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Sunday, December 23, 2012

Holding mental health and child protection professionals criminally liable

An interesting case in France should send a chill to many mental health professionals.  It is the case of Daniele Canarelli, a French psychiatrist. Dr. Canarelli has been held criminally liable for the actions of a patient who killed his grandmother. As BioEdge reports:

Daniele Canarelli, 58, was guilty of a "grave error" in her treatment of Joel Gaillard, her patient of four years. She should  have had him committed or referred him to another medical team. Instead, he escaped from a consultation with her and went on to hack to death the 80-year-old partner of his grandmother.

French Psychiatrist Daniele Caranelli

The implications for mental health professionals, if this became commonplace, are astounding. At the heart of the notion is the idea that it is possible to accurately predict the behavior of clients. The reality is that is not possible. This court decision could create an over response. We have seen that with child protection workers when governments and the media lambast them for failing to protect a child.

This is different from those situations where a social workers might be held liable for a failure to protect in that this involves criminal convictions. That is very different than malpractice.  The latter is becoming more of a concern for child protection workers. For example, earlier in 2012, we saw a case in which civil liability was deemed appropriate in a Colorado case. The Juvenile Justice Information Exchange reported:

Earlier this month, the Colorado Court of Appeals ruled that social workers in Adams County may be held legally responsible for failures to protect children in foster care from abuse....The ruling allows the siblings to proceed with their lawsuit against the Adams County Department of Social Services, on the grounds that their rights to safety were violated by county social workers...The appellate court determined that the state’s division director of Child Welfare Angela Lytle, who supervised social workers Joan Forsmark and Cathy O’Donnell, acted “recklessly in conscious disregard” of the plaintiffs’ safety.

There can be a strong argument that a failure to act when the risk is known is quite different from holding a professional criminally accountable for something that may or may not occur within an unspecified level of risk. It will be fascinating to see if this French case leads to other such actions in other jurisdictions. However, we continue to await the results of charges against 2 American social workers in the Marchella Pierce case. As the New York Times reported in March 2011:

A former New York City child welfare worker and his supervisor were indicted on charges of criminally negligent homicide, the Brooklyn district attorney announced on Wednesday, saying that their failures had contributed to the death of a 4-year-old, Marchella Pierce, who had been repeatedly beaten and tied to a bed and weighed 18 pounds at the end of her life in September.

Damon Adams and Cheerece Bell - Social workers accused in the Marchella Pierce case

 Such cases will make child protection workers fearful of the implications of their decisions. This trend can make them more cautious, less willing to risk family preservation and more intrusive. This is a trend that needs to be watched.

We might reflect on the now famous Tarasoff case in the US and the ways that it led to changes in intervention - some good but often very concerning. As The Guardian noted in their coverage of the Caranelli case:

In the 1970s, a psychologist who had been treating Prosenjit Poddar, a student at the University of California at Berkeley, was held liable by the California supreme court for failing to warn Poddar's girlfriend, Tatiana Tarasoff, that he intended to kill her, as Podder had told the psychologist in therapy he intended to do.
"Psychiatrists rushed about rounding up their patients," said Turner. They looked for reasons to put them in institutions. "It set up a lot of concerns as to risk management and risk assessment."

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