Why Mandated Reporting Should Focus on Help, Not Punishment

Recently, while training on a child psychiatry consult-liaison service, I encountered a 5-year-old boy preparing for surgery due to a congenital heart defect, whose parents were perceived to be “refusing” treatment. The medical team deliberated contacting child welfare for potential neglect; however, upon meeting the family, I discerned a different scenario—concerned parents seeking information. The mother clarified, “We’re not saying no; we just want to understand why this is urgent.” After addressing their inquiries and providing reassurance, they consented, and their son’s recovery went smoothly. No report was necessary.The real issue was a lack of communication, not noncompliance. Families, particularly those marginalized due to race, income, or trauma, often face undue system scrutiny, which is exacerbated by mandated reporting laws misclassifying issues rooted in poverty as neglect. This has shifted toward a more supportive approach, termed “mandated supporting,” emphasizing resource allocation over punitive measures. By empowering families through initiatives like the THRIVE Fund, we enhance well-being and promote sustainable futures.