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1. Presented by:Mr. Suresh Kumar
Sharma
RN, ACCN,
MSN PSYCHIATRY
Legal issues in
Psychiatric Nursing.

3. Psychiatry and the law
Relationship between
Psychiatry and the
Law reflects a tension
between individual
rights and social
needs.

4. Ethical considerations for Psychiatric
Nurses
Ethical dilemmas
“What is the right
thing to do?”
When is it
appropriate for
society to
regulate personal
behavior?

5. Ethical Considerations
Sensitivity to patient’s
rights and needs.
The element of power
Skilled clinician
versus”keeper of the
keys”
Paternalistic attitude:
deciding what is best for
another person, without
considering the person’s
thoughts, feelings, or
preferences.

6. Mental Health and the Legal System:
An Overview

Mental Health and the Legal System


Guided by ethical principles and state and federal laws
Shifting Perspectives on Mental Health Law



Liberal era (1960 to 1980) – Rights of persons with mental illness
dominated
Neoconservative era (1980 to present) – Emphasized limiting rights of
mentally ill
The Issues

The nature of civil vs. criminal commitment

Balancing ethical considerations vs. legal considerations

The role of psychiatrist in legal matters

Rights of patients and research subjects

7. Sources
of Laws

8. Constitutional Law
Statutory law or Legislative Law
Sources of Law
Administrative Agencies
Court Decisions

9. HISTORY
Indian Lunacy asylum Act, Act 36 of1858
Indian Lunacy Act, Act 4 of 1912
1946- Bhore Commitee
1947- Indian Psychiatry Society
1949- adhoc Committee
1978- MHA Introduced in Loksabha
1981- MHA Re-introduced in Loksabha
MHA Passed rajyasabha (1986), Loksabha
(1987)
1993- MHA Act came into effect
NATIONAL MENTAL HEALTH CARE ACT, 2010
(DRAFT)

10. Definition of the act
"An act to consolidate and amend the law
relating to the treatment and care of mentally
ill persons, to make better provision with
respect to their property and affairs and for
matters connected there with or incidental
thereto."

11. THE INDIAN
LUNACY ACT
1912

12. introduction
Derived from English lunacy act, 1890
it replaced act 36 of the indian lunatic asylum
act, 1858
OBJECTIVES:Govern reception
Detention lunatics
Care of lunatics & their property
Consolidate & Amend the law relating to lunacy
Opening of many new asylums
Improving the general condition of asylums
awareness regarding the prevailing of lunatics in
such asylums

13. .
4 parts
8chapters
100 sections
CHAPTER 1:preliminary information and definitions
CHAPTER 2:Admission in mental hospital

14. ILA,1912 CONTD…
CHAPTER 3:Administering care, treatment & discharge.
TERM:Parole:permission given to patients to perform
certain rituals or attend certain family function
Acc..
Can leave any time from hospital
Can be brought back forcefully within a max
period of 90 days.

15. CHAPTER 4:Proceedings of lunacy in presidency town
.
CHAPTER 5:Proceedings of lunacy outside presidency town
CHAPTER 6:Establishment of asylums.
CHAPTER 7:Expenses of lunatics
CHAPTER 8:Rules to be imposed by the state govt regarding care
of lunatics

16. Mental health
Act 1987
.

17. INTRODUCTION
Protecting the rights
Accessible and effective mental health
services
Legal framework
To overcome stigma
Standards for high quality medical care
Protect civil, political, social and economic
rights Right of access to
education, employment and social security

18. HISTORY
1978- Introduced in Loksabha
1981- Re-introduced in Loksabha
Passed rajyasabha (1986), Loksabha (1987)
1993-Act came into effect

19. Objectives of the act
1. To establish central and state authorities for
licensing and supervising the psychiatric
hospitals.
2. To establish such psychiatric hospitals and
nursing homes.
3. To provide a check on working of these
hospitals.
4. To provide for the custody of mentally ill
persons who are unable to look after
themselves and are dangerous for themselves
and or, others.

