Grievances and law suits against public mental health professionals: cost of doing business?

R. D. Miller,
Bull. Amer. Acad. Psychiatry & the Law 20(4): 395-408, 1992.
Although there has been an increase in risk of malpractice for all physicians, general psychiatrists continue to have a relatively low risk of being sued. With the change in the nature of involuntary patient populations as a result of dangerousness criteria for commitment, and the advent of an activist mental health bar, however, psychiatrists who work in the public sector are significantly more likely than private psychiatrists to face grievances and law suits. While specific data providing direct comparisons of numbers of lawsuits between private and public psychiatrists are not available, a review of the existing literature supports this hypothesis, particularly with respect to grievances. The author suggests reasons for the increased risk of legal challenges faced by psychiatrists working with committed patients, and discusses various strategies for preparing ward staff as well as professional staff to reduce the risk of being challenged as well as the chance of losing grievances and law suits. While the article focuses on psychiatrists, most of its arguments are equally applicable to other mental health professionals, whose risk of being legally challenged is escalating rapidly.