This Article empirically examines the effect of the dangerous patient exception to the psychotherapist-patient evidentiary privilege. The U.S. Supreme Court first recognized the psychotherapist-patient privilege in Jaffee v. Redmond. This evidentiary privilege prevents mental health professionals from testifying about confidential statements made by patients for the purposes of treatment. Since Jaffee, federal circuit courts have split on whether there should be an exception to this privilege in cases involving so-called dangerous patients that pose a serious risk to themselves or others. Central to this debate has been a disagreement among federal courts about whether the dangerous patient exception discourages vulnerable patients from receiving life-saving mental health treatment. While commentators have predicted that the U.S. Supreme Court may soon resolve this circuit split, no prior studies have empirically tested the effect of the dangerous patient exception.
By taking advantage of the timing of this circuit split, we find that the introduction of the dangerous patient exception is associated with a statistically significant increase in suicides, but no change in homicides. Both results are consistent with claims by prominent critics, including the American Psychiatric Association, that the dangerous patient exception provides minimal public safety benefit while discouraging vulnerable patients from seeking mental health treatment. These results caution against recognizing or extending the dangerous patient exception in future cases.
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