20. 5. To protect the society from dangerous
manifestations of mentally ill.
6. To regulate procedure of admission and
discharge of mentally ill persons to the
psychiatric hospitals or nursing homes either
on voluntary basis or on request.
7. To safeguard the rights of these detained
individuals.

21. 8. To protect citizens from being detained
unnecessarily.
9. To provide for the maintenance charges
of mentally ill persons undergoing
treatment in such hospitals.
10. To provide legal aid to poor mentally ill
criminals at state expenses
11. To change offensive terminologies of
Indian Lunacy act to new soother ones.

22. Facts:
At the time of conception of law,
1.private psychiatry was still in infancy
2.growth and development of private
psychiatry was not foreseen
The field of psychiatry itself has grown

23. Terminologies used in the act
New term
Psychiatric hospital
/ Nursing home
Mentally ill person
Mentally ill prisoner
Outdated terms
Asylum
Lunatic
Criminal lunatic

24. Salient features of the act
Mental health act is divided into 10 chapters
consisting of 98 sections.

25. CHAPTER I
“Medical Officer”
a gazetted medical officer in the service of Government and
includes a medical practitioner declared, by a general or
special order of the State Government, to be a medical
officer for the purpose of this Act.
“mentally ill person”
a person who is in need of treatment by reason of any mental
disorder other than mental retardation
“psychiatrist”
a medical practitioner possessing a post-graduate degree or
diploma in psychiatry, recognized by the Medical Council of
India, constituted under the Indian Medical Council
Act, 1956,

26. “Psychiatric hospital" or “Psychiatric nursing
home"
for the treatment and care of mentally ill persons
and which provides also for psychiatric
services;
“ Reception order"
an order made under the provision of this Act for
the admission and detention of a mentally ill
person in a psychiatric Hospital or psychiatric
nursing home

27. Chapter I: (criticism
):) 1.Medical officer: “ A registered medical
practitioner.” - Ayurvedic or homeopathic medical
officer ?
2. Mentally ill person: “person who is in need of
treatment by reason of any mental disorder other
than mental retardation”
-not specify the types of mental illness to be
included
-Mentally retarded subjects have been
excluded.

28. Chapter I:
3. Licensed psychiatric hospital or licensed
psychiatric nursing home:
“ means a psychiatric hospital or psychiatric
nursing home as the case may be licensed, or
deemed to be licensed, under the Act”
-discriminatory, uniform policy should be
adopted.

29. CHAPTER II
Central Authority For Mental Health Services
The Central Government shall establish an authority
for mental health
It shall be in charge of
regulation, development, direction and co-ordination
with respect to Mental Health Services under the
Central Government.
Supervise the psychiatric hospitals and psychiatric
nursing homes and other Mental Health Service
Agencies (including places in which mentally ill
persons may be kept or detained) under the control
of the Central Government.
Advise the Central Government on all matters
relating to mental health
State Authority for Mental Health Services in States/UTs

30. CHAPTER III
It lays down the guidelines for
establishment and maintenance of psychiatric
hospitals and nursing homes.
There is a provision for licensing authorities to
process applications for license and their
renewal.
Criticism:
1. No mention is made of incorporating General
hospitals
2. Licensing process should be made simpler.
3. No Provision for checking & working of licensing
authorities

31. CHAPTER IV
It deals with the procedures of
admission and detention of mentally ill in
psychiatric hospitals
1.Reception order with petition
2.Reception order without petition
3.Voluntary admission
criticism:Temporary treatment order
Emergency addmission
set criteria and procedure for involuntary
admission

32. CHAPTER V
It deals with the inspection,
discharge,
leaves of absence and
Removal of mentally ill persons.
Criticism:
1.No provisions are made for after discharge care
and rehabilitation, of patients.
2.Much stress is laid on hospital admission and
treatment
3.No provisions are made for home treatment.

