Scenario: Patient is a 17 year old female reporting to emergency department for SI without specific plan, secondary to verbal altercation with parents. While treating patient for psych, it was admitted that patient is emotionally invested in a 30 year old male. The patient denies physical relations. The 30 year old male admits reciprocating feelings and "waiting until she's 18". Mother of patient admits opinions/feelings of 30 year old male - did not speak with him personally.
Can someone provide any information that spells it out more clearly as to this being child line report. No physical contact is admitted, nor anything sexually related was admitted. Reports to Child Line made by parents. Authorities were contacted by parents. Child line confirms this was sufficient.
While I understand that this is wrong, ethically. Does anyone have info where this is LEGALLY wrong, as nothing illegal appears to have been committed as of yet. I want to know my responsibilities as this patient's advocate, aside from patient education.
Oct 15, '17
From my understanding of child abuse reporting, we can go on clinical judgment of suspicion. I would report it, and educate the patient appropriately.
Oct 16, '17
When in doubt, I'd always err on the side of reporting. CPS can screen the report out if they don't find it sufficient to open an investigation.
In my state, I don't think CPS would do anything in this case. Neither party admits to an inappropriate relationship. Overall, CPS in my state is more interested in child abuse/neglect in the home. Sexual relations between a random adult and a minor would be a matter for the police. (As a side note, I don't understand why abuse of one's own child is not a matter for the police in my state. I've never seen a parent get arrested for, say, shaking their baby.) I am aware of a situation with one of my current teenage patients last year in which she snuck out of her house and had sex with an adult male. Her mother woke up and noticed that she had left, searched for her, confronted her when she came home, she admitted what she had done and her mother appropriately reported this to her medical team (oncology) the next day. As mandated reporters, they filed with the state and the state responded by taking emergency custody of this teenager and her siblings and banning the mother from visiting. I still cannot wrap my head around that, as I don't think a teenager sneaking out and doing something her mother in no way endorsed and appropriately reported when she found out about it is a sufficient enough case of neglect to warrant revoking the mother's custody. When the case went to court, the mother did regain custody.
Actually, now that I'm writing this, it reminds me of 2 situations when I was in high school. One of my classmates, who was 17 when the relationship started, was dating a 29 year old. She was 18 by the time senior prom rolled around and was allowed to bring him as her date. As far as I know, the school never reported anything to the authorities before she turned 18.
I also had 2 friends who had a questionably inappropriate relationship with a 45ish year old man who was a customer at the pizza shop they worked at. The one who I am still friends with denied that she ever did anything with him but admits that our other friend did. Our assistant principal called my friend's mom but definitely no one filed a report with the state about it.
Oct 20, '17
Thank you both for your replies. I know mandated reporting has changed a lot since the PA Joe PA scandal. For example, one of our crisis workers had to report on a 70 year old who admitted to be a victim of abuse when she was a child (since she never reported it).
My only concern was if this guy didn't even know the minor was attracted to him. Which is what I thought prior to talking to mom. And I have a hard time defaming someone who doesn't deserve it, whether I'm protected or not.
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