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Research ArticleRegular Articles

Unsolicited E-mails to Forensic Psychiatrists

Susan Hatters Friedman, Jacob M. Appel, Peter Ash, Richard L. Frierson, Deborah Giorgi-Guarnieri, Richard Martinez, Alan W. Newman, Debra A. Pinals, Phillip J. Resnick and Alexander I. F. Simpson
Journal of the American Academy of Psychiatry and the Law Online December 2016, 44 (4) 470-478;
Susan Hatters Friedman
Dr. Friedman is Associate Professor, University of Auckland, New Zealand, and Case Western Reserve, Cleveland, OH. Dr. Appel is Assistant Professor of Psychiatry, Icahn Mount Sinai School of Medicine, New York, NY. Dr. Ash is Professor, Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA. Dr. Frierson is Professor, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC. Dr. Giorgi-Guarnieri is in Private Practice, Williamsburg, VA. Dr. Martinez is Professor of Psychiatry and the Law, University of Colorado, Denver, School of Medicine, Denver CO. Dr. Newman is Chair of Psychiatry, California Pacific Medical Center, San Francisco, CA. Dr. Pinals is Clinical Professor of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Resnick is Professor of Psychiatry, Case Western Reserve University, Cleveland, OH. Dr. Simpson is Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Authors represented the Committee on Psychiatry and Law for the Group for the Advancement of Psychiatry.
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Jacob M. Appel
Dr. Friedman is Associate Professor, University of Auckland, New Zealand, and Case Western Reserve, Cleveland, OH. Dr. Appel is Assistant Professor of Psychiatry, Icahn Mount Sinai School of Medicine, New York, NY. Dr. Ash is Professor, Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA. Dr. Frierson is Professor, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC. Dr. Giorgi-Guarnieri is in Private Practice, Williamsburg, VA. Dr. Martinez is Professor of Psychiatry and the Law, University of Colorado, Denver, School of Medicine, Denver CO. Dr. Newman is Chair of Psychiatry, California Pacific Medical Center, San Francisco, CA. Dr. Pinals is Clinical Professor of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Resnick is Professor of Psychiatry, Case Western Reserve University, Cleveland, OH. Dr. Simpson is Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Authors represented the Committee on Psychiatry and Law for the Group for the Advancement of Psychiatry.
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Peter Ash
Dr. Friedman is Associate Professor, University of Auckland, New Zealand, and Case Western Reserve, Cleveland, OH. Dr. Appel is Assistant Professor of Psychiatry, Icahn Mount Sinai School of Medicine, New York, NY. Dr. Ash is Professor, Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA. Dr. Frierson is Professor, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC. Dr. Giorgi-Guarnieri is in Private Practice, Williamsburg, VA. Dr. Martinez is Professor of Psychiatry and the Law, University of Colorado, Denver, School of Medicine, Denver CO. Dr. Newman is Chair of Psychiatry, California Pacific Medical Center, San Francisco, CA. Dr. Pinals is Clinical Professor of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Resnick is Professor of Psychiatry, Case Western Reserve University, Cleveland, OH. Dr. Simpson is Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Authors represented the Committee on Psychiatry and Law for the Group for the Advancement of Psychiatry.
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Richard L. Frierson
Dr. Friedman is Associate Professor, University of Auckland, New Zealand, and Case Western Reserve, Cleveland, OH. Dr. Appel is Assistant Professor of Psychiatry, Icahn Mount Sinai School of Medicine, New York, NY. Dr. Ash is Professor, Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA. Dr. Frierson is Professor, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC. Dr. Giorgi-Guarnieri is in Private Practice, Williamsburg, VA. Dr. Martinez is Professor of Psychiatry and the Law, University of Colorado, Denver, School of Medicine, Denver CO. Dr. Newman is Chair of Psychiatry, California Pacific Medical Center, San Francisco, CA. Dr. Pinals is Clinical Professor of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Resnick is Professor of Psychiatry, Case Western Reserve University, Cleveland, OH. Dr. Simpson is Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Authors represented the Committee on Psychiatry and Law for the Group for the Advancement of Psychiatry.
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Deborah Giorgi-Guarnieri
Dr. Friedman is Associate Professor, University of Auckland, New Zealand, and Case Western Reserve, Cleveland, OH. Dr. Appel is Assistant Professor of Psychiatry, Icahn Mount Sinai School of Medicine, New York, NY. Dr. Ash is Professor, Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA. Dr. Frierson is Professor, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC. Dr. Giorgi-Guarnieri is in Private Practice, Williamsburg, VA. Dr. Martinez is Professor of Psychiatry and the Law, University of Colorado, Denver, School of Medicine, Denver CO. Dr. Newman is Chair of Psychiatry, California Pacific Medical Center, San Francisco, CA. Dr. Pinals is Clinical Professor of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Resnick is Professor of Psychiatry, Case Western Reserve University, Cleveland, OH. Dr. Simpson is Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Authors represented the Committee on Psychiatry and Law for the Group for the Advancement of Psychiatry.