33. CHAPTER VI
It deals with the judicial inquisition regarding
alleged mentally ill persons possessing
property and its management.
Criticism: control one's inherited assets
requires the opinion of a medical professional

34. CHAPTER VII
It deals with the maintenance of
mentally ill persons in a psychiatric hospital or
psychiatric nursing homes
Criticism: No provision for patients with no
estate and no relative, the state should be
made responsible for such patients.

35. CHAPTER VIII
PROTECTION OF HUMAN RIGHTS OF
MENTALLY ILL PERSONS
1) No mentally ill person shall be subjected during
treatment to any indignity (whether physical or
mental) or cruelty.
(2) No mentally ill person under treatment shall be
used for purposes of research, unless(i) such research is of direct benefit to him for
purposes of diagnosis or treatment; or
(ii) such person, being a voluntary patient, has
given his consent in writing or where such person
(whether or not a voluntary patient) is incompetent
by reason of minority or otherwise, to give valid
consent, the guardian or other person competent to
give consent on his behalf, has given his consent in
writing for such research.

36. Criticism: - Once a person is admitted to
mental hospital he is termed insane or mad informed consent for experimental treatment

37. CHAPTER IX
It deals with the penalties and procedures for
infringement of guidelines of the act.

38. CHAPTER X
It deals with miscellaneous matters not covered
in other chapters of the act.

39. MHA-87;Focus on treatment and
care of Patients
Establishment or maintenance of
psychiatric hospitals or psychiatric nursing
homes only with license
Psychiatric hospital and psychiatric
nursing home to be maintained in
accordance with prescribed conditions
Inspection of psychiatric hospitals and
psychiatric nursing homes and visiting of
patients
Admission And Detention In Psychiatric
Hospital
Or Psychiatric Nursing Home

40. Summary-MHA 87
An Act to regulate and set standard for
restrictive psychiatric treatment facilities
To establish procedure for Guardianship for
mentally ill who need it
To protect Human Rights of mentally ill
To set up authorities for development
, regulation and coordination of mental health
services

41. Suggestions for improvement of the
act
1. Provisions for educating society about mental
illness and treating it at par with physical
illness should be incorporated.
2. Licensing process should be made simpler.
3. Provision should be there for checking the
working of licensing authorities and powers
vested in them to be limited.
4. Licensing authorities should appoint a doctor
preferably a psychiatrist as inspecting officer.

42. 5. Private Doctors and general nursing homes
should be allowed to treat such patients at par
with recognized centres.
This will help in reducing the workload on the
system and will provide much better health care
to the patients.
This provision can be withdrawn later, once there
are adequate recognized hospitals with adequate
staff.
6. To regulate procedure of admission and
discharge of mentally ill persons to the
psychiatric hospitals or nursing homes either
on voluntary basis or on request

43. 7. Adequate provisions to be provided for long
term treatment and expenses on treatment. If
this is not possible, then community mental
health centres should be opened to provide such
care.
8. Provisions for rehabilitation centres are to be
incorporated. Efforts should be there for post
discharge care and rehabilitation.
9. Strict provisions should be there for punishing
the individuals requesting unnecessary
detention and exploitation of mentally ill.

44. 10. Stress should be on treatment of illness
rather than the ill
11. Treatment should be based on concept of
socialization and not on hospitalization.

