Behavioral Health: Danger to Self or Others

Course overview

Failure to prevent suicide is the single most common cause of action in psychiatric malpractice suits, and failure to protect identifiable others is another major source of potential liability exposure. Many healthcare team members in non-psychiatric settings have never been trained to recognize risk factors indicating that a patient represents a danger to himself or others, nor are they necessarily aware of duty to third party law and how it applies to patients who represent a danger to others. However, there is considerable co-morbidity between psychiatric and somatic afflictions, and some patients will experience psychiatric difficulties even if that is not the reason they seek medical assistance. Mental illness is not wholly predictive of violence, but it may suggest a susceptibility to other stressors in which violence may occur. Non-psychiatric healthcare team members need to have a good working knowledge of the proper evaluation and management of mental health problems that may unexpectedly arise, especially when the possibility of harm to self or others exists. In this activity, we present evidence-based medical and legal literature and cases related to dangerousness to self and others. In addition, we discuss the interview and documentation pertaining to dangerousness as well as civil commitment and duty to third party law. After completing this activity, nurses should be able to: examine the prevalence of psychiatric disease; plan proper management of patients who are a danger to themselves or others; analyze suicide risk factors; and examine civil commitment and the duty to protect.