PER CURIAM.

Northwest Alabama Mental Health Center, a public corporation ("Northwest"), and its executive director, Skip Newman, petition this Court for a writ of mandamus seeking the vacation of an order of the Lamar Circuit Court that required them to produce the mental-health records of Northwest patient Dimoris Johnson. We grant the petition.

I. Facts and Procedural History

In the fall of 2007, Lawrence Neil Broadhead was admitted to Bryce Hospital, a State-operated mental-health facility, for treatment of depression and drug abuse. Broadhead remained a patient of Bryce Hospital until February 19, 2008, when he was transferred to a mental-health facility operated by Northwest and known as The Hope Residential Facility. Johnson was also a patient at The Hope Residential Facility. Broadhead remained at The Hope Residential Facility from February 19, 2008, through February 29, 2008. During that time, Johnson allegedly beat Broadhead so severely that, since the alleged assault, Broadhead has remained in a semi-comatose condition.

In October 2008, Broadhead, through Sheila Yaw, his mother and next friend, sued Northwest and Newman, among others.1 Yaw asserted that the defendants had negligently or wantonly breached certain duties allegedly owed Broadhead, including, among other things, the duty to take proper security measures to ensure Broadhead's safety, the duty to properly supervise Johnson, and the duty to properly train, monitor, and supervise Northwest's employees. Johnson was not named as a party to the action.

During discovery, Yaw filed a request for the production of Northwest's records pertaining to Johnson. Northwest and Newman objected to the request, asserting that the requested materials were subject to the psychotherapist-patient privilege. See Ala.Code 1975, § 34-26-2; Rule 503, Ala. R. Evid. In response, Yaw filed a motion to compel Northwest and Newman to produce the records.2 Northwest and Newman filed a brief in support of their argument that Johnson's records were privileged; that brief, however, is not included in the materials before us on this petition for the writ of mandamus. In response to the trial court's request that Yaw provide it with a memorandum explaining why she believed the records at issue were discoverable, Yaw filed a "letter brief" in which she stated:

(First emphasis in Yaw's brief; second emphasis added.) Yaw then proceeded to make a "public policy" argument that "Mr. Johnson's right to have his mental health records concealed" must yield to "the public interest in safety." She also argued that the records should be discoverable because, she argued, they were "essential to a just determination of the present case" and because, according to Yaw, an insanity defense had been raised by Johnson in a collateral criminal proceeding and the raising of that defense had effected a waiver of the privilege.3

In September 2009, the trial court issued a protective order requiring Northwest to submit the records at issue to the court for an in camera inspection.4 The protective order provided:

Northwest and Newman filed a motion requesting that the trial court reconsider its September 2009 protective order and that the court issue an order protecting the records at issue from disclosure or production.5 The trial court denied the motion.

At some point after the entry of the September 2009 protective order, Northwest apparently submitted Johnson's records to the trial court for an in camera review in response to the protective order. In January 2010, after reviewing the records, the trial court entered an order finding that "all records are materially relevant to the issues pending herein" and ordering that Johnson's records be provided to Yaw for inspection and copying. The trial court further ordered that "the disclosure of these otherwise confidential materials shall be restricted to this litigation as permitted by the [September 2009] Protective Order."

Northwest and Newman filed the present petition for a writ of mandamus in response to the trial court's January 2010 order.

II. Standard of Review

This Court has held that it reviews by petition for a writ of mandamus a trial court's discovery orders only "[i]n certain exceptional cases"; one of those circumstances is "when a privilege is disregarded," or allegedly so. Ex parte Ocwen Fed. Bank, FSB, 872 So.2d 810, 813 (Ala.2003).

Ex parte National Sec. Ins. Co., 727 So.2d 788, 789 (Ala.1998).

The issues presented in this case concern the parameters of an evidentiary privilege and, in particular, whether the law recognizes contended-for exceptions to that privilege. Such questions are matters of law. See, e.g., Hutchinson v. Farm Family Cas. Ins. Co., 273 Conn. 33, 38, 867 A.2d 1, 4-5 (2005) ("Whether the trial court properly concluded that there is an exception to the attorney-client privilege when an insured has made an allegation of bad faith against an insurer ... and, if so, whether it properly delineated the scope and contours of such an exception, are questions of law."); State v. Gianakos, 644 N.W.2d 409, 415 (Minn.2002) ("The determination whether a particular testimonial privilege or exception exists ... is a question of law which this court reviews de novo."). Accordingly, we apply a de novo standard of review. Regions Bank v. Reed, 60 So.3d 868, 877 (Ala.2010) (explaining that when a petition presents only questions of law, this Court applies "a de novo standard"); see also Gianakos, supra.

