The SAFE Act may actually be more protective of patient confidentiality in that it specifically limits disclosure to non-clinical information. The Tarasoff law has no such limitation.
Finally, one aspect of the law might be more problematic for clinicians but has been given no media attention. The SAFE Act requires the Office of Mental Health to develop an administrative process by which a gun owner can have his or her rights restored. The standard of review is that the individual “will not be likely to act in a manner dangerous to public safety and where the granting of the relief would not be contrary to public safety.” I’m sure there will be a few vigorous debates and sleepless nights over the determination of exactly what “not likely” means and how someone will prove that he or she is really safe. Assessment of competency to own and use a weapon is one thing I was not taught in residency.
The act also extends the current assisted outpatient treatment law, closes some loopholes in the law, and adds additional steps to identify eligible patients, but the specifics of this are beyond the scope of this column. The act modifies nine previously existing laws and these complicated pieces of legislation sometimes result in unanticipated contradictions that will get litigated over time. Until then, I think clinicians have some breathing room to know the law might not be as onerous as was first reported.
—Annette Hanson, M.D.
DR. HANSON is a forensic psychiatrist and co-author of Shrink Rap: Three Psychiatrists Explain Their Work. The opinions expressed are those of the author only, and do not represent those of any of Dr. Hanson’s employers or consultees, including the Maryland Department of Health and Mental Hygiene or the Maryland Division of Correction.