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  • 03-21-2016, 06:24 PM

    Your not alone...

    Hi If you don't mind me saying I would be up front with people. I am no laywer but I know from experience that when the system got involved it made things worst for us. They took us from one abusive home to another. And it was all because of a school counselor and nurse contacting them without them tellimg me first. It was a mess....Sarah
  • 03-19-2016, 11:48 PM

    Mandatory Reporting

    My personal experiences have led me to lean on the side of allowing a professional to make an informed decision (not mandatory), but I agree that in all aspects, this is a frightening subject worthy of much consideration.
  • 02-01-2016, 03:22 AM
    Read the post above agree with what you are saying about mandatory reporting being just that - mandatory. That to not report actual or reasonable suspicion of abuse is not an option for those whose profession or calling carries this duty.

    As a child who survived a tough, tough childhood at the hands of my parents...I prayed that someone in authority would take action to remove me from the harm that I endured on a daily didn't happen...still amazes me that my parents' spurious explanations for my clearly not accidental injuries were accepted. The only good thing I suppose was they continued to feel confident that they would hide the true cause of my they continued to seek medical attention for their clumsy child who "spilled a pan of hot fat down the back of her thigh"..."fell astride a tree branch" etc.

    Maybe the professionals; doctors/teachers/nurses I came in contact with truly never joined the dots...picked up on the ample evidence that was there for them to see...maybe they felt compelled to give my parents the benefit of the doubt...idk. Thing that desperately mattered to me was that someone with more power than I had would do something to 'save' me.
  • 01-30-2016, 10:38 PM

    Mandatory Reporter Disclosure

    As a mandatory reporter, you have a legal obligation to report suspected or known abuse. I understand that as a medical professional you also have an obligation to protect your patient's confidentiality. However, your job as a mandatory reporter trumps your job as a medical professional in a way, so you MUST report abuse when you have reasonable suspicion but are not technically required to explain this to your patient. However, doing so would definitely be a great and probably much appreciated courtesy that will still give you some trustworthiness in the eyes of your patients, regardless of the fact that they may feel angry or tricked. For their own sake, it would probably be best to inform them of this if you choose to do so AFTER they have shared serious information of this nature with you. If you are still having doubts, I would recommend that you ask some of your fellow co-workers about how they have handled instances in which they became privy to disturbing information. I believe that can share this with you as long as they are not specific and do not share details that would breech confidentiality. I hope this was helpful!
  • 01-11-2016, 09:39 PM

    I'd Wait

    I know as a survivor, that if I knew that the doctor would have to report abuse when they see it, I would keep my mouth shut and make up a story that would keep my abuser from any trouble. It's to avoid trouble and because I tended to see the abuse I received as something I deserved. So I would wait until they tell you everything, and then explain that you have a legal duty to report the incident. I understand that you want their trust and don't want to trick them, but this is honestly the safest thing for them as it will provide them with safety and protection.
  • 01-03-2016, 12:29 PM

    Re: when to disclose mandatory reporting by a professional

    I've only been lurking here for a few days -but I have a couple of personal experiences in my history which relate to this.
    1) A particular psychologist I saw after the incident which preceded my first appt. with him, discussed with me his legal obligations regarding mandatory reporting and the types of scenarios which would trigger his actions pursuant to that duty. He did so before he let me begin our dialog. I REALLY APPRECIATED THAT ESPECIALLY AFTER THE HELL I HAD JUST BEEN THROUGH.

    2) The Hell. For a variety of reasons which aren't important, I have always had a sort of dark, gallow humor. Idiot me indulged in it when I was still pretty new to the operations of Facebook (I'm nearly 60 yrs. old) in a post at a particular 'down' point in my life, utilizing a joke that had been one of several for years between my then-college undergrad son and myself that "I was worth more dead than alive" which of course is pure fact due to having had about $300k in life insurance since 6 mos. after he was born. Well, some Look-At-ME!-know-it-all-busy-body decided to take it as a suicidal threat, even from a different part of the state than where I was living managed to do everything short of call out the National Guard.

    Next thing I knew, I was being escorted off a perfectly non-threatening bar stool, from a practically deserted bar, while listening to really bad karaoke (sp?) and jotting down the occasional piece of lyric on paper bar napkins, by THREE uniformed city police officers. My car was illegally searched, I was taken against my consent to the local hospital ER and held there for nearly 7 hrs., and eventually booked into the local 'rubber room' mental health facility. Yes, it go worse, but my point is not to tell the whole, sordid story. My point is to relate it to the "mandatory reporting" (aka "mandatory actions") aspect.

    That "mandatory reporting" and "mandatory" taking control over one's own life for them and making decisions that aren't really what is called for or needed - it can be a slippery slope.

    I'll note that upon discharge two days later from the psych facility (for which I was billed, btw - even though I was already broke and that was half of the reasons I was down in the dumps to begin with and NEVER consented to being there - signed everything I was forced to sign with the added phrase "UNDER DURESS AND I DO NO CONSENT") - the Chief shrink who was doing my discharged looked me in the face and said, "No, the system, we, No, we did NO do you any favors the way this was handled." Considering that being hunted down, cornered, trapped, and locked up with my every movement and every spoken word written down by staff, and wasn't even allowed to defecate in my room's bathroom with the toilet area pull screen closed, etc., WAS NOT VERY HELPFUL FOR A PTSD-DIAGNOSED PERSON WITH CHRONIC COLITIS AND ANXIETY ISSUES. Duh.