45. NATIONAL MENTAL HEALTH
CARE ACT, 2010 (DRAFT)
Chapter I: Preliminary (sec 1-6)
Chapter II : Rights of Persons with Mental
Illness (sec 7-16)
Chapter III Duties of Government (sec 17-20)
Chapter IV Mental Health Review Commission
(sec 21-31)
Chapter V State Mental Health Authority (sec
32-38)

46. Chapter VI Mental Health Facilities (sec 39-41)
Chapter VII : Admission, Treatment and
Discharge (sec42-55)
Chapter VIII : Responsibilities of Other
Agencies(sec 56-60)
Chapter IX : Penalties and Miscellaneous
provisions (sec 61-67)

47. Basic Rights of
Psychiatric
Patients and
Nurse's
Responsibilities

48. .
.
Patients’ Rights
(AHA) Patient’s
Bill of Rights

49. As a person receiving mental health
services, you have the right to:
Be treated with dignity and respect.
Choose the services or programs in which you
participate based upon information about
rules, treatment procedures, costs, risks, rights
and responsibilities.
Ask questions and get answers about services.
Participate fully in all decisions about treatment
or services.

50. Request changes in treatment or services.
Receive treatment in the least restrictive
setting - one that provides the most
freedom appropriate to your treatment
needs.
Refuse treatment or service unless
ordered by the Court to participate.
Be informed about the rules that will result
in discharge from a program if violated.

51. Participate fully in decisions regarding
your discharge from a program and
receive advance notice, unless your
behavior threatens the well being of
another person.
Be given help in obtaining another place
to live prior to discharge from a
residential program.
Know the name of the medication you
are taking, why you are taking it, and
what its possible side effects might be.

52. Refuse to take medication, if you
choose. (Note: You should not
discontinue taking medication suddenly
without first discussing the possible
dangers with a psychiatrist.)
Have your family involved in your
treatment.
Refuse family participation in your
treatment, if you choose.
Not be subjected to
verbal, physical, sexual, emotional or
financial abuse; harsh or unfair

53. Make complaints, have them heard, get a
prompt response, and not receive any threats
or mistreatments as a result.
File a grievance if you are not satisfied with
the response to a complaint.
Be assisted by an advocate of your choice; for
example, family, friend, case
manager, member of a consumer advocacy
committee or organization, etc.
Review your record, with two exceptions.
Limited portions of your records can be
withheld from you if your treatment team
leader has written that seeing specific
information would,

54. Visit and communicate privately with family
and others, at home or in the community
(unless restricted by service plan); send and
receive personal mail unopened; have access
to a telephone.
Meet and participate with social, religious and
community groups of your choice.
Keep and use personal clothing and
possessions as space permits, unless it
infringes upon others.
Exercise all civil and legal rights afforded to
citizens of the United States; for

55. Right to consent
• Psychosis does not necessarily mean that
a person is unable to consent to treatment
and many psychotic patients are capable
of giving informed consent.For patients not
able to consent and for all
minors, informed consent should be
obtained from a substitute decision
maker.

56. Right to refuse medication
• Symptoms such as delusions and
denial may cause the refusal.
• Nurses should judge each situation
on a case-by-case basis.

57. Right to treatment in the
least restrictive setting
• Maintain the greatest
amount of personal
freedom, autonomy, dignity,
and integrity in determining
treatment
• Restriction includes the
nature of the choices being
restricted and the method
by which choices are
restricted.

58. Forensic Psychiatry

59. What is forensic psychiatry?
Forensic psychiatry is a branch of medicine which
focuses on the interface of law and mental health.
it may include psychiatric consultation in a wide
variety of legal matters :1. Crime & psychiatric disorders
2. Criminal responsibility
3. Civil responsibility
4. Law relating to psychiatric disorder
5. Admission procedures in psychiatric hospital
6. Civil rights of mentally ill


60. 1.Crime & psychiatric disorders
Mentally ill people may commit offence because : They don’t understand the implication of their
behaviour
 Due to delusions & hallucinations
 Abnormal mental states like confusion, excitement etc
 Drug related violence

61. 2. Criminal responsibility

Acco. Indian penal code(1860) Sec 84:-

“Nothing is an offence which is done by a
person who, at the time of doing it, by
reason of unsoundness of mind, is
‘incapable of knowing the nature of the
act, or that he is doing what is either wrong
or contrary to law’

