Investigation of any threat of violence by the patient:
Establish the four important parameters: type of harm, seriousness of harm, imminence of harm, likelihood of harm.
Determine which threats are likely to be real, based on details about the threat: past history of violence (the most important risk factor for future violence), impulsiveness, ability to resist violent impulses, reaction to violence, motivation to maintain self-control, use of alcohol and drugs (another major risk factor of violence). Try to obtain data from other family members about history.
Discharge the Duty:
“The discharge of this duty may require the therapist to take one or more of various steps. This, it may call for him to warn the intended victim, to notify the police, or to take whatever steps are reasonably necessary under the circumstances.”
Changing the treatment program for the patient.
Requesting the patient be voluntarily committed.
Civil commitment (California: 5150).
Warning the potential victim.
Warning others who would be likely to notify the victim.
Contacting the police in the area of the victim or the patient.
Minimize Liability:
Follow the above steps.
Consult with colleagues.
Document all steps taken, document details about how violence was assessed, conclusion of determination of violence based on the assessment.