Forensic aspects of everyday practice: legal issues that every practitioner must know.

In their education and training, mental health care professionals are taught the intricacies and nuances of providing medical care to individuals with any and all psychological or psychiatric problems. This training, however, as comprehensive as it is from a medical perspective, does not and cannot prepare psychiatrists for the complex legal world that effectively has changed the manner and method in which mental health care is provided. As a result of the invasive meddling of the legal process into the mental health field, every patient is potentially a plaintiff in a lawsuit or a complainant in a licensure matter. The practitioner must navigate around the legal roadblocks without the benefit of a law degree. The questions as to who can provide consent, the adequacy of consent, the release of information, and the other issues set forth in this article only scratch the surface of the pervasive intertwining of the law with the mental health field. As most psychiatrists say in their parting advice to a patient, "call me if you have any problems," in this age of complex and potentially harmful interfacing between the psychiatric profession and the law, the psychiatrist must follow his or her own advice. When faced with an uncertainty as to the adequacy of consent, the release of information, or any legal issue, a psychiatrist must place a call to his or her insurer, health care attorney, or medical board to obtain guidance and direction. When there is a letter, a call, a subpoena, or almost anything other than a Christmas card from an attorney, the psychiatrist also should place a call to his or her insurer or health care attorney to ensure that he or she does not find himself or herself in Dr. Peters' position. Being accused before a licensure board or in a courtroom of failing to adequately obtain consent, failing to release information, or, conversely, releasing too much information is not a recommended mental health activity. Being in Dr. Peters' position and being accused of medical malpractice in which a patient has suffered emotional or physical damage or has committed suicide is also not a recommended activity for a psychiatrist. Although avoidance of attorneys and the legal process is not possible for the practitioner, with the proper information and legal resources, the child and adolescent psychiatrist can navigate around the legal potholes.