III. Analysis

The psychotherapist-patient privilege, as adopted by the legislature, provides, in pertinent part, that "the confidential relations and communications between licensed psychologists, licensed psychiatrists, or licensed psychological technicians and their clients are placed upon the same basis as those provided by law between attorney and client, and nothing in this chapter shall be construed to require any such privileged communication to be disclosed." Ala.Code 1975, § 34-26-2. Rule 503, Ala. R. Evid., "Psychotherapist-Patient Privilege," provides further explication of this privilege, providing, in pertinent part:

As noted, Yaw argued to the trial court that there should be a "public policy" exception to the psychotherapist-patient privilege in cases where such an exception is "essential to protect the public interest of the community," i.e., the public interest in safety. Northwest and Newman reject this position and argue that "public policy" actually supports the application of the privilege in a case such as this.

"The strength of the public policy on which the statutory psychotherapist-patient privilege is based has been well recognized by this Court. It follows that the privilege is not easily outweighed by competing interests." Ex parte United Serv. Stations, Inc., 628 So.2d 501, 504 (Ala. 1993). The Court has explained the public policy that supports the privilege as follows:

Ex parte Rudder, 507 So.2d 411, 413 (Ala. 1987).

As important as maintaining the psychotherapist-patient privilege is to patients and the public, this Court has recognized that "this psychiatrist-patient privilege may not in all cases be an impenetrable shield." Rudder, 507 So.2d at 417. Yaw cites one case from another jurisdiction that appears to allow an exception to the privilege for a situation involving "[a] mental patient's threat of serious harm to an identified victim."6 At least one other jurisdiction allows an exception to the privilege in a situation "where the public interest in safety from violent assault is threatened."7 No Alabama case has been brought to our attention creating such an exception, however, and we are aware of none.

In Ex parte Pepper, 794 So.2d 340, 343 (Ala.2001), this Court declined an invitation to create "an exception to the privilege applicable when a party seeks information relevant to the issue of the proximate cause of another party's injuries." 794 So.2d at 343. The Court explained:

Pepper, 794 So.2d at 343-44.

Northwest and Newman argue that the Alabama Rules of Evidence state five exceptions to the psychotherapist-patient privilege, see Rule 503(d), and that the situation presented here falls into none of those five exceptions. In the face of those five exceptions, we decline to use our adjudicatory authority over an individual case such as this to create an additional exception in the interest of "public policy." "`"The term `public policy' is inherently not subject to precise definition.... `Public policy is a vague expression, and few cases can arise in which its application may not be disputed....'"' ... Such creations are best left to the legislature." Hinrichs v. Tranquilaire Hosp., 352 So.2d 1130, 1131 (Ala.1977) (quoting Petermann v. International Brotherhood of Teamsters, 174 Cal.App.2d 184, 188, 344 P.2d 25, 27 (1959)). We agree that such creations are best left to the legislature, or perhaps to the normal rule-making authority of this Court. See 25 Charles Alan Wright & Kenneth W. Graham, Jr., Federal Practice & Procedure: Evidence § 5542 (1989) ("If there is not an applicable exception to a statutory patient's privilege, courts have no power to create exceptions by judicial decision.").

Yaw also argued in the trial court that Johnson's medical records should be discoverable because, she argued, they are "the only source of relevant evidence" for her legal action and their release is "essential to a just determination of the present case." In their petition, Northwest and Newman argue that the privilege, as articulated by the legislature and by Rule 503, Ala. R. Evid., does not contemplate such an exception.

The legislature has established parameters for the psychotherapist-patient privilege, namely, that "the confidential relations and communications between licensed psychologists, licensed psychiatrists, or licensed psychological technicians and their clients are placed upon the same basis as those provided by law between attorney and client." Ala.Code 1975, § 34-26-2. We have been directed to no Alabama statute, rule, or precedent8 that recognizes, or impels us to recognize in this case, an exception to the privilege that would narrow those parameters by making the privilege inapplicable when a plaintiff establishes that privileged information is "necessary" to proving a cause of action. Such an exception might be compared to the exception recognized in Rule 26(b)(3), Ala. R. Civ. P., for the discovery by one party of another party's work-product. Obviously, however, there are differences in the policies that underlie the psychotherapist-patient privilege and the work-product privilege, and overriding the former, we think, arguably has more serious ramifications than overriding the latter. Moreover, we note with approval the special writing of Justice Lyons, joined by Justices Houston, See, and Brown, in Ex parte Etherton, 773 So.2d 431, 436 (Ala. 2000) (plurality opinion):

