Mental health policies on reporting child sexual abuse andphysician-patient sexual relationships

摘要

The reporting of child sexual abuse (CSA) and physician-patient sexual relationships (PPSR) are currently the focus of professional, legal and media attention in several countries. This paper briefly reviews mental health policies on these issues and reports on a WPA survey of them. While the WPA Madrid Declaration permits breaching confidentiality for mandatory reporting of CSA and clearly prohibits PPSR, it is not known how or to what extent these policies are implemented in WPA Member Societies’ countries. It is also not known whether policies or laws exist on these topics nationally or to what extent psychiatrists and the public are aware of them. Representatives of WPA Member Societies were e-mailed a survey about issues pertaining to CSA and PPSR. Fifty-one percent of 109 countries replied. All reporting countries had laws or policies regarding the reporting of CSA, but this was often voluntary (63%) and without protection for reporting psychiatrists either by law (29%) or by Member Societies (27%). A substantial number of psychiatric leaders did not know the law (27%) or their Society’s policy (11%) on these matters. With respect to PPSR, some reporting countries lacked laws or policies about PPSR with current (17%) or past (56%) patients. Fewer than half of respondingrepresentatives believed that their Society’s members or the publicwere well informed about the laws and policies pertaining to CSA or PPSR.There is clearly a wide range of laws, policies and practices about CSA andPPSR in WPA Member Societies’ countries. There is a need in some countriesfor laws or supplemental policies to facilitate the protection of vulnerablechild and adult patients through clear, mandatory reporting policies for CSAand PPSR. Mechanisms to protect and support reporting psychiatrists shouldalso be developed where they do not already exist. There is also a need insome countries to develop strategies to improve the education of psychiatrists,trainees, and the public on these issues.