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Richard Martinez
Dr. Friedman is Associate Professor, University of Auckland, New Zealand, and Case Western Reserve, Cleveland, OH. Dr. Appel is Assistant Professor of Psychiatry, Icahn Mount Sinai School of Medicine, New York, NY. Dr. Ash is Professor, Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA. Dr. Frierson is Professor, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC. Dr. Giorgi-Guarnieri is in Private Practice, Williamsburg, VA. Dr. Martinez is Professor of Psychiatry and the Law, University of Colorado, Denver, School of Medicine, Denver CO. Dr. Newman is Chair of Psychiatry, California Pacific Medical Center, San Francisco, CA. Dr. Pinals is Clinical Professor of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Resnick is Professor of Psychiatry, Case Western Reserve University, Cleveland, OH. Dr. Simpson is Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Authors represented the Committee on Psychiatry and Law for the Group for the Advancement of Psychiatry.
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Alan W. Newman
Dr. Friedman is Associate Professor, University of Auckland, New Zealand, and Case Western Reserve, Cleveland, OH. Dr. Appel is Assistant Professor of Psychiatry, Icahn Mount Sinai School of Medicine, New York, NY. Dr. Ash is Professor, Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA. Dr. Frierson is Professor, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC. Dr. Giorgi-Guarnieri is in Private Practice, Williamsburg, VA. Dr. Martinez is Professor of Psychiatry and the Law, University of Colorado, Denver, School of Medicine, Denver CO. Dr. Newman is Chair of Psychiatry, California Pacific Medical Center, San Francisco, CA. Dr. Pinals is Clinical Professor of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Resnick is Professor of Psychiatry, Case Western Reserve University, Cleveland, OH. Dr. Simpson is Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Authors represented the Committee on Psychiatry and Law for the Group for the Advancement of Psychiatry.
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Debra A. Pinals
Dr. Friedman is Associate Professor, University of Auckland, New Zealand, and Case Western Reserve, Cleveland, OH. Dr. Appel is Assistant Professor of Psychiatry, Icahn Mount Sinai School of Medicine, New York, NY. Dr. Ash is Professor, Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA. Dr. Frierson is Professor, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC. Dr. Giorgi-Guarnieri is in Private Practice, Williamsburg, VA. Dr. Martinez is Professor of Psychiatry and the Law, University of Colorado, Denver, School of Medicine, Denver CO. Dr. Newman is Chair of Psychiatry, California Pacific Medical Center, San Francisco, CA. Dr. Pinals is Clinical Professor of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Resnick is Professor of Psychiatry, Case Western Reserve University, Cleveland, OH. Dr. Simpson is Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Authors represented the Committee on Psychiatry and Law for the Group for the Advancement of Psychiatry.
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Phillip J. Resnick
Dr. Friedman is Associate Professor, University of Auckland, New Zealand, and Case Western Reserve, Cleveland, OH. Dr. Appel is Assistant Professor of Psychiatry, Icahn Mount Sinai School of Medicine, New York, NY. Dr. Ash is Professor, Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA. Dr. Frierson is Professor, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC. Dr. Giorgi-Guarnieri is in Private Practice, Williamsburg, VA. Dr. Martinez is Professor of Psychiatry and the Law, University of Colorado, Denver, School of Medicine, Denver CO. Dr. Newman is Chair of Psychiatry, California Pacific Medical Center, San Francisco, CA. Dr. Pinals is Clinical Professor of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Resnick is Professor of Psychiatry, Case Western Reserve University, Cleveland, OH. Dr. Simpson is Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Authors represented the Committee on Psychiatry and Law for the Group for the Advancement of Psychiatry.
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Alexander I. F. Simpson
Dr. Friedman is Associate Professor, University of Auckland, New Zealand, and Case Western Reserve, Cleveland, OH. Dr. Appel is Assistant Professor of Psychiatry, Icahn Mount Sinai School of Medicine, New York, NY. Dr. Ash is Professor, Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA. Dr. Frierson is Professor, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC. Dr. Giorgi-Guarnieri is in Private Practice, Williamsburg, VA. Dr. Martinez is Professor of Psychiatry and the Law, University of Colorado, Denver, School of Medicine, Denver CO. Dr. Newman is Chair of Psychiatry, California Pacific Medical Center, San Francisco, CA. Dr. Pinals is Clinical Professor of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Resnick is Professor of Psychiatry, Case Western Reserve University, Cleveland, OH. Dr. Simpson is Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Authors represented the Committee on Psychiatry and Law for the Group for the Advancement of Psychiatry.
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    Table 1

