How e-prescribing saves time and prevents issues
E-prescribing is a standard of practice across healthcare fields, including psychiatry.
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What do therapists have to report, as mandated reporters?
While you as a therapist have an essential responsibility as a mandated reporter, the process can be challenging to navigate.
Confidentiality is one of the core values that creates a safe, trusting therapeutic relationship. When your clients feel confident that what they share stays between the two of you, they’ll be more likely to share their thoughts and feelings authentically, leading to more productive therapy. That said: In rare and serious cases, you may have an ethical and legal obligation to break client confidentiality.
Mandatory reporting laws, or mandated reporting, require therapists to report to authorities when a person is being harmed or is in danger of being harmed. While you as a therapist have an essential responsibility as a mandated reporter, the process can be challenging to navigate.
Situations that require mandated reporting
In general, mandated reporting laws exist to protect individuals — and specifically vulnerable persons including elderly people, children, or those living with disabilities, for example — who often cannot protect themselves from harm. Each state in the U.S. has its own mandated reporting requirements for therapists, with guidance about which situations are mandatory to report and how they should be reported.
The most common mandated reporting situations include:
- Physical harm can be any form of bodily harm against another person, such as beating, hitting, kicking, biting, or choking. In some states, this also includes spanking.
- Sexual harm involves any form of sexual abuse. According to the National Sexual Violence Resource Center, sexual abuse takes place when “a person knowingly causes another person to engage in a sex act by threatening or placing the other person in fear, or if someone engages in a sexual act with a person who is incapable of appraising the nature of the act or unable to give consent.”
- Neglect entails ignoring a vulnerable person’s emotional, educational, medical, or physical needs.
Some mandated reporting situations can be murkier, such as the circumstances surrounding a client disclosing intent to harm or kill another individual; your state may have a law about the circumstances under which you are allowed to tell the individual your client plans to harm. That’s why it’s so important to be aware of your state’s individual laws, and your responsibilities within them.
How to report
In order to report, you need specific information. For example, you typically would not report if a client tells you they’re having intrusive thoughts about harming a child. However, if the client admits they harmed a child in some way, or if they reveal a plan and intent, you would be mandated to file a report.
Where you report depends on the information you’ve received. If a child is being harmed, then you’d contact your area’s Child Protective Services. If an elderly individual is being harmed, then you’d contact Adult Protective Services. Call the police if someone is homicidal, and the suicide hotline (988 or your state’s designated number) if someone is considering self-harm or suicide. In any case, always defer to your state’s laws when it comes to mandated reporting.
In addition, some states require that therapists notify clients and/or their families when they file a report.
Your informed consent paperwork at the start of therapy should include all the information a client needs about their confidentiality rights and your responsibility as a mandated reporter.
Please always consult your state licensing and reporting laws for understanding your client’s specific situation and any obligations that may arise.
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