The child-abuse reporting law is the one everyone has heard of. Its counterpart for people 65 or older and for dependent adults is just as binding on your therapist, and it has one exception that covers psychotherapists, along with physicians and registered nurses.

The short answer: yes, if what you describe is physical abuse, abandonment, abduction, isolation, financial abuse or neglect of an elder or dependent adult — whether the person at risk is you, or someone you talk about in enough detail that the therapist has knowledge of an incident that "reasonably appears to be" abuse or "reasonably suspects" it. Every "health practitioner" is a mandated reporter,¹ and the definition names the "psychiatrist, psychologist, … licensed clinical social worker or associate clinical social worker, marriage and family therapist, licensed professional clinical counselor," and their trainees and interns.² A mandated reporter who "in their professional capacity … has observed or has knowledge of an incident that reasonably appears to be physical abuse, … abandonment, abduction, isolation, financial abuse, or neglect, or is told by an elder or dependent adult that they have experienced" such behaviour, "or reasonably suspects that abuse, shall report the known, suspected, or alleged instance of abuse by telephone or through a confidential internet reporting tool … immediately or as soon as practicably possible," and, if the first report was by telephone, a written or internet report "within two working days."¹ Outside a long-term care facility, state mental hospital or state developmental center, the report goes "to the adult protective services agency or the local law enforcement agency."¹ Other kinds of harm — mental suffering on its own, or a person whose "emotional well-being is endangered in any other way" — are ones the therapist "may report," not must.¹ And there is a therapy-specific exception: a psychotherapist "shall not be required to report" what an elder or dependent adult tells them if there is no corroborating evidence, the person "has been diagnosed with a mental illness or dementia, or is the subject of a court-ordered conservatorship because of a mental illness or dementia," and "in the exercise of clinical judgment" the therapist "reasonably believes that the abuse did not occur."¹

Who is protected

  • An elder is "any person residing in this state, 65 years of age or older."³
  • A dependent adult is "a person, regardless of whether the person lives independently, between the ages of 18 and 64 years who resides in this state and who has physical or mental limitations that restrict his or her ability to carry out normal activities or to protect his or her rights, including, but not limited to, persons who have physical or developmental disabilities, or whose physical or mental abilities have diminished because of age," and anyone 18 to 64 "admitted as an inpatient to a 24-hour health facility."⁴

A person with a serious mental illness that restricts their ability to carry out normal activities or protect their rights can be a dependent adult. And if you are 65 or older you are an elder, protected whether or not you have any limitation — including when you are describing what a relative or carer is doing to you.

What must be reported

The mandatory list is specific: "physical abuse, … abandonment, abduction, isolation, financial abuse, or neglect."¹ The definitions do the work:

  • Neglect is "the negligent failure of any person having the care or custody of an elder or a dependent adult to exercise that degree of care that a reasonable person in a like position would exercise" — and also "the negligent failure of an elder or dependent adult to exercise that degree of self care that a reasonable person in a like position would exercise." It includes "failure to assist in personal hygiene, or in the provision of food, clothing, or shelter," "failure to provide medical care for physical and mental health needs," "failure to protect from health and safety hazards," "failure to prevent malnutrition or dehydration," and "substantial inability or failure of an elder or dependent adult to manage their own finances."⁵ Self-neglect is on the list.
  • Isolation includes "acts intentionally committed for the purpose of preventing, and that do serve to prevent, an elder or dependent adult from receiving his or her mail or telephone calls," falsely telling callers or visitors the person is not present or does not want to see them, false imprisonment, and physical restraint "for the purpose of preventing the elder or dependent adult from meeting with visitors."⁶
  • Financial abuse occurs when a person "takes, secretes, appropriates, obtains, or retains real or personal property of an elder or dependent adult for a wrongful use or with intent to defraud, or both," assists in doing so, or does so "by undue influence."⁷