    Considerations in Deciding Course of Action After Receiving Unsolicited Email From an Unknown Person

    Determine whether the sender's identify can be verified. Could it be a person other than who the sender claims to be?
    Potential for creation of doctor–patient relationship with duty of care if you reply, despite lack of ability to examine or obtain collateral information in a potentially complex case
    Licensing and malpractice concerns if sender is not in state
    Potential for the e-mailer to misinterpret your response
    False expectations: potential for lack of appropriate action by e-mailer because he believes that he is following psychiatric advice, or alternatively, because he is waiting for a reply from the psychiatrist
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    Table 2

    Potential Decisions Regarding Response to Unsolicited E-mail From an Unknown Person

    Maintain a high junk-mail filter so as to avoid knowing that e-mails have been received
    Do not open e-mails from unknown senders as a matter of policy
    Set an automatic reply that unsolicited e-mails are not read or replied to
    Read e-mail, but choose not to reply for various reasons
    Read e-mail, acknowledge by thanking sender, politely stating that you are unable to assist and declining further contact
    Read e-mail, give general reply and clarify that there is not a doctor–patient relationship and that you are unable to provide medical advice; encourage sender to seek help in sender's own area; and record your course of action
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Journal of the American Academy of Psychiatry and the Law Online: 44 (4)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 44, Issue 4
1 Dec 2016
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Unsolicited E-mails to Forensic Psychiatrists
Susan Hatters Friedman, Jacob M. Appel, Peter Ash, Richard L. Frierson, Deborah Giorgi-Guarnieri, Richard Martinez, Alan W. Newman, Debra A. Pinals, Phillip J. Resnick, Alexander I. F. Simpson
Journal of the American Academy of Psychiatry and the Law Online Dec 2016, 44 (4) 470-478;

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Unsolicited E-mails to Forensic Psychiatrists
Susan Hatters Friedman, Jacob M. Appel, Peter Ash, Richard L. Frierson, Deborah Giorgi-Guarnieri, Richard Martinez, Alan W. Newman, Debra A. Pinals, Phillip J. Resnick, Alexander I. F. Simpson
Journal of the American Academy of Psychiatry and the Law Online Dec 2016, 44 (4) 470-478;
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