[startgroup] Re: Use of T.H.R.E.A.T.

  • From: "Brink, Johann" <jbrink@xxxxxxxxxxxxxx>
  • To: "'startgroup@xxxxxxxxxxxxx'" <startgroup@xxxxxxxxxxxxx>
  • Date: Mon, 5 Apr 2010 12:51:12 -0700

Dear Alex
The THREAT acronym is a stand-in for a Tarasoff type situation where there is a 
duty to warn and protect. While this may not be a legal, professional or 
ethical requirement in countries other than the USA, the issue of whether there 
exists a likely, identifiable, targeted victim remains urgent. While in Canada 
we have not had clear case law to parallel the California Tarasoff ruling, our 
courts have signalled that should such a case come to court, the bench would 
follow the Tarasoff reasoning and require that arranging for the safety of an 
identified and targeted victim would take preference over client 
confidentiality. The scenario that you describe would  thus not in my view 
qualify as a THREAT. 
Best regards

Johann Brink MB ChB BA Hons FCPsych(SA) FRCPC
Director, Clinical Services & Scientific Director
Forensic Psychiatric Services Commission
BC Mental Health and Addiction Services
70 Colony Farm Road
Coquitlam, BC
V3C 5X9
Clinical Professor
Dept Psychiatry, UBC
Adjunct Professor
School of Criminology, SFU
ph: 604-524-7702
fax: 604-524-7905
Admin Assistant: Lynn White
ph: 604-524-7749
fax: 604-524-7905

-----Original Message-----
From: startgroup-bounce@xxxxxxxxxxxxx [mailto:startgroup-bounce@xxxxxxxxxxxxx] 
On Behalf Of Alexander M MILLKEY
Sent: April 5, 2010 12:39 PM
To: startgroup@xxxxxxxxxxxxx
Cc: Brooke HOWARD; Darci WALKER; ebalduzzi622@xxxxxxxxx; Nicholls, Tonia
Subject: [startgroup] Use of T.H.R.E.A.T.

Hello Colleagues,

We are debating the proper use of the THREAT at our hospital, and I am hoping 
that we can benefit from the experience of others on the list.

We are attempting to rate a patient who is violent on perhaps a weekly basis. 
The violence is not targeted - the people being assaulted are selected due to 
convenience, not premeditation. Others have been seriously injured by this 
patient. This patient's PRESENT risk for violence is high. 

Would this patient be rated a Yes or No on THREAT? The risk of violence is 
real, enactable, and perhaps acute. However, it is not targeted. Must the risk 
for violence be targeted to be a THREAT on the START, or are the latter three 

Thanks in Advance,


Alexander M. Millkey, Psy.D. 
Evaluation Psychologist
Forensic Evaluation Service
Oregon State Hospital
Office: (503) 945-9262
Fax: (503) 945-9747

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