gould referred him to dr. Lawrence Moore who is a 34 year old therapist now dr. Moore's wife had attempted suicide and attempted to murder their child so he had some significant stressors in his history as he started these sessions with Poddar so they met several times weekly and more noted that Poddar had a pathological attraction to a young woman who had rejected him and that Poddar fantasized about harming her now hadar never told dr. Moore that the woman was Tarasov but dr. Moore figured it out from the information had available on August 18 1969 dr. Moore determined from padarthas remarks that Hadar in fact intended to kill Tarasov when she returned from this vacation in Brazil now this time Moore consulted with dr. Gould and another doctor named dr. Ian Dallas and the three professionals concurred that Hadar should be committed involuntarily for evaluation now this is where things get a little bit tricky there was a new law in California that authorized the police to pick up individuals who needed evaluation and the law was somewhat confusing now in August 20th 1969 two days after dr. Moore determined there was a threat he contacted the police and Moore told the police that he would sign a 72-hour hold for perd are all they had to do is pick him up and transport him to the hospital he also indicated in a letter to them that hadar can appear quite rational but at other times appears quite psychotic and at this point he was a danger to the welfare of other people and himself and specifically he was threatening to kill an unnamed girl and that he loses strongly to a compulsion to get even with and hurt the girl so we can see at this point that dr. Moore's actions seem reasonable Tarasov was in brazil so he really could take the two days wrong estate teen to August 20th to kind of figure things out and he did determine he was a threat and he contacted the police so the police took Hadar into custody and they interviewed him and they concluded that he was rational and not a danger and actually indicated that he changed his attitude altogether the police told Hadar to stay away from Tarasov and they released him now this of course seems clearly negligent but it should be noted here that the timings not clear in terms of the police and their decision right so they did make a decision to release Poddar but they may have been pressured by a mental health professional named dr. Paulson who was on vacation during a lot of these different discussions when he came back from vacation he ordered the campus police to return that letter that dr. Moore had written to the police and he further ordered dr. Moore to destroy all those notes that pertained to Poddar and demanded that Moore take no further action to commit Poddar so we don't know what pressure if any dr. Paulson exerted on the police at the time when they made the decision to release her darn one thing though is fairly clear here which is no one notified Tarasov or her family of Poddar threats so action was taken to try to hospitalize Poddar and of course that action failed but nobody told Tarasov what was going on now Tarasov returned from Brazil returned from vacation and Poddar approached her again she rejected him again and after this rejection he went to her house she wasn't there he returned later with a pellet gun and a kitchen and confronted her she was there alone at this time he shot her with the pellet gun and chased her down and stabbed her to death with that kitchen knife in the yard this was October 27 1969 Bedard then called the police and told him what he had done now he was convicted of second-degree murder on appeal it was reduced to manslaughter and then the California Supreme Court in 1974 determined that inaccurate jury instructions had not given put are a fair trial so the conviction was reversed and he was remanded for retrial now interestingly he was never retried there was an agreement made where he would leave the country return to India and if he never returned to United States he would not be retried so he did return to India and he eventually married a lawyer so the murder occurred 1969 and Poddar was released in 1974 now dr. Moore the therapist was fired from the clinic and Tara sauce family sued the campus police and the University Health Service for negligence no court before this had recognized a legal duty to warn the potential victim of a client so this was all new territory when the Tarasov case was hurt so as you can see this is a bit of an unusual case the way it turned out and it's much different from the short descriptions we hear in the mental health counseling field the circumstances of the case really I think make it appear much differently than that short version and really give us insight into what the court might have been thinking as they were hearing eventually these two cases Terrace off one and Terrace off two now the actual civil case was settled with an out-of-court settlement so no actual liability was found against the defendants in this case but still we have these two findings Tarasov one and Tarasov two so what we see here is after Terrace off one after the duty to warn case was established the therapist protested and what they really protested against was this idea that a therapist could reliably predict the violent acts of a client and they also said that this warning would constitute a breach of confidentiality this of course led to Tarasov to which vacated terrace off one so the findings of terrace off one are