Why mandated reporting should be mandated supporting

Not long ago, during training on a child psychiatry consult-liaison service, I was asked to see a 5-year-old boy awaiting surgery for a congenital heart defect — surgery his parents were said to be “refusing.”

- By RUPINDER K. LEGHA, MD

The medical team was considering calling child welfare to report medical neglect, but when I sat down with the family, I didn't see neglect; I saw parents asking questions.

“We're not saying no,” the mother told me. “We just want to know why this has to happen now.” After receiving answers to their questions, validation of their concerns, and time to reflect, they consented. Their son recovered well. No report was filed.

The issue wasn’t noncompliance. It was communication. They needed clarity, not a report. The neglect was on our end, not theirs.

In my role as a psychiatrist, I've seen this happen too often. Families — especially Black, Indigenous, immigrant, and low-income ones — are often broken up not because of abuse, but because of poverty, trauma, or discrimination. A big part of this is mandated reporting: laws that make teachers, doctors, and social workers report suspected child abuse, even when it's really about hunger, unstable housing, or grief.

Mandated reporting was designed to protect kids, but it's become a tool of surveillance, pushing families into a system that prioritizes investigation over help. Research consistently shows that Black children are reported much more often than white kids for the same behaviors. Once in the system, families are scrutinized, separated, and scarred. Kids suffer from the trauma of removals, while parents face stigma and loss.