62. Contd…
Criteria used to determine Criminal
responsibility:
1.
2.
3.
4.
M’NAGHTEN’S RULE
THE IRRESISTIBLE IMPULSE TEST
THE DURHAM TEST/PRODUCT RULE
AMERICAN LAW INSTITUTE

63. 1. M’NAGHTEN’S RULE


Individual at the time of the crime didn’t know
the nature & quality of the act & if he did know
what he was doing, he did not comprehend it
to be wrong.
These rules are referred to as the nature &
quality rule & right from wrong test

64. 2. THE IRRESISTIBLE
IMPULSE TEST
a
person may have known an act
was illegal but as a result of
mental impairment lost control
of their actions.

65. 3. THE DURHAM TEST
/PRODUCT RULE

an accused is not criminally responsible if his
unlawful act was the product of mental
disease/defect.

In this the causal connection b/w the mental
abnormality and the alleged crime should be
established

66. 4. AMERICAN LAW
INSTITUTE (ALI) TEST


A person is not responsible for criminal
conduct if at the time of such conduct, as a
result of mental disease or defects he lacks
adequate capacity either to appreciate the
criminality of his conduct or to conform his
conduct to the requirement of the law.
Similar to M’NAGHTEN’S RULE & THE
IRRESISTIBLE IMPULSE TEST.

67. 1.Crime & psychiatric disorders
2. Criminal responsibility
3. civil responsibility of a mentally
ill person.

68. 3. civil responsibility of a mentally
ill person.
1. Management of property: Application from any relative court may direct an
inquiry whether a person is of unsound mind and
incapable of managing his property.
 Manager appointed by the court of law who may
include sale or disposal of the property to settle
his debts/expenses.

69. Contd…2. MARRIAGE:



HINDU MARRIAGE ACT(1955)
If one is unsound of mind at the marriage time
that marriage is consider null & void in the eyes
of the law.
One is unsound of mind for long time(>2yrs)
with RX can file for obtaining divorce.
However if divorced is filed after a 3yrs period
then other party has to pay maintance charges for
mentally ill person

70. Contd..3. TESTAMENTARY CAPACITY



AS per indian succession act, TESTAMENTARY
CAPACITY of a mental ability of a person is
precondition for making a valid will.
Test for orientation, concentration & memory
Delusional person can also make a valid will if
those delusion are not related to the disposal of
property

71. Contd..4. RIGHT TO VOTE

Cannot contest for elections or exercise the
privilege of voting.

72. 1.Crime & psychiatric disorders
2. Criminal responsibility
3. civil responsibility of a mentally
ill person.
4. law relating to psychiatric
disorders

73. 4. law relating to psychiatric disorders
I.
II.
III.
IV.
V.
VI.
Law relating to psychiatry in India
Mental health related legislations
Civil laws relating to mental ill persons
Civil laws relating to psychiatry
Suicide and Indian law
The narcotic drug & psychotropic substances
act

74. 1.Crime & psychiatric disorders
2. Criminal responsibility
3. civil responsibility of a mentally
ill person.
4. law relating to psychiatric
disorders
5.psychiatrists ant the court

75. 5.psychiatrists ant the court

Can give convincing a judge that crimes
were committed as a result of his mental
illness.

76. Role of the Nurse in
Admission Procedure

77. 1. Settling the patient in the ward.
2. Before assigning him a bed consider
his biological and emotional needs.
3. Shown various facilities like
eating, recreation, bathroom facilities.
4. Acquaint him with some of the ward
rules.
5. Nurse needs to be sensitive to
feelings, and give enough time and
attention and allow them to express
their feelings about the patient's
condition, treatment and outcome.