not in effect Tarasov to was 1976 of course after 1974 with the first terrace off case so we see here again the duty to protect was put in place with Tarasov two so we see here these findings that when a therapist determines or should have determined that a threat existed that they need to take action and this action can be trying to hospitalized a client learning other people learning the intended victim or a variety of other actions so they're not restricted here to a duty to warn they can learn but the duty is to protect now it's also interesting with Tarasov too that it required non negligent behavior not perfection therapists are required to use a reasonable degree of skill knowledge and care ordinarily possessed by a member of that profession under similar circumstances so it kind of was softened moving from terrace off one to Tarasov two but still a big change for mental health clinicians and therapists now we had this duty to protect in place that affected everybody as other states started to hear cases kind of built on what happened with the terrace off case and this is where the problems really start with terrace off to and what we see here with the other states we see that certain states have broadened Tarasov other states have narrowed it and some states don't really recognize it at all so a mental health professional really needs to know the laws in the jurisdiction where they're operating as a therapist we see that there have been some significant cases and a lot of people kind of look at these cases and believe they apply to a wide region but again their state specific like we see a case again in California nineteen eighty Thompson versus the county of Alameda that said that the Tarasov ruling did not apply to nonspecific threats made against nonspecific so this finding required a readily identifiable victim which of course was much different than we saw and Tarasov - so a lot of clinicians believe that there needs to be a clearly identified victim if they are to report it or to act in a way to protect but that's not the case in some areas we also see a lot of confusing language as we look at the various cases and their findings like we see that in some places a counselor has no requirement to interrogate a client or conduct a special investigation to determine a victim's identity but they are required to exercise a moment's reflection that's the term a moment's reflection which may inadvertently reveal the victim's identity but there's no real clarity on what that means what is a moment's reflection we know it's not a special investigation but what is it now once the therapist determines or again should have determined the foreseeable danger then they are liable for exercising a reasonable care to protect the potential victim so this gets into a lot of gray areas and I think that's really the big struggle with Tarasov - and all these other findings is that many clinicians don't know what the findings are that affect them in their particular state we see research indicates a large percent of clinicians don't understand the duty to protect or the duty to learn most know that it exists but they don't know the details they don't know what their actual responsibilities are technically speaking now knowing that all the laws are different from state to state the general idea in most states is that if a therapist breaks confidentiality because they're trying to learn somebody's in danger they can't be held liable for that so most clinicians again realize that they understand the basic ideas of Tarasov or whatever law affects them in their particular state and interestingly most therapists agree that a duty to one or Duty protect is necessary that it's really ethically mandated part of the profession but not necessarily something that they should have to do legally although again most know that that legal component is there in some form so I think there were a lot of concerns after Tarasov - that would have a chilling effect on therapeutic relationships the evidence doesn't support that there was also this fear that mental health professionals would not want to treat clients who are dangerous we have mixed findings here there are definitely some therapists that will not treat clients who are dangerous and specifically they cite Tarasov and the subsequent findings as the reason now that's another kind of ethical debate to get into but it has had a chilling effect in that way now I don't know if many mental health clinicians will say that kind of publicly right I don't know if many will say they're simply not going to treat people they think are dangerous but from talking to clinicians and being in this field for a long time it definitely has an impact on how counselors and other mental health professionals are on their practice if you practice because that's how you make a living which is what happens most of the time when counselors are in practice and you have a client who repeatedly makes threats you repeatedly hospitalized that client there comes a point where a counselor just may not want that liability so they'll find a reason to discharge that client to refer them to another level of care or another professional now again as I said that gets into another ethical debate but we do see this effect from Tarasov - and this is somewhat problematic I think that with the laws varying from state to state again now health professionals might not know that law and clients certainly wouldn't know that law so if the