When Therapy Crosses the Line: Legal Lessons from 2,000+ Mental Health Malpractice Cases
- Laura Nozicka
- May 7
- 3 min read
By Laura Nozicka, Host of Desperate for a Diagnosis
Mental health care is meant to be a space for healing, safety, and trust. But in some cases, it becomes a place of harm, confusion, and legal fallout. When therapy goes wrong, it doesn’t just hurt the patient, it can end careers, result in lawsuits, and sometimes, cost lives.
In a recent episode of Desperate for a Diagnosis, I spoke with attorney Scott Hammer, who has represented more than 2,000 mental health professionals throughout his legal career. From psychiatrists and psychologists to social workers and therapists, he has seen what happens when care crosses ethical, clinical, or legal lines.
Suicide Is the Leading Cause of Litigation
The most common reason mental health professionals are sued is patient suicide.
When a patient dies by suicide, families are left searching for answers and often, accountability. Providers become targets, even when they followed protocols and acted appropriately.
Hammer has handled more than 200 suicide-related cases. These cases are deeply emotional and legally complex. Providers are often devastated, not only by the loss of a patient but by the possibility of being blamed for it.
Even when documentation is solid and care was reasonable, grief can drive legal action. Suicide is difficult to predict, yet courts and juries often expect hindsight-level clarity that providers could not possibly have had in the moment.
Confidentiality Breaches Can Be Career-Ending
Maintaining confidentiality is fundamental to therapeutic relationships. But in today's digital age, even well-meaning clinicians can violate it unintentionally.
One therapist mentioned another patient to build rapport, revealing just enough details for the new client to identify the person. When apology letters were sent, the envelopes were switched and both patients filed lawsuits.
Whether it’s a slip in conversation, a misdirected email, or a social media post, a confidentiality breach can destroy trust and invite litigation.
Boundary Violations Are Often the Most Disturbing
Some of the most alarming cases involve therapists who cross professional boundaries.
Hammer described a therapist who gave a couple MDMA (ecstasy) during a session, then remained in the room while they engaged in sexual activity.
Another case involved a therapist who believed in “re-birthing” therapy. He had female clients sit naked on his lap and drink from a baby bottle, claiming it helped them reprocess early trauma. These behaviors were presented as “therapeutic,” but they were profoundly inappropriate—and resulted in legal action and license revocation.
Boundary violations often involve ethical delusion or exploitation, and they are among the most damaging for patients.
System Failures Can Be Deadly
Not all malpractice cases are interpersonal. Some are the result of institutional negligence.
One case involved a psychiatric inpatient who died after choking on a plastic-wrapped muffin. Though it seemed minor, it was later ruled a suicide. The facility failed to prevent a known high-risk behavior suicide by suffocation despite clear warning signs.
This case underscored how even routine items can become lethal in mental health settings and why safety protocols must be rigorously followed.
Alternative Treatments Come With New Legal Risks
The mental health field is evolving rapidly. With the rise of ketamine clinics, psychedelic therapy, and other nontraditional practices, new legal risks are emerging. Hammer shared examples of therapists giving ketamine without medical oversight, distributing hallucinogens, and referring harmed patients to “cult recovery” groups after therapy had gone wrong. Lack of regulation, improper consent, and blurred medical boundaries can leave both patients and clinicians vulnerable to significant harm—and litigation.
Families Must Stay Engaged and Informed
Scott emphasized that families play a critical role in protecting loved ones during treatment.
If a patient’s condition is worsening or a therapist seems evasive or overly familiar, those red flags should be taken seriously. Even when providers are bound by confidentiality, they can listen and acknowledge concerns.
In some cases, lawsuits were triggered because a therapist ignored repeated outreach from family members. Persistent concerns from loved ones should never be dismissed.
The Real-World Costs of Missteps in Mental Health
This episode served as a stark reminder that when mental health care crosses the line, the consequences can be severe.
Legal cases like these highlight how professional misjudgment, ethical violations, or lapses in systems of care affect not only patients, but also providers, families, and entire organizations.
Whether you’re a provider, a healthcare leader, or a researcher in the behavioral health space, these stories emphasize why boundaries, communication, and caution matter more than ever.
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