78. • Types of Hospital Admission

79. Types of Hospital Admission
•Voluntary
•Involuntary

80. Characteristics of Voluntary
Admission
• Written application by the patient
• Civil rights are fully retained by the patient
(right to vote, hold a driver’s license, buy
and sell property, hold office, practice a
profession, engage in a business.
• Discharge is initiated by the patient
• Justification: patient voluntarily seeks help

81. Involuntary Admissions
To retain without the right is false imprisonment
Magistrate’s order – check chart to understand what’s going
on for the admission
1) Evaluation/emergency care (ED) –form filled
out by police/others; usually for 48 to 72
hours- gives time to assess & find illness
(UTI)/mental
2) Order of protective custody (OPC)- legal
papers filed in court; vary from days to weeks
–
2 different drs have assessed & court decides to
lock up – 7d to 14d pt must be released after the
time/OPC is up.

82. 1)Extended/indeterminate care- legal
system involved; long term; may be
30-90 days
2)Magistrates warrant – legal sworn
statement issued about a patient
through judge, by a family
member, signs document that pt is
incompetent.

83. Involuntary Hospitalization
• Laws are determined by each state;
•
•
know the laws of the state where you
practice
Persons detained in this way lose only
the right to freedom; all other rights are
intact
Persons held without their consent must
present an imminent danger to
themselves or others

84. Characteristics of Involuntary
Admission (Commitment)
• Admission did not originate with patient
• Discharge is initiated by the hospital or
•
•
•
•
•
court
Patient may retain some, none or all civil
rights depending on state law.
Justification: mentally ill and one or more
of the following:
Dangerous to self or others
Need for treatment
Unable to meet own basic needs

85. The Commitment Process
• Process begins with a sworn petition by a
•
•
relative, friend, physician stating that the
person is mentally ill and needs treatment.
Examination of the patient’s mental
status. (Some states require at least one
of the physicians be a psychiatrist.
Determination as to whether to hospitalize
the patient or release them is made next
by the physician or courts (judge or formal
jury)

86. Three Lengths of Hospital Stay
• Emergency- to control an immediate
threat to self or others
• Short-term or Observational- to diagnose
and for short-term therapy
• Long-Term is for an indefinite time or until
the patient is ready for discharge. Periodic
reviews may be made every 3, 6, or 12
months.

87. Role of the Nurse in
Leave of absence.

88. Relatives are clearly instructed about the
purpose for which the patient is being
sent home and when he should be
brought back.
Instruct the relatives as to how they
should converse or behave with the
mentally ill person according to the
instructions given by the doctor.
If the patient is receiving any
medications, insist on regularity and give
necessary instructions to the family
members about dosage, side-effects, etc.

89. Role of the Nurse in
Discharge Procedure

90. Nurse must ensure that the patient leaves the
unit with all belongings and personal effects.
All necessary instructions especially regarding
his medication regimen, side-effects etc. must be
given clearly to patient and family members.
Any paper work, signing of documents should
be completed.
The hospital file along with all charts and notes
should be sent to the medical records section.
The nurse should ascertain his travel plan and
offer assistance if necessary.
The nurse must bear in mind that the patient
may have mixed feelings about leaving the
hospital and going back to his home
environment.

91. Conservatorship
• Legal guardianship is separate from civil
•
commitment for hospitalization
A hearing can be held to determine whether
the person is competent. An incompetent
patient cannot provide his or her own
shelter, food, and clothing; cannot act in his
or her own best interests; and cannot run his
or her own business and financial affairs. If a
patient is found incompetent, a guardian is
appointed to speak for the patient.

92. Legal
responsibilitie
s of
Psychiatric
Nurse

93. Report pertinent
information to co- workers.
Accurate records.
Confidentiality.
Current knowledge of law.
Respect rights of
individual.
Inform consent.
Vigilant and watchful.

94. Nurse's implications for
protecting Patient's Rights.
• To protect patient's rights, the nurse should
be aware of these rights in the first place.
• She should ensure that ward procedures
and policies should not violate patient's
rights.
• Discussing these rights with the mental
health team and including these rights in
the nursing care plan is all part of her
responsibility in protecting the patient's
rights.

