By Douglas Meyer
In light of recent personal events, I have been
forced to reevaluate my views on mandated reporting. By mandated reporting, I
am referring to the collection of laws and professional codes of conduct that
force people to file a variety of reports for situations including, but not
limited to, child and elder abuse, sexual assault and self-harm. While the specifics
of the situations that must be reported vary widely, a general theme is that an adult must report any risky situation they observe in a professional
capacity so that those involved can get necessary help. What follows should not
be taken as a comprehensive argument against mandated reporting, but rather as
a suggestion for why “getting someone the help they need” is not strong enough
to warrant mandated reporting.
Imagine a sixteen year old, we’ll call him Sam, who
was recently sexually assaulted. Sam is showing mild signs of depression and
has night terrors almost every night as a result of the assault. He knows that
some psychological help may prove beneficial, but is unwilling to forfeit his
privacy, even if necessary to get the help he needs. I’m going to make a few
assumptions for the purposes of analyzing Sam’s case:
1. Sam’s peers would be supportive, but lack
sufficient training to help him.
2. Sam’s high school has guidance
counselors who are well trained in helping sexual assault survivors.
3. Sam would not be able to afford a
psychiatrist without financial assistance.
One of Sam’s options would be to seek the help of a
Mental Health Professional (MHP). For the purposes of this discussion, I will
define an MHP as a person who has received extensive training in offering
psychological assistance and who
maintains patient confidentiality. This would be Sam’s best chance of getting
the help he would need for his depression and night terrors because the mental
health professional would be able to help Sam work through his traumatic
experience. In addition, this option would let Sam maintain his privacy, since
the only person who would find out about his experiences would be the MHP. Unfortunately, Sam would likely need to explain why he was in
need of an MHP to his parents in order to receive their financial assistance.
Sam’s unwillingness to forfeit his privacy coupled with his inability to afford
an MHP on his own means that this option is unavailable to him.
There are likely only two free options available to
Sam. First, are anonymous helplines (AHs) which include services such
as online support groups and hotlines Sam could use. AHs would
be helpful to Sam, but they would only be beneficial as supplements to other
forms of help. Most support groups are comprised
of well-meaning peers who bond over shared tragedies, but without sufficiently
trained professionals included, they just do not have the
capacity to provide all the help Sam needs. Hotlines are very often staffed
by volunteers who have minimal training to provide basic guidance and support
to callers, but these volunteers would only be able to guide Sam in finding
MHPs and another type of assistance, which will be discussed momentarily. As a
result, AHs could provide Sam with a lot of support, but only supplementally.
The other possibility would be a cluster of
psychological services, which I’ll call Nonconfidential Psychological Agents
(NPAs.) As the name suggests, NPAs are services and people, including school
guidance counselors and teachers, who cannot offer their clients
confidentiality because of their mandated reporting obligations. NPAs can be
assumed to have sufficient training to provide Sam with the help he is seeking,
and I’ll assume that there are sufficient NPAs available at little to no cost
such that cost would not be a barrier to Sam.
Unfortunately for Sam, these three options are
insufficient to deal with his case. Option 2 (AHs) would only be able to
provide supplementary assistance, but on its own, couldn’t provide Sam with
the necessary assistance. Options 1 and 3 (MHPs and NPAs, respectively) would
be able to provide the necessary assistance to Sam. However, option 1 would be
inaccessible to Sam due to financial barriers.
Earlier, I mentioned that my interpretation of the
purpose of mandated reporting was to get someone the help they need. However,
this would seem to fall apart when applied to Sam’s case. Mandated reporting
does nothing to alleviate the financial burden associated with psychological
counseling, and so it would not make MHPs a valid option to Sam. Mandated
reporting does have a very strong effect on Sam’s access to NPAs. By preventing
NPAs from protecting client confidentiality, mandated reporting actually acts
as a barrier to these services. Ironically, the program that was implemented to
get people help actually prevents many people seeking counseling
from accessing those services. Moving forward, programs that promote access
to counseling, like financial assistance programs, should be considered as
replacements for mandated reporting strategies.
Douglas Meyer recently
completed his first year at UCLA studying microbiology and the
intersection between advancements in biology and society. Next fall, he
will serve as Co-president of UCLA's Undergraduate Bioethics Club.
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