(Lyons, J., concurring in the result); see also Wright & Graham, § 5542 ("If there is not an applicable exception to a statutory patient's privilege, courts have no power to create exceptions by judicial decision.").9

Having concluded that none of the recognized exceptions to the privilege apply here and that this Court should not in this proceeding create a new exception to the privilege, the only remaining question is whether Johnson waived the privilege. Yaw notes that one of the recognized exceptions to the psychotherapist-patient privilege is that the privilege is waived by implication when a criminal defendant raises the defense of insanity. See Rule 503(d)(3), Ala. R. Evid. ("There is no privilege under this rule as to an accused in a criminal case who raises the defense of insanity." (emphasis added)). Yaw contends that Johnson waived the psychotherapist-patient privilege by raising the issue of his sanity in the criminal case pending against Johnson for his alleged assault of Broadhead. Assuming without deciding that a defendant's raising the defense of insanity in a criminal proceeding effects a waiver of the psychotherapist-patient privilege in a related, but collateral, civil proceeding, Yaw's argument must be rejected because it does not appear that Johnson did in fact assert an insanity defense in any criminal proceedings arising out of the alleged assault of Broadhead.

Yaw relates in her brief to this Court that the trial court stated at a hearing in this case that, in the related criminal case against Johnson, it had ruled that Johnson was incompetent to stand trial and had ordered that he be committed to Taylor Hardin Secure Mental Facility for evaluation. We note, however, that "[t]he [defendant's] sanity at the time of the offense and his competency to stand trial are two distinct issues." Frazier v. State, 758 So.2d 577, 584 (Ala.Crim.App.1999). We are presented here with no argument that an inquiry into the competency of a defendant to stand trial in a criminal proceeding has any bearing on the availability of the psychotherapist-patient privilege in a collateral civil proceeding. See generally Rule 11.2(b)(1), Ala. R.Crim. P. (results of mental examinations as to competency to stand trial are inadmissible in a trial for the offense charged).10

As noted above, although Rule 503(c) authorizes the patient and certain other persons to invoke the psychotherapist-patient privilege, "only the client may waive the privilege." Watson v. State, 504 So.2d 339, 344 (Ala.Crim.App.1986). Moreover, the patient must "objectively manifest a clear intent not to rely upon the privilege" in order to waive it. Ex parte United Serv. Stations, Inc., 628 So.2d at 505. The materials before us do not support the conclusion that Johnson waived the privilege. Therefore, the trial court's order requiring Northwest and Newman to produce Johnson's medical records cannot be justified on this basis.11

IV. Conclusion

Based on the arguments and materials that were presented to the trial court and that are properly before us, we conclude that the trial court's order requiring the production of Johnson's medical records was entered in error. We therefore grant Northwest and Newman's petition and order the trial court to vacate that order.

PETITION GRANTED; WRIT ISSUED.

COBB, C.J., and WOODALL, BOLIN, and MAIN, JJ., concur.

MURDOCK, J., concurs specially.

MURDOCK, Justice (concurring specially).

I write separately to comment on the presumption that, when a psychotherapist invokes the privilege, he or she has the "authority" to do so: "The person who was the psychotherapist at the time of the communication is presumed to have authority to claim the privilege but only on behalf of the patient." Ala. R. Evid. 503(c). In an argument made by Sheila Yaw in her brief to this Court, but not made to the trial court, see 68 So.3d at 801 n. 11, Yaw argues that Northwest Alabama Mental Health Center and Skip Newman's invocation of the privilege in this case was not done on behalf of Dimoris Johnson, the patient. This argument is premised on the notion that the last clause of Rule 503(c), "but only on behalf of the patient," contemplates a different issue than whether the psychotherapist has "authority" to invoke the privilege. In particular, Yaw argues that in order for Northwest and Newman to invoke the privilege "on behalf of Johnson" the disclosure prevented by the invocation of the privilege must be "prejudicial" in some way (exactly how is not explained), other than prejudicing the confidence of members of the community in their ability to make confidential disclosures to their physicians and the efficacy of the physicians' advice or treatment, and the general interest of the community as a whole in the efficacy of that treatment. As stated in the opinion, however, whether the "on behalf of the patient" requirement (which presumably could be refuted by the production of a waiver from the patient) does in fact contemplate something more than the general presumption of authority (see generally 25 Charles Alan Wright & Kenneth W. Graham, Jr., Federal Practice & Procedure: Evidence § 5541 (1989) (questioning whether the "on behalf of the patient" requirement fails only where the patient has waived the privilege or is deceased); see also id. at § 5553 ("[I]t is generally held that the court can assert the privilege on behalf of an absent patient, either on its own motion or that of a party.")) is not an issue properly before us.