95. Do’s
• Do document all unusual incidences.
• Do report all unusual incidents.
• Do follow policies and procedures as
established by your employing agency.
• Do keep current year license to practice.
• Do perform procedure that you have been
taught and that are within the standard
scope of your practice.
• Do protect patients from injuring
themselves.

96. Don'ts
• Do not remove side rails on patients
bed, unless there is an order or hospital
policy to do so.
• Do not allow patients to leave the hospital
or nursing home unless there is an order to
signed release.
• Do not accept money or gifts from patients.
• Do not give advice that is contrary to
doctors orders or nursing care plan.
• Do not witness a patient’s will.
• Do not take medications that belong to
patients.
• Do not work as a nurse, in a state in which
you are not licensed.

97. Legal Role of the Nurse
• Nurse as Provider:
• .
• To avoid litigation, the psychiatric nurse can
follow the following preventive measures:

98. Legal Role of the Nurse
• Know one’s state laws
• Keep accurate and concise
records
• Maintain patient confidentiality
• Consult a lawyer if any
questions arise.

99. Nurse as Employee
• Nurses are responsible to supervise and
evaluate those under their authority for the
quality of care given.
• They must observe their employer’s rights
and responsibilities to clients and other
employees, fulfill the obligations of the
contracted service.

100. Nurse As Citizen
• This role forms the foundation for the
nurse’s other legal relationships.
• These are inherent rights that include civil
rights, property rights, right to protection
from harm, and right to due process.

101. Common areas of liability in
psychiatric services
•
•
•
•
•
•
•
•
Sexual contact with a patient
Preventing patient suicide
Med errors
Problems related to ECT
Breach of confidentiality
Failure to refer a patient
Failure to obtain informed consent
failure to report abuse

102. Malpractice in Nursing
• A failure in the professional
duty, practice or skill that
leads to the injury or harm
to the client or patient.

103. Tort Law



Torts are civil wrongs for which money damages
are collected by the injured party (plaintiff) from the
wrongdoer (defendant)
Civil liability for nsg practice falls in the area of tort
law
3 types of torts:



Intentional
Quasi-intentional
Unintentional

104. Tort: A wrongful Act That Results in
Injury, Loss, or Damage
Have to watch what say & do – assault & battery
Unintentional Torts
 Negligence: harm
caused by failure to do
what is reasonable
and prudent
 Malpractice: breach of
duty directly causes
injury or loss to the
client
Intentional Torts
 Assault: causes
person to fear being
touched in an
offensive manner)
 Battery: harmful or
unwanted actual
contact)
 False imprisonment:
unjustifiable detention

105. Intentional

Assault


Battery


An act resulting in a person’s apprehension of an
immediate harmful or offensive touching (battery)
Harmful or offensive touching
False imprisonment


An act with intent to confine a person to a specific area
The use of seclusion or restraint that is not defensible as
being necessary or in the pt’s best interest

106. Quasi-Intentional

Defamation is made up of 2 torts:
Slander or oral communication
 Libel or written communication


Breach of confidentiality

107. Unintentional

Professional negligence


Involves harm resulting from the failure of a person to
conduct himself or herself in a reasonable and prudent
manner
4 items needed to prove negligence are:




Duty—measured by standard of care
Breach of duty—conduct that exposes the client to an
unreasonable risk of harm
Proximate cause—Intervening actions or persons that
were, in fact, the causes of harm to the client
Damages—pain and suffering

108. Duty to Warn Third Parties
Do have the right to warn the person that is being
threatened – error on the side of safety


Duty to warn a third
party is an
exception to client
confidentiality
Clinicians must
warn identifiable
third parties of
threats made by a
client
• Is the client dangerous to
others?
• Is the danger the result of
serious mental illness?
• Is the danger serious?
• Are the means to carry out
the threat available?
• Is the danger targeted at
identifiable victims?
• Is the victim accessible?

109. .
111

110. •ASSIGNMENT
law relating to
psychiatric
disorders???????????
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