2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter II - General Responsibilities of Mental Health Service Providers and General Provisions for Adults and Minors (§§ 6153 — 6153y) › § 6153q - Duty to warn third parties at risk or under threat of harm

(1) When a person informs a physician, psychiatrist, psychologist, social worker, professional counselor, or any other healthcare professional of a threat to physically harm a third party, the physician, psychiatrist, psychologist, social worker, professional counselor, or healthcare professional shall have the duty to warn said third party of the possibility of a threat, when he/she may be reasonably identified, after complying with the provisions of this section.
(2) In the event that the threat to harm a third party is informed to any other person rendering services to a mental health patient, he/she shall immediately so notify the physician, psychiatrist, psychologist, social worker, professional counselor, or any other healthcare professional in charge of rendering mental healthcare services to the person, and shall so state in detail in the clinical record.
(3) In order for the duty to warn to arise, the physician, psychiatrist, psychologist, social worker, professional counselor, or other healthcare professional must:
(a) Have identified, evaluated, and verified the existence of a threat to harm a third party in particular, and
(b) have established that, upon taking into consideration the risk factors associated with violence, there is a great probability that said threat could be carried out.
(4) Once the threat is notified, the physician, psychiatrist, psychologist, social worker, professional counselor, or other healthcare professional shall warn the person under threat, and carry out the following actions:
(a) Provided it is therapeutically indicated, he/she shall inform the person who proffers the threat of the duty to warn that he/she has pursuant to this chapter;
(b) notify the threat to the police station closest to the residence of the third party put at risk;
(c) notify the third party of the threat to harm him/her, handling this situation with tact and caution, and
(d) if he/she has reasonable basis to believe that the third party is not able to understand or is a minor, he/she shall notify a family member of the existence of the threat.
(5) In those situations in which the professional believes that the person issuing the threat meets the criteria needed for hospitalization, such professional shall initiate the procedures for voluntary or involuntary hospitalization.
(6) In those situations in which the risk is informed while the person is hospitalized, the physician, psychiatrist, psychologist, social worker, professional counselor, or other healthcare professional, shall notify the medical director, and shall so state in detail in the clinical record.
(7) Any information entered in the clinical record as per the requirements of this section shall be included in a separate section within the clinical record. This information shall be deemed to be privileged and confidential for disclosure purposes.
(8) When a psychiatrist, physician, psychologist, social worker, professional counselor, or any other healthcare professional determines that a particular situation requires carrying out the duty to warn, he/she shall be held harmless from any civil liability, insofar as there is no gross negligence involved in the discharge of his/her duty. Moreover, mental healthcare professionals who, in good faith, carry out their duty to warn shall not be breaching the physician-patient privilege, pursuant to the provisions of Rule 26 of the Rules of Evidence of 1979, as amended.
(9) Any law enforcement officer (from both the Commonwealth and the municipal police) who has been notified by a mental healthcare professional, a relative, or any citizen, as to the risk or threat posed by a mental health patient to harm him/herself or others or to damage property, shall respond as soon as practicable to protect the persons or the property involved.
History —Oct. 2, 2000, No. 408, § 2.18; Aug. 6, 2008, No. 183, § 15.