The Top Liability Exposures in Mental Health Care, and How Providers Can Reduce Their Risk

While changes in consumer demands, technology, and treatment options increase the liability risks mental health care providers face, there are also resources they can use to continue providing quality care.

The pandemic placed great strain on the health care system and some of its effects persist today. In particular, the mental and behavioral health field has seen an influx of patients, increasing liability risks for physicians who are already stressed.

The pandemic increased everyone’s stress levels. We know more people will be seeking behavioral health care services, and like all other sectors, are struggling with employee retention and recruitment. Burnout is certainly an issue for mental health professionals, which increases the vulnerability of the system and the potential for mistakes to be made. “We have seen a lot of liability exposures related to suicide, abuse and negligent treatment in this area,” said Valerie Beatrice, CPCU, product specialist, Philadelphia Insurance.

Beatrice explains the ins and outs of these risks and what mental and behavioral health practitioners can do to reduce their risk.

Top Liability Risks in Mental Health Care

One major change driven by the pandemic was the shift toward telemedicine. Although it grew in popularity as a way to maintain social distancing, it has stuck around due to its convenience and cost-effectiveness. However, in some cases, virtual visits may disrupt the quality of care.

Knowing that a virtual service doesn’t provide the same sense of intimacy or connection as an in-person conversation can present a new set of challenges, Beatrice said.

When visits are not face-to-face, practitioners such as psychiatrists and psychologists may have difficulty establishing the rapport that is important in understanding a patient and providing appropriate treatment. Because the same level of privacy is not easily achieved with a virtual visit, patients may not feel free to speak freely. These factors may lead to inadequate or inappropriate treatment.

One of the most serious risks associated with telemedicine in the mental health field is the increased risk of suicide. Of course, the treatment any suicide victim receives will be under scrutiny. If perhaps the patient was not prescribed the most effective medication or dosage, this omission could invite medical malpractice claims.

Other forms of self-harm, abuse or any violent behavior may also raise questions around the adequacy of treatment or the appropriateness of the treatment setting.

Portrait of Valerie Beatrice

Valerie Beatrice, CPCU, Product Specialist, Philadelphia Insurance

In places of insecurity, unfortunately there is opportunity for abuse. It could also be physical or sexual abuse between a practitioner and a client, or between clients in a group setting, Beatrice said.

Although this risk is not new, it may be more prevalent now as mental and behavioral practices are experiencing recruitment and retention shortages, as are most industries.

This risk has increased today given the pressure on staffing. Beatrice said there is a risk that background checks may be rushed, or policies may not be followed to retain practice staff. This increases the likelihood that abusers with documented histories may get away with it.

Finally, risks associated with new treatments are emerging, such as ketamine or transcranial magnetic stimulation (TMS) which is an FDA-approved therapy for depression.

There are new treatments emerging that doctors have had great success with, Beatrice said, but they are still new. As carriers, we need to evaluate exposure carefully. One question is to determine for whom these treatments are best suited and how any side effects are monitored and managed.

Risk Mitigation Strategies

Even in the face of new trends, mental and behavioral health care providers can often rely on tried-and-true strategies to reduce their liability exposure.

For example, with respect to misuse risk, incident prevention begins with strong guidance from leadership and top-down enforcement of incident response policies.

Beatrice said it is important to foster a culture of preventing abuse and implement written policies and procedures so the organization can take a position on what will happen if an abuse incident occurs.

Organizations can also rely on their carrier partners for risk management resources, such as training for practitioners on suicide and self-harm identification and prevention.

At Philadelphia Insurance, we have partnered with Abuse Prevention Systems where our policyholders can receive free online abuse training annually. We also partner with the Suicide Prevention Resource Center (SPRC). It has an initiative called the Zero Suicide Academy, which aspires to zero suicides within an organization. It is based on the belief that suicide can be prevented, Beatrice said, and it equips behavioral health professionals with the knowledge to identify at-risk individuals and understand how to intervene.

The SPRC includes an online library of resources, including tools, fact sheets, and reports to keep providers informed. Other available resources include the CDC suicide prevention site, which offers a section on support for teens and young adults, and the National Institute of Mental Health (NIMH) website, which discusses signs and symptoms, risk factors, and ongoing research. Is.

When it comes to the realm of virtual therapy, Beatrice said, there’s no substitute for in-person interaction, especially for the initial visit.

I think it makes sense if the patient has been properly evaluated for their eligibility for virtual services. “But in terms of underwriting, we definitely prefer in-person evaluations first, then virtual services, just because of the nuances of the treatment that you do virtually,” she said.

Providers can also use the CMS Telehealth Toolkit, which outlines appropriate uses for telehealth and provides suggestions about how to adapt virtual health services to the needs of different populations.

As the need for mental health care services increases, providers can provide better care and also protect themselves by being proactive and utilizing all of these available resources. ,

Katie Dwyer is a freelance editor and writer based in Philadelphia. can be reached [email protected],

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