{"id":474897,"date":"2026-03-14T08:23:14","date_gmt":"2026-03-14T08:23:14","guid":{"rendered":"https:\/\/www.newsbeep.com\/uk\/474897\/"},"modified":"2026-03-14T08:23:14","modified_gmt":"2026-03-14T08:23:14","slug":"when-protection-becomes-punishment-psychology-today-united-kingdom","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/uk\/474897\/","title":{"rendered":"When Protection Becomes Punishment | Psychology Today United Kingdom"},"content":{"rendered":"

I\u2019ll never forget being called to do a psychiatric<\/a> consult on a preschooler hospitalized for a serious heart condition. His parents had been labeled \u201cnoncompliant\u201d and \u201cdifficult.\u201d <\/p>\n

\u201cThey\u2019re refusing surgery,\u201d the resident calling in the consult said. \u201cMy attending said we might have to call Child Protective Services (CPS) for medical neglect.\u201d<\/p>\n

When I met with the family, that narrative dissolved. These parents were not \u201cnoncompliant,\u201d but frightened and confused. \u201cWe\u2019re not saying no,\u201d the mother said. \u201cWe just want to understand why this has to happen now.\u201d<\/p>\n

The parents, who were Black, recounted past experiences of untreated pain, missed diagnoses, and delayed treatment. They understandably feared for their child\u2019s life. But once their questions were answered and their fears validated, they consented. Their child did well. No CPS report was filed. <\/p>\n

That case changed my understanding of mandated reporting as a mechanism for keeping children safe. In the years since, I\u2019ve witnessed similar situations: providers jumping straight to reporting rather than helping families overcome the obstacles they face. These stories, to me, reveal a deeper problem: providers\u2019 fundamental misunderstandings about what mandated reporting is, what it does, and who it harms.<\/p>\n

What Training Doesn\u2019t Teach Us<\/p>\n

Mandated reporting instructional materials<\/a> typically focus on how to file reports and the legal and licensure penalties<\/a> for failing to do so. They mirror the online trainings that I, and many other clinicians, complete for licensure and hospital accreditation. The takeaway is clear: When in doubt, report.<\/p>\n

These trainings rarely acknowledge how CPS (sometimes called the family regulation system<\/a>) can function less like help and more like policing, especially for families navigating racism<\/a>, poverty, or disability. A discussion of racialized overreporting or the harms of exposing children to carceral systems is rarely included. The result is a set of powerful misconceptions shaping clinical decision-making<\/a>, including:<\/p>\n

1. \u201cReport to keep kids safe.\u201d <\/p>\n

Mandated reporter trainings often emphasize the lifelong consequences of abuse and neglect. But they largely ignore the harms that can come with CPS involvement. <\/p>\n

Children placed in foster care<\/a> face heightened risks for abuse<\/a>. Family separation is a profound trauma<\/a> for children<\/a> and parents<\/a> alike. Even when an investigation closes with no finding, the fear<\/a> and stigma<\/a> can remain, and reports made by medical professionals can impact parents\u2019 willingness to engage with the healthcare system<\/a> again. <\/p>\n

2. \u201cReport to get them resources.\u201d <\/p>\n

Many clinicians are taught that CPS is a way to get families help. But investigations do not guarantee food, clothing, childcare, medical care, or mental healthcare. Nationwide, one-third of parents<\/a> involved with child welfare were in need of mental health services, but only half received them. When mandated reporter trainings present child welfare as \u201cchild protection\u201d without naming inequities related to reporting, loss of parental rights, or out-of-home placements, they reinforce the notion that child welfare provides help without harm. Furthermore, these trainings rarely feature the stories and voices of parents whose parental rights have been terminated and the trauma they and their children endure as a result.<\/p>\n

CPS investigates over 3 million referrals<\/a> annually, most of which are closed as unsubstantiated. Yet Black children are nearly twice as likely<\/a> as white children to be investigated, while Native children<\/a> have the highest rates of entry into foster care. These disparities exist not because<\/a> maltreatment is more common in these communities but because poverty, housing instability, and other racialized structural barriers are more heavily policed.<\/p>\n

Families know this. In my practice, parents have told me they avoid medical care or disclosing the whole truth to providers for fear of triggering a report.<\/p>\n

