10 Ways American Horror Story Cult Explores Mental Illness In America Through Ally

2. Ivy Called Ally's Therapist Without Ally's Permission

Ally missed an appointment with her therapist Dr. Rudy. Not only was Dr. Rudy concerned but Ivy was concerned as well, so Ivy invited him over as a surprise for Ally when she was having the house fortified. Ally wasn't happy, and because of doctor-patient confidentiality Dr. Rudy couldn't inform Ivy that Ally borrowed a gun from the neighbors. The result: Ally accidentally murders Pedro, a restaurant employee.

These scenes highlight an important procedure regarding the treatment of mentally ill in the United States. It's the physician's duty to warn if a patient is threatens to harm others or themselves. This legal responsibility was enacted by several states in the wake of the 1976 California supreme court case Tarasoff v. The Regents of the University of California.

Tatiana Tarasoff was murdered by a graduate student who had earlier confided to his psychiatrist his intent to kill her. Due to confidentiality, the psychiatrists didn't warn Tarasoff or her family, resulting in her death. Today, 33 states require physicians to report dangerous patients and Michigan is one of those.

Of course, Ally didn't threaten anyone, but this scenario also demonstrates the limits of current mental health practice and law in the United States. Despite her history, her increasing anxiety, fortification of their house and her possession of a handgun (which currently requires a carry permit in Michigan that as far as we know she doesn't have), Dr. Rudy couldn't have predicted she would actually kill someone. That requires Ally to threaten a specific person. Pedro's death was accidental, but could have been prevented if Dr. Rudy had legal authority to inform Ivy of the handgun.