Mandatory reporting

[grum]

It's a conversation that got kind-of started at someone else's LJ, but it was at best tangentially related. So I figured I'd start it here.

What do people think of mandatory reporting laws? Of the intent behind their creation? Of their implementation?

Comments

[docorion.livejournal.com]

Depends.

I am subject to mandatory reporting of child abuse and elder abuse. Both of these laws assume that the victim cannot report the problem themselves, and that reporting is almost always a good thing. I suspect these are probably good assumptions. Domestic violence (something many people think there *ought* to be mandatory reporting for) is probably not best served by mandatory reporting; it would likely put the woman (it's almost always a women) at higher risk. So say the experts, and from what I've seen, I suspect they're right. Moreover, in general a woman who is being abused is still an independent actor (she could report if she wanted to, or thought it would benefit her; this contrasts with the elder and child abuse cases).

Implementation...well, they're sort of like laws against smoking; they create a standard, an expectation. Hardly anyone is ever charged with the crime of not reporting, to my knowledge (just like hardly anyone is ever charged with 'smoking in a public place where it's not allowed'; they're just told to put it out). They also create an infrastructure for making and investigating reports.

That's the gist of what could be a much longer conversation :-)

[fallenpegasus]

"always a women"

That attitude makes the male victims invisible, and unwilling to speak.

I personally know two male DV victims, and one male rape victim, where the perp was female. The hell that "The State" gave the rape victim was... unspeakable.

[damiana-swan.livejournal.com]

Hmm. I was going to comment that docorion had said "almost always a woman" which is different from "always a woman", but then I went out and got some statistics and found that they don't really back that up, either.

According to the CDC:

--Nearly 5.3 million incidents of IPV occur each year among U.S. women ages 18 and older, and 3.2 million occur among men. Most assaults are relatively minor and consist of pushing, grabbing, shoving, slapping, and hitting (Tjaden and Thoennes 2000a).
--In the United States every year, about 1.5 million women and more than 800,000 men are raped or physically assaulted by an intimate partner. This translates into about 47 IPV assaults per 1,000 women and 32 assaults per 1,000 men (Tjaden and Thoennes 2000a).
--IPV results in nearly 2 million injuries and 1,300 deaths nationwide every year (CDC 2003).
--Estimates indicate more than 1 million women and 371,000 men are stalked by intimate partners each year (Tjaden and Thoennes 2000a).
--IPV accounted for 20% of nonfatal violence against women in 2001 and 3% against men (Rennison 2003).
--In 2002, 76% of IPV homicide victims were female; 24% were male (Fox and Zawitz 2004).

It's not equal between men and women, but there's way too many men being abused to call it "almost always women". Hell, there's just way too many PEOPLE being abused, period.

[fallenpegasus]

It's good to see those statistics. But I suspect that the men are still being undercounted.

[damiana-swan.livejournal.com]

I suspect you're right, and probably by a higher percentage than is true for women and children. Perhaps a significantly higher percentage.

[docorion.livejournal.com]

Fair enough. Men probably are undercounted. (I hadn't looked at the numbers in a while (read: since the early 90's, when the studies undercounted men even more, and said so)). Women are probably *also* undercounted, but not by as much as men. I stand by the idea that it is more often a woman than a man who is the victim.

All of which is only tangentially relevant to the question of mandatory reporting laws. Which I still think are not useful in IPV, except in a statistical sense (I would really like to see a statistical summary of the questions patients are asked at most ED triage encounters, which are things like "Do you feel safe at home?" and "Have you felt threatened by your partner or spouse?").

[damiana-swan.livejournal.com]

Just talked with my daughter (who is training to become a health care worker) about this.

What she pointed out to me is that this is the only method of abuse prevention we have in our state--we don't have mandatory education or anything else, only after-the-fact reporting, and if it wasn't mandatory most of it would go unreported. It's also a significant method of suicide prevention, which again, would mostly go unreported if it wasn't mandatory.

My own opinion is that it's a good thing, provided the information is handled correctly. As docorion pointed out, mishandled information about DV can be disastrous ... but officially ignoring the situation is perhaps even likelier to end badly.

[grum]

Is it a good thing on its own merits, or only because we don't have anything that would be better?

Should suicide prevention be lumped in with abuse inflicted on someone who cannot report the problem (children/elderly), or should it be grouped in with domestic violence (which is not currently something that requires reporting) on the grounds that the person being hurt is someone who could call for help if they decided it was in their best interests?

[damiana-swan.livejournal.com]

Hmm.

Well, it would be nice if we had something that was actually preventative and effective.

That being said though, yes, I think mandatory reporting is, in and of itself, a good thing. Why? Because the people who are mandatory reporters are people whose jobs are to take care of other people, and if they see abuse and *don't* report it, then they are most emphatically NOT taking care of the person they think is being abused. If someone chooses to go into one of those fields, they are choosing to take on that responsibility. They can't say "not my job, not my business" because they have chosen to make it their job.

Should suicide prevention be lumped in with abuse? Yup. Someone who is at risk for suicide is in danger every bit as much as someone whose fill-in-the-blank is beating them or raping them. It shouldn't matter whose hand is raised against them, even if it's their own. (Of course, there you get into self-determination issues ... but in a way, it's two separate problems.)

BTW, violindaine says that she is, in fact, required to report suspected DV along with any other type of abuse to whatever doctor she ends up working for, who is then responsible for reporting it to the appropriate authorities. Perhaps a difference in state laws? And yeah, although I think it needs to be handled a little more delicately, I think that's probably a good thing too. If one person in a household is a victim of DV, there's a reasonable possibility that others are as well--it really isn't safe to assume that it's just the parent being abused, and that the abusive partner would never touch the kids.

[docorion.livejournal.com]

Laws about DV reporting differ by state; MA does not currently require *any* reporting of DV, even on a statistical basis. ("On a statistical basis" means collection of data stripped of identifying information for the purposes of public health; this is currently done in MA for gunshot and stab wounds, for instance).

Suicide is another story; suicidal ideation is a potentially fatal problem, frequently caused by an organic thought or mood disorder. (Yeah, DV is also not infrequently fatal; it is not caused by an organic medical problem, at least not one on the part of the victim). As a result, it is the duty of the medical practitioner to protect the suicidal patient from themselves. This is embodied in law in the power to involuntarily commit people to psychiatric care, usually for limited periods (in MA, up to 72 hours). There's no reporting requirement, though; patients who say they're suicidal, or who commit acts of self-harm, are committed without need to inform the state (or, if they present voluntarily, they can be 'voluntarily committed', meaning they sign themselves in for the 72 hour period).

[memegarden.livejournal.com]

One tricky bit about mandatory reporting of child abuse is that statutory rape is included in that sweep. Meaning that a high school teacher who finds out that one of her students is sleeping with an older person is required to report it, which I submit in most cases is not going to be in *anyone's* best interest. I knew a teacher who, when she had a suspicion, made sure not to find out for sure.

Also, one of my gradeschool teachers reported suspicion of abuse/neglect for me because my clothes didn't match (my mom let me pick my own outfits). It would be one thing if I'd arrived at school shoeless, or dressed far too lightly in winter, but that's just silly.

I think mandatory reporting is a good-faith effort to make sure people get noticed and helped, but it has flaws.