Confidentiality facilitates honest communication by assuring patients that the innermost details of their lives, shared with their health care providers, will remain private. Yet, nearly 50 years ago, the Tarasoff case imposed a duty to warn on California mental health professionals, requiring them to take reasonable steps to protect potential victims of their clients. Numerous states followed suit.

This duty is balanced against the patient's right to privacy under HIPAA. In recent years, many courts have held that the duty to warn can be overridden by the patient's right to privacy if the risk of harm is not imminent or if there is no other way to protect the potential victim. Subsequently, California was among the states that enacted legislation establishing that all mental health professionals have a duty to protect the public and that the duty to warn or protect takes precedence over protecting therapist-patient confidentiality.