3. \u201cReport to avoid liability.\u201d <\/p>\n

The trainings I\u2019ve completed highlighted the penalties for failure to report\u2014including loss of licensure or criminal charges\u2014and the legal protections providers receive when they do report. While some medical education<\/a> is beginning to address systemic racism and disproportionality in reporting, efforts remain uneven. Deepening this gap is the absence of clinical standards addressing the consequences of overreporting or misreporting. <\/p>\n

As the opening case shows, what looks like \u201cnoncompliance\u201d might actually be a failure of communication, trust-building, or willingness to consider the impact of racism in healthcare. Mandated reporter training teaches clinicians how to protect themselves\u2014but I worry that it does not teach us how to best protect families.<\/p>\n

From Mandated Reporting to Mandated Supporting<\/p>\n

A growing movement known as mandated supporting offers a fundamentally different approach: When families are struggling, our first response should be support, not surveillance. <\/p>\n

This framework, developed by Just Making a Change for Families, has been embraced by many impacted parents, legal advocates, and organizers reimagining how communities and systems respond to family stress<\/a> in equitable, antiracist, and harm-reductionist ways. <\/p>\n

Healthcare has been slower to catch up. Mandated supporting may resonate with clinicians in principle. But often, what\u2019s missing are concrete clinical standards for what mandated supporting looks like during a brief medical appointment. As a child, adolescent, and adult psychiatrist, I\u2019ve begun to operationalize it in three ways.<\/p>\n

First, I speak openly with families about mandated reporting. I explain plainly what mandated reporting is; who reports; how racism, ableism, and poverty can shape investigations; and what investigations usually involve. I am especially proactive about this with families who are already highly surveilled, including racially minoritized, disabled, impoverished, or queer and trans parents.<\/p>\n

Second, I document in ways that aim to protect, rather than criminalize, families. Clinical notes are not neutral. They shape how families are viewed by every professional who reads them\u2014including CPS caseworkers and judges. I strongly believe that naming family strengths, structural barriers, and system failures\u2014not just deficits\u2014counters racist narratives framing Black and Brown parents as uninvolved or neglectful. Instead of labeling families \u201cnoncompliant\u201d or \u201cdifficult,\u201d I try to document the context we see: \u201cParents are supportive and engaged but fearful of medical procedures due to prior mistreatment in healthcare settings.\u201d<\/p>\n

Third, I make an effort to exhaust supportive options first, instead of defaulting to calling CPS: food programs, childcare support, rent assistance, transportation vouchers, and school advocacy. I might, for example, connect them with a community organization that provides direct cash aid for rent, legal expenses, and other essentials, helping families stabilize without being pulled deeper into child welfare oversight. Slowing down, answering questions, acknowledging prior harms, and thoughtfully explaining recommendations can be enough to prevent an unnecessary report. <\/p>\n

What Comes Next<\/p>\n

Several states, including California, are exploring ways to limit unnecessary CPS contact and expand financial and social supports instead. But legislative reform alone won\u2019t close the gap between policy and practice.<\/p>\n

Health care institutions need training, protocols, and decision-support tools that help clinicians distinguish between unmet needs and true danger. Providers need better guidance on when a CPS report is genuinely necessary\u2013and how they can document, consult, and mobilize support when it is not.<\/p>\n

As clinicians, we can begin this change immediately by asking better questions, being open about the possible risks of system involvement, and aligning our actions with what actually keeps children and families safe. For the preschooler with the heart condition, that shift made all the difference.<\/p>\n

Our oath as healthcare providers is to protect children from harm. But constant oversight is not the same as protection. And families doing exactly what we ask of them\u2014reaching out for help\u2014should not be treated as suspects.<\/p>\n

The real question isn\u2019t whether better approaches exist. It\u2019s whether we\u2019re willing to use them.<\/p>\n","protected":false},"excerpt":{"rendered":"I\u2019ll never forget being called to do a psychiatric consult on a preschooler hospitalized for a serious heart…\n","protected":false},"author":2,"featured_media":474898,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[59,57,58,50,56,54,55],"class_list":["post-474897","post","type-post","status-publish","format-standard","has-post-thumbnail","category-united-kingdom","tag-gb","tag-great-britain","tag-greatbritain","tag-news","tag-uk","tag-united-kingdom","tag-unitedkingdom"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/474897","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=474897"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/474897\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/474898"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=474897"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=474897"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=474897"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}