Post Traumatic Stalking Disorder

MDD is diagnosed when one has experienced five or more of the diagnostic symptoms during a two week period including either decreased mood or loss of interest (APA, 2013). This can range between mild to severe, and can also be in stages of remission and can be accompanied by other specific features. This diagnosis requires a mental health professional.

In Logan, et al.'s (2006) study of partner stalking she found participants described a diminished sense of independence and autonomy. As well as having lost sight of or an inability to pursue their goals. They were uncomfortable or unable to dress how they wanted either due to their stalkers' demands or due to being in hiding.

Women and men describe feeling decreased self-esteem due to stalking incidence, loss of power, and hopelessness, as well as a general byproduct of depression. In Logan, et al. (2006) study she found that women described negative perceptions of themselves, often due specifically to emotional abuse and the after effects of stalking. Logan, et al. (2006) also found women described a decrease in self-confidence often linked to feelings of blame. 

Some women in the Logan, et al. (2006) study took some level of responsibility for either choosing their partner or the actions that resulted in the stalking (or other) behavior(s). Women articulated that they should have known better, or should have set better boundaries when behavior emerged.

Logan, et al.'s (2006) participants identified

• cost 
• lack of insurance
• or financial resources 

were primary reasons women did not seek health or mental health care services

Women in Logan, et al.'s (2006) study identified stalking as a reason they could not access services . They also listed:

• not knowing where to go
• scheduling conflicts or delays

In the partner-stalking study conducted by Logan, et al. (2006) the majority of participants noted this barrier as paramount. Embarrassment and stigma, particularly in rural areas, not only around the stalking but also regarding mental health treatment.

Logan, et al. (2006) identified that many victims do not feel that mental health treatment will help them, talking about solutions is not action, does not stop the stalking behavior, and at times victims do not take the behaviors seriously to begin with. The behaviors, will require CJS intervention. Some victims do not want to talk about it, or feel that talking to those in their circle is sufficient. However others may not be ready, and need more time to face the seriousness about their situation (Logan, et al. 2006).

In the Tarasoff vs. Regents of the University of California, Tarasoff’s parents acting as the plaintiffs asserted that there was a failure on the part of the four psychologists who had a duty to warn Tatiana or her parents of Poddar’s expressed threats to kill Tarasoff.

This case required that the courts find a balance between the need to protect privileged communications made by a patient and the protection of society against possible threats.

Essentially, a provider owes a duty of care to those exposed to harm by their conduct when the conduct is risky or dangerous. The law imposes a liability on the professional only if the they have a special relationship with the stalker or victim.

In the Tarasoff vs Regents case, The California Supreme Court found that mental health professional(s) have a duty to their patient(s), third parties (secondary-victims), who are specifically threatened by their patient.

There must be a balance between privileged information and public safety.

The courts concluded that information shared with a health professional must be kept confidential and privileged, however, client-communications may be revealed if the disclosure is essential to prevent dangers to third-party.

This is also known as “duty to warn” or “duty to protect,” and is a statutory obligation in many states.

Ewing I and Ewing II, expanded Tarasoff to include "family members of patients." Therefore, a communication from a patient's "family member" to the patient's therapist about the patient threatening to physically harm or kill someone may create a duty upon the mental health professional to warn an intended victim of the threatened violent behavior. Threats must still be analyzed to determine their veracity.

 This expansion has complications. First, Ewing I and Ewing II limit this rule to "family members" or to the patient's "immediate family," with no further specification, or clarification. The goal is to maintain confidentiality which the court opined that assurances of confidentiality are important for three reasons: (1) to avoid the stigma that results from seeking mental health care; (2) to effectuate counseling; and, (3) to facilitate trust between the patient and the therapist. However, to protect individuals from physical harm, is the priority. 

Providers do not generally acknowledge the identities of their clients to third-parties. However, suicides or homicides rarely come without red-flags. Therefore, in a situation where a patient a danger to themselves, others, the law permits them, to contact whomever necessary to prevent the threat from being acted upon. 

However, 'hearing a threat,' does not always necessitate a 'duty to warn' obligation, whether from a patient, a family member, or another credible third-party.