Can you describe a situation where you had to break confidentiality in order to prevent harm to a patient or others?
As a Psychiatrist, you may need to break confidentiality if a patient is at risk of harming themselves or others. In situations where a patient is expressing suicidal thoughts or has a plan to harm themselves, you may need to take action to ensure the patient's safety. Similarly, if a patient is expressing violent or aggressive thoughts or has a plan to harm others, you might need to take action to protect potential victims. It is important to note that breaking confidentiality is not done lightly and should only be done when necessary to prevent harm. You must balance the patient's right to privacy with the need to ensure the safety of the patient and others. Let the interviewer know when you had to break confidentiality for the good of your patient or others.
"I had a client who brought her infant daughter to our sessions since she was a single mom without outside help. At one of our last scheduled sessions, she spoke about wanting to hurt her daughter and had a plan on how to do so. At the same time, I noticed the child was quieter than usual, and my patient would not let me look at her. I calmly excused myself and said I urgently needed to use the restroom and would be right back. I called 911 and asked for a police response. When the officers arrived, I told them what my patient had said and how I was worried about the infant. When they questioned her and asked to look at the baby, they noticed bruising around the baby's neck and called for an ambulance. They took the infant to the hospital and the mother in for questioning. I highly value my client's confidentiality until they give me a reason to believe they will harm themselves or others."
"During my training, I have not encountered a situation where I had to break a patient's confidentiality. What I learned was that it is appropriate to do so when a patient is a harm to themselves or others, or unless the state law provides other reasons for doing so, such as reports of financial elder abuse. While I will safeguard my patient's confidentiality to develop trust and offer privacy in our interactions, I am prepared to break that bond if the situation warrants."
"I have only had to break confidentiality twice in my ten-year career, and both times were for patients who were planning on harming themselves after our session. One patient had a bottle of pills in his backpack that he planned on taking with a bottle of vodka, and the other was going to jump off a 324-foot bridge that was on his way home. In both situations, I called the police to intervene."
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