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Protection for Mental Health Professionals

August 1, 2017

From time to time I receive emails from mental health professionals seeking to protect themselves in the context of their work with difficult clients or clients in difficult situations.

Consistent in the mix of issues is someone who threatens or may threaten the service provider or has posted spurious complaints on rating websites.

At times the service provider is also unsure as to their reporting obligations.

My guidance is consistent:

  1. If there is a minor child who has been harmed or is at risk of being harmed, mental health service providers are typically mandated to report to a child protection agency. The child or the parent does not have a choice in this matter. This is typically a matter of statute (law) which is binding on the service provider.
  2. Occasionally, the service provider is uncertain if the concern reaches the threshold required for mandated reporting and/or expresses concern that reporting may bring the risk of greater harm to the child. In such situations, I suggest that the service provider phone the child protection agency for a “non-disclosing consultation”. I advise that the service provider speak with an intake person and describe the situation without providing names. The intake person can advise of the position of the child protection agency with regard to the information provided. If intervention is required, a plan can be discussed to mitigate risk to the child. Please be prepared as you may be required to make that report formal.
  3. If the person who has been harmed or is at risk of being harmed is no longer a minor child, then there typically is no reporting obligation to a child protection agency. However the mental health service provider may wonder if there is an obligation to report to police. This is a trickery issue. I suggest that the service provider obtain a consultation from their own regulatory body and a ‘non-disclosing consultation” from the police. Much will also depend on whether or not the service provider or agency has a policy in place in the event of such situations. The client can be referred to a shelter or other place of safety.
  4. As for complaints posted to rating or complaint websites, very often there is little the service provider can do. However, it is advisable to not reply or respond to the web-based complaint as that may engage the person who posted the comments and incite additional posts.
  5. As with all clients, it is good clinical practice to document your work. The greater the concern for personal risk, the greater the need is for detailed documentation. Many mental health professionals now audio record and some video record all their client sessions and interactions. This may provide the only tangible evidence of the service provider’s actions in the event a client seeks to make a claim against the service provider of untoward treatment.
  6. Malpractice insurance is also a must. Given mental health service providers work with persons whose reality testing, attitudes or behavior may be suspect, mental health service providers are at risk of complaints to their licensing bodies. Defending oneself against a claim can be expensive and would be paid for by the malpractice insurance.

Please note, the above does not constitute legal advice. If you are in a challenging situation do seek input from your regulatory body and/or police or a child protection agency and/or a lawyer who practices defense work even if a claim has not yet been made against you. You can also seek a consultation from a respected colleague.

Our work is valuable to the general public and our work carries risk. It is important for mental health professionals to be aware of laws governing their practice and to have access to resources for consultation.

I am Gary Direnfeld and I am a social worker. Check out all my services and then call me if you need help with a personal issue, mental health concern, child behavior or relationship, divorce or separation issue. I am available in person and by Skype.

Gary Direnfeld, MSW, RSW

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Gary Direnfeld is a social worker. Courts in Ontario, Canada, consider him an expert in social work, marital and family therapy, child development, parent-child relations and custody and access matters. Gary is the host of the TV reality show, Newlywed, Nearly Dead, parenting columnist for the Hamilton Spectator and author of Marriage Rescue: Overcoming the ten deadly sins in failing relationships. Gary maintains a private practice in Dundas and Georgina Ontario, providing a range of services for people in distress. He speaks at conferences and workshops throughout North America. He consults to mental health professionals as well as to mediators and collaborative law professionals about good practice as well as building their practice.

  1. Thank you! As a professional – I have been tentatively thinking about creating a book on the topic of therapist harassment. Fortunately, I have never had a complaint against me in 32 years and yet many of my colleagues and I have been harassed due to our advocacy for trauma survivors. I think there might be an untold story here. There are issues to work out but I am curious what you think. Best, Dr. Scott

    • I think there is room for research and information about this. People are far more litigious these days and as mental health professionals we wade into contentious issues.

  2. Mike Biro permalink

    Great article Gary. Those working in this field need to be extremely cautious when reporting. If you are not comfortable with the direction from your supervisor or if you feel you may not be backed up by your agency then you may put yourself in a difficult situation. I found most are very honest and work for the betterment of their clients however I know and experienced some who will hang the counsellor out to dry if you give them the chance. My advice is to know and trust your feelings about others you work with. Some are into this business for the money not the people who are struggling.

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