Navigating client confidentiality is a balance between respecting privacy and maintaining safety. I always thought that I wouldn’t deal with reporting someone as a threat until much later in my career. I’m a social work student and a social work intern so I thought I wouldn’t come across an instance of threat to harm until I graduated. In the course of my work as an employment specialist I came across a situation where I needed to report a client.
I had a client make a bomb threat during a phone session when I was coaching him about his job. Immediately I told him I was a mandated reporter. When our call ended I contacted my boss to explain what happened. She agreed that I should report his threat to the police. Although I was not acting as a therapist, I still had mandated reporting responsibilities in my role as an employment specialist.
I called and reported the threat to his local police station. They did a wellness check. Later on I would learn that my client went to the hospital. I was certain my client would hate me for notifying the police. But weeks later he contacted me and expressed his thanks. He had been off medication and needed the hospitalization to stabilize.
Reflecting now on what happened I see that even when someone is a threat to others they are still in need as individuals. We don’t know what state of crisis they are in to go so far as to threaten others. A social worker’s responsibility is to protect those who would be harmed but also the person threatening to do the harm. Maybe in their right mind that person wouldn’t threaten anyone. By reporting the threat we are helping even when the client doesn’t see that.
I had established a rapport with that client. We developed a relationship of trust. Although it felt like I was breaking confidentiality, I was acting within its ethical limits, which require reporting when there is a credible threat of harm. Confidentiality never supersedes the threat to self or others. Despite that as a future clinician I felt horrible about making that phone call to the police. My client was a good man and would never in his right mind threaten anyone, but I couldn’t take the risk that he would make good on his threat. So I made the call and felt relief and fear. Relief because I knew he won’t carry out his threat. Fear because I feared losing my client. Then there was the fear of retaliation. What if my client wanted to find me and get revenge for getting him in trouble? These were worries that made what I had to do all the more uncomfortable.
In the end my fears were unfounded, but that doesn’t mean that they couldn’t be realized in another case of mandated reporting. As a person in human services I take a risk by dealing with people. Even more so when I do become a therapist and help people with mental illness. However, I also always remind myself that I too have trauma and I too suffer from mental illness. People are capable of recovery and they deserve the intervention that mandated reporting provides. This experience taught me that ethical decision-making is rarely comfortable, but discomfort can be a sign that we are taking our responsibility to others seriously.
Have you ever faced an ethical dilemma involving mandated reporting? How did you navigate it?