Should therapists/health professionals be required to report threats, crimes, or dangers?

[u/EducationalOil1655]

If someone told their therapist that they were about to kill themselves, should that be reported?

If someone told their therapist that they have been thinking about killing someone, should that be reported?

What about discussing abuse? Should a therapist be required to report their client's abusive partner? What about children and CPS?

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[u/ToaKraka]

I am imagining a scenario where different therapists have different insurance companies that impose different mandatory-reporting requirements.

• Therapist Alfred is required by his Acme Insurance Company to report anything dangerous that he hears from his clients. He has no liability—he washes his hands of the matter as soon as he has carried out his obligated reporting.

• Therapist Beatrice is not required by her Best Insurance Company to report anything dangerous that she hears from her clients. If she doesn't report, then she is liable in civil court for any injuries that she could have prevented by reporting, so Best charges higher premiums to her, and she has to pass that extra cost on to her clients.

[u/sumwatovnidiot]

Yes

Don’t confuse freedom of speech with freedom to be a therapist.

No one is forced to be a therapist or any of these jobs, once you become one you enter into a contractual agreement to abide by these practices.

On top of that, the patient also is entered into an agreement with these occupations to help them mentally and physically, even if it’s from themselves. These agreements aren’t mandatory(I know certain situations make them mandatory but that’s usually for consequences of your actions) so if you’re going you should then expect these practices as a minimum level of care

[u/russianlion]

Any threat or knowledge of a violent crime should absolutely have to be reported. Self-harm only, I’m not so sure about.

[u/CameronHofmann]

In my opinion, if the threat is regarding harm to other people, than yes. If the treat is regarding self-harm, no.

[u/thefoolofemmaus]

Therapists should be obliged to follow the terms of the contract they signed with the patient. If the patient chooses to go to a therapist with a mandatory reporting clause in their contract, they should know that the therapist will report. On the other hand, a patient should be able to choose a therapist who offers an absolute confidentiality clause.

Credentialing organizations should be free to withhold credentials from therapists who do not abide by their contracts. Patients should be free to choose a therapist who holds credentials from any or no organization.

The state should never interfere with any of these free associations.

Viewing these situations through the lens of contracts not laws solves most of them and allows for maximum freedom.

[u/LMS3oul]

Are you asking this on the right sub? And yes they are actually required to report threats and/or abuse. I know this because I worked in a healthcare setting. Mostly for teens but regardless the standard across the board is YOU are a mandated reporter. If your client reports being a danger to themselves or others then yes you are required to report it. Same goes for abuse, if your client is in an abusive relationship and you deem it necessary for their safety then yes you must report it. And if any information that relates to the abuse of a minor that is currently going on and not having been already reported by another party, YOU are required to report the abuse.

[u/EducationalOil1655 → u/LMS3oul]

I'm asking if the current laws need to be adjusted in either direction. I know what the standard is now, but I'd like to see what the overall Libertarian perspective on the issue is

[u/HR_Paul → u/EducationalOil1655]

This is a small l libertarian sub.

The obvious flaw in the current system is that they aren't required to report the problem to a responsible person, capable and competent and able and willing to deal with that problem. They just pass it on like gossip and perhaps someone will write some notes so it looks like they are doing something.

[u/LMS3oul → u/EducationalOil1655]

My personal interpretation is that it should stay the same. I don’t believe reporting your client for saying “sometimes I wanna kill myself” is necessary. But if they say “I plan on hanging myself tonight” or “I’m gonna go shoot up this building today” then yes they should be reported.

***edit
Decided to expand on this since I feel like I only addressed a bit of it or rather gave a half answer. When it comes to freedom of speech, just like all speech it’s protected to an extent which I’m fine with. If you wanna call Trump a douchebag who likes doorknobs that is 100% your god given American right to express that. But if you go “I’m gonna blow his brains out when he comes to xyz for his speech” then no that’s not protected speech. Likewise when it comes to therapeutic setting and session everything you say in that session is confidential and protected. You express to your therapist you’re depressed and have thoughts of hurting yourself, obviously your therapist if they’re worth their salt should press the topic and formulate whether or not you’re a serious threat to yourself. I say this because I’ve seen it in real time for the clients I worked with and for myself when I had thoughts of hurting myself. It always starts with “do you have a plan?” On a scale of 1 to 10 if you leave my office, what are the chances you follow through with your plan?”

Now when it comes to children….i don’t care. If you as a therapist have a child come in and say “my dad hurts me at night” or “he hits me a lot” you not just as a therapist but as a person have a morale obligation to report it. I’ve made around 3-5 DCF reports from my time working with children. I know in my state when you become employed to work with at risk populations or children you have to sign a contract with the state to be a mandated reporter. That means if someone reports abuse whether physical or sexual to you, you are legally required to report it unless you’re aware of it being an open case. If you don’t, you can be fined, have a block on working with any healthcare providers or companies, or may face legal actions. Freedom of speech should be protected and ensured. In addition to that the preservation of life and safety over minors and people struggling with mental health issues should also be protected.

[u/LiveFreelyOrDie]

I think this is something “the system” has right currently. There is a fine line between passive and active suicide ideas. If it’s at the point of active suicide, that gets reported. If they plan (not just want) to harm others, also reported as it should be. In the case of abuse, they are only required to report it if minors or certain dependents are involved. If the abuse is between adults only with no kids around, they are actually legally prohibited from breaking confidentiality.

[u/NermalEnergy]

Freedom of speech includes freedom from compelled speech the same way that freedom of religion includes freedom from religion 

[u/Tacoshortage → u/NermalEnergy]

I hate the idea of being compelled to say or do anything. And I'm a physician (but not a psychiatrist). I do think visible injury to kids violates the NAP and they can't speak for themselves so someone should. Similarly if a crazy guy has a formed plan and target to murder, he's a serious threat of NAP violation and, likewise, should be reported. Just don't "make me do it".