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June 12, 1996

Don't Ignore Patients' Threats, Psychiatrists Told

JAMA. 1996;275(22):1715-1716. doi:10.1001/jama.1996.03530460019010

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"I HATE YOU, I hate you, I hate you," a patient shrieks into a psychiatry resident's answering machine. A later message is more ominous: "I'm going to kill you." More chilling still: The resident's program director did not take these threats seriously, said forensic psychiatrist John Lion, MD, who played tapes of the calls at a workshop on the management of threats on the lives of clinicians at this year's annual meeting of the American Psychiatric Association (APA).

Attacks Not Uncommon  Physicians commonly discount risks of attacks by patients, said Lion, clinical professor of psychiatry at University of Maryland School of Medicine, Baltimore, adding, "They don't want to think the places they work may be dangerous."But at least 1 US physician is killed by a patient nearly every year, Lion said. About half of the 30 workshop attendees reported having been threatened, physically attacked, or stalked; some even reported