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A Framework for Mandated Reporting for Substance-Related Parental Abuse and Neglect.
Matthew Robert Dernbach1, Jacob M Appel2
1Dr. Dernbach is a medical toxicologist and current addiction psychiatry fellow, Department of Psychiatry, Harvard Medical School, Boston, MA. Dr. Appel is a Professor of Psychiatry and Medical Education, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. mrdernbach@carilionclinic.org.
The Journal of the American Academy of Psychiatry and the Law
|September 10, 2025
Summary
Clinicians must navigate complex laws when deciding whether to report parental substance use around children to child protective services (CPS). This study analyzes US regulations and offers a framework for these difficult decisions.
Area of Science:
- Addiction Medicine
- Child Welfare Law
- Clinical Ethics
Background:
- Clinicians face mandated reporting obligations for parental substance use around children.
- Limited research exists on postnatal substance use reporting compared to perinatal cases.
- Decisions involve legal, ethical, and clinical considerations beyond mere reporting.
Purpose of the Study:
- To survey US statutes and regulations on postnatal mandated reporting for substance-related child abuse and neglect.
- To identify legal obligations, ambiguities, and gaps in current laws.
- To propose a clinical framework to guide reporting decisions in addiction treatment.
Main Methods:
- Comprehensive review of statutes and regulations across all 51 US jurisdictions.
- Analysis of legal requirements for postnatal mandated reporting.
- Development of a clinical decision-making framework.
Main Results:
- Significant variability exists in mandated reporting laws nationwide.
- Identified areas of clear legal obligation, interpretation, and legislative gaps.
- The study highlights the complexity of balancing child safety with patient treatment needs.
Conclusions:
- Clinicians require clear guidance due to inconsistent mandated reporting laws.
- A proposed framework aids clinicians in reporting decisions, considering child safety, family well-being, and treatment continuity.
- Addressing legal ambiguities is crucial for consistent child protection and effective addiction treatment.
Keywords:
addictionchild abusechild endangermentchild neglectchild protective servicesmandated reportingMore Related Videos
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