Mandatory Reporting

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Anytime I start with a new client, that's the first thing I go over is these are the very specific things need to report outside of that confidentiality. If it were like a pyramid, confidentiality would be on the bottom as the base. So just giving people transparency and what I like to call like, consensual choice to continue knowing what I'm obliged to report to local law enforcement, mandatory reporting is something I do take seriously. The first thing mandatory reporting wise is if you're actively suicidal. That doesn't mean you've contemplated it or you've thought about it. For me, and depending on your therapist, this could be interpreted many different ways. So this is why I try to be specific as possible. If I feel like you're going to take your own life within like five or ten minutes of telling me, God forbid, on the phone, then that's when I would report it. If you'd report, like, previous attempts or just kind of like thinking about it, that's not going to raise the same amount of flags as if I really thought it was an immediate and imminent threat. The second one is if you tell me the first and last names of someone you would like to murder. If you have homicidal thoughts. And again, something I think that's going to be immediate and imminent, I would need to report that. The third one is if you tell me the first and last names of an older, vulnerable adult or child that has been abused or neglected. And then Swinson, Oregon, if you name first and last names of any two people within a correctional institution that have had sex, then I would need to report that in Oregon, we have what's called PRIA, the prison Rape Elimination act. So, yeah, people out of state always laugh at that. I'm like, I didn't make it up.

As just a layperson. The first and last name, I'm curious as to why that delineation was made.

Well, so if you do pick up the phone and call whatever, local helpline or local law enforcement, I'm also a criminologist, so I can say, as a criminologist, you can't do much with this person's aunt or this person's mom because that's technically hearsay and the process of the court, you got to have enough evidence to do that. I mean, Olivia, you might have a different stance on it, and especially if you're from a different state. I don't know what yours is, but unless it's a child, police are going to kind of laugh at you. It's like, what are we supposed to do with a nickname or a last name or just a first name? Sorry. So just the burden of proof. And if people do want to extend to that point, then they do have the consent of saying first and last names. But sometimes people just want to process things, and it is kind of unnatural to be like Roger Victor. What's up, captain? Roger Victor did this versus my aunt or my uncle or Roger whatever. So it also is a way for people to process things without feeling like I'm going to turn around and immediately go call law enforcement.

Yeah.

And as therapists, you have a duty to warn. Someone says that they are going to kill somebody and that they have a plan to do it and they're going to act on it. We have to not just warn law enforcement, but also the intended victim. It's because there was an incident that happened, I think, in California where this guy told his therapist he was going to kill his girlfriend, I think, or his ex girlfriend, and the therapist warned police, but police did not warn the victim, and then he killed the victim. The therapist was on the hook for the fact that she didn't directly warn the victim. So that's where that law came from. But, yeah, it's a lot of pressure, but that's very similar to the mandatory reporting that we have of if there's suicidality, homicidality, child or elder abuse. So it's good to know that that is still followed for you both.

How do you determine the level of suicidality? Are there cues that you two personally look out for, as in planning or giving away things? I wonder what you two pick up on.

Yeah, I mean, for me, there are specific scales that you use because it has to be pretty standardized to justify breaking confidentiality. So, like, the Columbia suicide severity rating scale is one of the most common ones. You can ask this list of questions, and their answers correspond to a certain amount of points. And if they score over a certain amount of points, that indicates they're at a higher risk based on the data. And it's not like if someone says I'm feeling suicidal that I'm immediately going to be like, well, let's just fill out this sheet of paper. You use that as the guide. And then if they are saying they have a plan and they're going to act on it and they have the means to do it. That's when you have to call or break confidentiality. If they're just saying that passively they're having suicidal feelings, but they don't actually intend to act on it and they don't have a plan and they don't have the means, that's more just going to be me talking through and processing with them and creating a safety plan rather than immediately, like behind their back. I'm like calling 911 and then also.

Kind of what I was talking about with consent. If someone knows that it takes, for example, first, last name and specificity. Some victims don't want it to get reported. And so that really allows people to process things. And if I can process things and I don't want it to go to the justice system, I can just talk about first names and get whatever closure I need between me and my healthcare professional. So that also allows people to process it. And maybe it starts with processing, and after talking about it, they do want to report it, but that's totally up to them. And I never want to take that choice away from a victim, especially if they don't want to report it. So giving them the power, and if they know it's this specific formula which will then lead to the next step of reporting, I want them to kind of have that power. Obviously, it's a little different with kids, but that's kind of like my stance on it. Or if they're suicidal, then they know to express that it's immediate and imminent, and this is how they're going to do it, which is why I always start with it, because then they can kind of be like, okay, if I need the next step, this is what.

I need to say.

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