When Protection Becomes Punishment |
What Are Adverse Childhood Experiences?
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Mandated reporter training emphasizes reporting but rarely addresses harms of overreporting.
CPS investigations can expose families to surveillance, stigma, and unnecessary trauma.
Many situations labeled “neglect” reflect unmet needs such as poverty or medical mistrust.
Support, transparency, and context often protect children better than immediate reporting.
I’ll never forget being called to do a psychiatric consult on a preschooler hospitalized for a serious heart condition. His parents had been labeled “noncompliant” and “difficult.”
“They’re refusing surgery,” the resident calling in the consult said. “My attending said we might have to call Child Protective Services (CPS) for medical neglect.”
When I met with the family, that narrative dissolved. These parents were not “noncompliant,” but frightened and confused. “We’re not saying no,” the mother said. “We just want to understand why this has to happen now.”
The parents, who were Black, recounted past experiences of untreated pain, missed diagnoses, and delayed treatment. They understandably feared for their child’s life. But once their questions were answered and their fears validated, they consented. Their child did well. No CPS report was filed.
That case changed my understanding of mandated reporting as a mechanism for keeping children safe. In the years since, I’ve witnessed similar situations: providers jumping straight to reporting rather than helping families overcome the obstacles they face. These stories, to me, reveal a deeper problem: providers’ fundamental misunderstandings about what mandated reporting is, what it does, and who it harms.
What Training Doesn’t Teach Us
Mandated reporting instructional materials typically focus on how to file reports and the legal and licensure penalties for failing to do so. They mirror the online trainings that I, and many other clinicians, complete for licensure and hospital accreditation. The takeaway is clear: When in doubt, report.
These trainings rarely acknowledge how CPS (sometimes called the family regulation system) can function less like help and more like policing, especially for families navigating racism, poverty,........