Closing the Loop: An Environmental Scan of APS-Reporter Feedback Policies and Practices

Abuse, neglect, and exploitation of older adults are prevalent and underreported in the United States. Pathways to identifying and resolving cases of abuse against older adults depend on mandated and non-mandated reporters bringing attention to these cases through reports to Adult Protective Services (APS). However, existing research points to several barriers to reporting. One significant barrier is a lack of communication from APS to reporters about reports they have made (e.g., whether the report is appropriate for APS, the investigation outcome, and services provided by APS). This lack of reciprocal communication likely serves as a disincentive for future reporting. This study aims to promote improved communication between APS and reporters by examining the legal, ethical, and practical barriers and facilitators to communication at key points in the reporting and response pathways. In this first phase of the project, we conducted an environmental scan of policies and practices related to reporting, investigation, and feedback. Early results from the environmental scan suggest most APS agencies (81%) do not currently provide feedback to reporters. Among those providing feedback, 20% provide feedback only to mandated reporters, and 50% provide only procedural feedback, which focuses on the process of receiving and screening reports for investigation and not on the outcome of the investigation. In the next phase of this study, we will supplement these findings through interviews with APS leaders across the U.S. These early results will begin to fill an important gap in the understanding of feedback loops between APS and reporters.

Should teachers be mandated reporters?

Teachers are assigned a multitude of responsibilities they do not want, for which they are poorly suited, and that disrupt their primary roles. One such responsibility is the obligation to serve as mandatory reporters of suspected child abuse and neglect. Joan Goodman reviews the history of this duty, its current parameters, the harmful over-reporting, and its unfortunate consequences for children, teachers, and families. As an alternative to referring suspected abuse cases to authorities, schools could use logarithms for initial screening, involve personnel with more extensive training in identifying potential abuse, or consult a team of in-school personnel to evaluate cases before making referrals.

Reports and Removals of Child Maltreatment-Related Hospitalizations: A Population-Based Study

Despite U.S. child protective services (CPS) agencies relying on mandated reporters to refer concerns of child maltreatment to them, there is little data regarding which children mandated reporters decide to report and not to report. This study addresses this gap by utilizing a population-based linked administrative dataset to identify which children who are hospitalized for maltreatment-related reasons are reported to CPS and which are removed by CPS. The dataset was comprised of all children born in Washington State between 1999 and 2013 (N = 1,271,416), all hospitalizations for children under the age of three, and all CPS records. We identified maltreatment-related hospitalizations using standardized diagnostic codes. We examined the records for children with maltreatment-related hospitalizations to identify hospitalization-related CPS reports and if the child was removed from their parents. We tested for differences in these system responses using multinomial regression. About two-thirds of children identified as experiencing a child maltreatment-related hospitalization were not reported to CPS. We found differences in responses by maltreatment subtype and the type of diagnostic code. Children whose hospitalizations were related to abuse and associated with a specific maltreatment code had increased odds of being both reported to CPS and subsequently removed by CPS.

Hide and Seek

The system of mandatory reporting was created in response to a growing recognition of devastation that child abuse was causing in the United States. All states designate people in certain professions as “mandated reporters.” This has led to discussion regarding unintended consequences or negative effects of mandatory reporting. What are our obligations toward adult patients who confide that they were abused as a child but are unsure if they want to report this now? Are we still the mandated reporters? How does patient autonomy factor into this? These laws and statutes are complex, and our legal obligations must be weighed against various ethical and practical considerations.

Mandated reporters’ experiences with reporting child maltreatment: a meta-synthesis of qualitative studies

ObjectiveTo systematically search for research about the effectiveness of mandatory reporting of child maltreatment and to synthesise qualitative research that explores mandated reporters’ (MRs) experiences with reporting.DesignAs no studies assessing the effectiveness of mandatory reporting were retrieved from our systematic search, we conducted a meta-synthesis of retrieved qualitative research. Searches in Medline (Ovid), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts, Education Resources Information Center, Criminal Justice Abstracts and Cochrane Library yielded over 6000 citations, which were deduplicated and then screened by two independent reviewers. English-language, primary qualitative studies that investigated MRs’ experiences with reporting of child maltreatment were included. Critical appraisal involved a modified checklist from the Critical Appraisal Skills Programme and qualitative meta-synthesis was used to combine results from the primary studies.SettingAll healthcare and social-service settings implicated by mandatory reporting laws were included. Included studies crossed nine high-income countries (USA, Australia, Sweden, Taiwan, Canada, Norway, Finland, Israel and Cyprus) and three middle-income countries (South Africa, Brazil and El Salvador). Participants: The studies represent the views of 1088 MRs.OutcomesFactors that influence MRs’ decision to report and MRs’ views towards and experiences with mandatory reporting of child maltreatment.ResultsForty-four articles reporting 42 studies were included. Findings indicate that MRs struggle to identify and respond to less overt forms of child maltreatment. While some articles (14%) described positive experiences MRs had with the reporting process, negative experiences were reported in 73% of articles and included accounts of harm to therapeutic relationships and child death following removal from their family of origin.ConclusionsThe findings of this meta-synthesis suggest that there are many potentially harmful experiences associated with mandatory reporting and that research on the effectiveness of this process is urgently needed.