    So I guess what I'm trying to say is: for those with that power PLEASE (A) DISCLOSE it up front and do NOT sandbag anyone, and (B) REALIZE THE POWER YOU HOLD over someone's life and the very thread they may be holding on by.

    After what I wen through described above, I absolutely would never tell 'too much' or EVER be able of willing to be completely open with ANY medical/psychological care provider. NEVER. AND NEVER AGAIN.
  • 01-02-2016, 10:12 PM
    I know that you've been thanked for asking the question already, but I'd like to add my thanks to the growing list. Well done.

    Everyone is different and so unfortunately, you're entering a grey area. To do the most good, you are going to have to evaluate on the fly. Many will secretly hope you'll help them. Others you might help, like myself, would benefit from a different approach. Something along the lines of:

    I need to ask you how this happened but before I do, I need to explain something to you. <explain your role as a mandatory reporter> If someone did this to you, I want you to tell me so I can help make certain this never happens again. I want you to tell me, but the choice is yours and I'll respect whatever you decide.
    Our stories are different but we all have faced powerlessness and a lack of respect. For some of us, this will be the first time we were in charge. That is incredibly empowering and engenders trust that years cannot forge. For me, telling me that you will tell regardless of my wishes just victimizes me again - and I will never trust you. Ever. In fact, I'll likely choose the devil I know and come to my abuser's defense, including perjuring myself, to escape this new danger.
  • 12-30-2015, 01:01 AM

    Thanks for asking...

    Ok, so first, thanks for thinking of this. It shows the conscientiousness you have and how much you care about other people. The huge thing I have to add is this: There is a right time to disclose upfront and a right time to disclose after talking. I have a feeling you'll know. I've had something that happened to me when I was 10 at the top of my mind the last few days...I'm going to make this very general...

    When I was 10, I had an injury...hand through a window. When asked why, I had a nice little answer I'd clue if I was coached...but I know I had to have a GOOD answer...otherwise they'd "take me away." No one questioned my answer, but had they, the up front approach would not have worked. I would have been even more reluctant to give the true details. However, had they asked gently, probed the inconsistencies in my answers, I might have been a bit more likely to let my guard slip. Same goes with something similar that happened when I was over 18...still at home, though. If I know you intend on "turning me in," because in the mind of many abuse victims, it isn't the abuser that did wrong, it's the abused, then I'm going to fight you every step of the way and withhold every ounce of info. But if you make me feel safe...not lie to me and say you won't "tell," but rather don't even bring up the subject until you have a reason to, then I might be a bit more forthcoming.

    I hope that makes sense.
  • 12-28-2015, 05:41 PM
    Thank you EFLP for giving this topic the respect it deserves, it is wonderful that there are people out there such as yourself willing to take extra time and energy to develop some compassion for this situation, understand its complexity and ask questions of survivors themselves.

    As a rule I would always put the child's needs first if there are any children involved; the younger the child (first 0-5yrs of life), the more vulnerable their development & future is.

    Some abusive parents, such as my mother, know the system well and disguise their parental abuse from the system, i.e. its professionals, in order to put their own needs first. But sometimes the system is an even worse environment that the home a kid was removed from. It's complex.

    Like Jane, as a little kid I had injuries and bruises that had been inflicted on me at home by my mother and her boyfriends but when professionals saw them they never did anything. They believed my mother's lies that I'd done them myself because I was a foolish or difficult child. No one reached out to me, asked me, considered my welfare, my safety, my future. It was like I was invisible. All I hoped and yearned for was that someone would see me, rescue me. But unfortunately all the many professionals involved focused entirely on my mother and her needs as she made such a convincing & voluble case. Me and my siblings needs went un-noticed & neglected, we were silent and ashamed.

    Maybe there isn't an exact formula for you to follow in every situation with every patient regarding mandated reporting. Maybe it is something that will develop further over time and with experience. If you put yourself in the child's shoes what would be best for them? That could be hard to imagine if you don't have an abusive parent who lies, don't know what it's like to be a kid to have no safe adult to turn to, haven't lived as a kid in the system & know how much worse it can be. Maybe its best to build rapport with the parent, so they are less defensive.

    It's complex, the system isn't perfect. But please don't underestimate the positive impact your kindness can have on patients, especially kids. A kind and reassuring bedside manner is a drastically under-rated quality in medical care.

    Above all, if as a doctor you have any time or interaction with a kid, please be kind to them. That could be the only positive interaction they have with an adult in a whole year, their only chance to feel safe & be seen. That child can only benefit if you act with warmth, reassurance & compassion towards them. Even if you say sincerely, "Good job," or "Well done," for how they stick out their tongue or sit on a chair for your examination, it could be a huge positive contribution to their future.

    I'm in my 40's and still avoid doctors because as a kid I found them cold and intimidating, interactions with them humiliating and I always felt like a fake, stupid and a liar even when I was very sick in ER. I have a lovely gp now and am so grateful for that.

    again for taking the time and energy to ask, that you care enough to ask survivors themselves asked suggests to me you'll be a wonderful doctor
  • 12-20-2015, 12:08 AM
    I really think you should be completely honest up front. Yes, this can deter people from telling you everything. However, I think it might be almost traumatic for them to feel tricked into you having to report things.
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