therapist doesn't know what the law is how are they going to communicate to the client in terms of informed consent what would have to happen if there was a threatmate now I've seen another interesting kind of occurrence here with Tarasov - and the other findings where mental health professionals in their informed consent specifically talk about the duty to protect and kind of frame it in a way to let the client know what they should and shouldn't talk about so now some professionals are really saying look just don't talk about it if you don't want me to act now the client has to know the limits of confidentiality are but at the same time clinicians are more or less saying don't tell me anything that could be dangerous because I don't want to have to get involved with hospitalizing and learning other people so this really is a gray area and again as I talked about before I've always found areas where mental health and the law intersect to be very dangerous we have again this one area we're trying to protect the public and this other area we're trying to help the client but then there's this third area that nobody talks about which is mental health counselors just trying to make a living and kind of staying at peace and sometimes that means they don't want to get involved in these situations look at all the work that dr. Moore in this case and the Tarasov case went through writing a letter to the police personally talking to police officers documenting everything with this client and yet he was still fired from that clinic I certainly don't know dr. Moore's feelings on Tarasov but it would be reasonable to think that something that situation would have wish that they never met that client right so that's kind of what I'm talking about here this is a really tricky and dangerous intersection so with all this kind of ambiguity and this release of liability when there's a potential danger what should mental health therapists do what's the best course of action well the first thing would be to know the laws in your jurisdiction that's crucial to understand the duty to warn and the duty to protect as it affects you as a clinician while so you have to really look at that informed consent and make sure the client does understand that duty to protect is there but of course you'd have to be careful and not encourage a client to withhold information too so there's kind of a delicate balance that occurs here I think really what's important is to treat every client according to the standard of care to do your best job to make sure that there is some sort of danger that the public wherever is being affected by that is protected also I think consulting with other professionals and seeking supervision makes a lot of sense we see in the Tarasov case of course that dr. Moore did seek consultation from other professionals which i think was an intelligent and rational decision although of course the end result still wasn't favorable but I think that part was a good decision so it makes sense seek supervision consultation to try to involve other professionals in the case and hope that their experience in their training can aid you in decisions I think it's also important to document what's going on very carefully in the notes and to try to illustrate clearly why you made each decision what evidence led you to each decision in the case cases that involve a danger to a third party are difficult to handle and they're stressful so another component would be as male health clinician it might be a good idea just to seek therapy when you have some of these kind of dangerous cases just to make sure that you're staying competent and grounded and not getting like compassion fatigue or burned out or stressed out the impact of the Tarasov - really puts clinicians in a tough place because clinicians don't want to be sued right they want to perform their job and kind of stay out of all lawsuits on one side you have this concern that a client would sue a clinician for breach of confidentiality and the other side you have this concern that somebody was harmed by the client would sue the counselor the clinician so it becomes kind of a dangerous environment and a tough environment for the clinician to make the decisions a lot of pressure fortunately cases that involve violence like this aren't particularly common and lawsuits against therapists are rarely successful but again it's important the therapists do a good job document everything carefully and seek supervision we have to make smart moves in terms of protecting the client and the public and also ourselves as professionals so I know whenever I talk about duty to warn do you protect and cases like the Tarasov case there gonna be a lot of different opinions if you agree or disagree with me or have any thoughts on this video please put those opinions and thoughts in the comments as always I hope you found this video on the duty to warn and a duty to protect to be interesting thanks for watching

Channel: Dr. Todd Grande

Views: 112,679

Keywords: duty to warn, duty to protect, Tarasoff, Tatiana Tarasoff, tanya Tarasoff, prosenjit poddar: Tarasoff versus the Regents of the University of California, Tarasoff I, Tarasoff II, protective privilege of therapy ends where public peril begins, confidentiality, privilege, breach confidentiality, protect the public, mental health, counseling, tarasoff murder case, tarasoff 1974, tarasoff 1976

Id: crtpAozyWu4

Length: 22min 3sec (1323 seconds)

Published: Sat Apr 20 2019