Arguments advanced in support of prosecuting patients include encouragement of patient responsibility, facilitation of reality therapy by limit-setting, improvement of staff morale, and deterrence of patient violence. Those who oppose arrest and prosecution argue that it subverts therapeutic alliances, invites countersuits, alienates patients from treatment, and may violate therapist-client confidentiality. A five-step approach for determining the appropriateness of prosecution involves presenting patients with their rights and responsibilities upon admission to psychiatric hospitals, establishing criteria for pursuing prosecution as part of hospital policy, reviewing violent incidents by outside clinicians, reviewing findings of the screening evaluation, and filing any complaint independent of the treatment staff. 18 notes