When Protection Becomes Punishment

What mandated reporter training misses about racism and family safety.

“I’ll never forget being called to do a psychiatric consult on a preschooler hospitalized for a serious heart condition. His parents had been labeled “noncompliant” and “difficult.”

“They’re refusing surgery,” the resident calling in the consult said. “My attending said we might have to call Child Protective Services (CPS) for medical neglect.”

When I met with the family, that narrative dissolved. These parents were not “noncompliant,” but frightened and confused. “We’re not saying no,” the mother said. “We just want to understand why this has to happen now.”

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

That case changed my understanding of mandated reporting as a mechanism for keeping children safe.”