Mental suffering — "fear, agitation, confusion, severe depression, or other forms of serious emotional distress that is brought about by forms of intimidating behavior, threats, harassment, or by deceptive acts"⁸ — is the result that makes "other treatment" abuse under the general definition,⁹ but it is not on the mandatory-report list; it falls under the permissive clause: a mandated reporter "who has knowledge, or reasonably suspects, that types of elder or dependent adult abuse for which reports are not mandated have been inflicted upon an elder or dependent adult, or that their emotional well-being is endangered in any other way, may report."¹ The child-abuse counterpart →

The therapy-room exception

Section 15630(b)(3)(A) is written for the clinician who hears an account they do not believe. A physician, registered nurse or psychotherapist "shall not be required to report" an incident "if all of the following conditions exist":¹

  1. the reporter "has been told by an elder or dependent adult that they have experienced" the abuse;
  2. the reporter "is unaware of any independent evidence that corroborates the statement that the abuse has occurred";
  3. the elder or dependent adult "has been diagnosed with a mental illness or dementia, or is the subject of a court-ordered conservatorship because of a mental illness or dementia"; and
  4. "in the exercise of clinical judgment," the clinician "reasonably believes that the abuse did not occur."

All four, together. The exception does not apply to what the therapist observed, to accounts from anyone else, or to a patient with no such diagnosis. And the statute adds that this "shall not impose upon mandated reporters a duty to investigate."¹

The consequences of not reporting, and of reporting

Failing to report, or "impeding or inhibiting a report of," the listed forms of abuse "is a misdemeanor, punishable by not more than six months in the county jail, by a fine of not more than one thousand dollars ($1,000), or by both"; a wilful failure where the abuse "results in death or great bodily injury" carries up to a year and $5,000.¹ The reporting duties "are individual," and "no supervisor or administrator shall impede or inhibit the reporting duties."¹ On the other side, no health practitioner who reports "shall be civilly or criminally liable for any report required or authorized by this article,"¹⁰ and the reports "shall be confidential."¹¹

What to do

  • If you are the elder or dependent adult and you tell your therapist what is happening at home: expect a report to Adult Protective Services or the police if it describes physical abuse, isolation, financial abuse or neglect.¹ That is the law working as intended; ask your therapist what will be in the report and what usually happens next.
  • If you are describing what a relative is doing to a parent: a third-party account triggers the duty if it gives the therapist knowledge of an incident that "reasonably appears to be" abuse or grounds to "reasonably suspect" it; the first-person "told by" prong, and the therapy-room exception, apply only when the elder or dependent adult is the one speaking.¹ Help for family caregivers →
  • If you are struggling to care for a parent yourself: neglect includes the negligent failure of a person "having the care or custody" of an elder to exercise reasonable care.⁵ Say so early. The permissive clause lets a therapist report a situation that is not yet mandatory;¹ once an account "reasonably appears to be" neglect, the report is mandatory however early it is raised.¹
  • If you are worried about a report that was made: the report is confidential and the reporter is immune;¹⁰ ¹¹ what follows is up to Adult Protective Services or the police.

Worked example

A 71-year-old man tells his therapist that his adult son, who lives with him, has taken on his care and controls his bank card, has stopped buying his heart medication and shouts at him when he asks. The therapist is a licensed clinical social worker, a health practitioner and so a mandated reporter.¹ ² What she has been told reasonably appears to be neglect — "failure to provide medical care for physical and mental health needs"⁵ — and possibly financial abuse.⁷ She must report by telephone or the online tool immediately or as soon as practicable, to Adult Protective Services or the police, and, if she phoned, follow up in writing or online within two working days.¹ The exception does not apply: he has no diagnosis of mental illness or dementia and she has no reason to disbelieve him.¹ The shouting alone, if it caused serious emotional distress, would have been mental suffering — reportable at her discretion — but the missed medication makes the report mandatory.¹ ⁸

Q&A

Q: I am 66 and my daughter yells at me. Will my therapist report her? A: Shouting on its own is not on the mandatory list; if it causes "serious emotional distress" it may be mental suffering, which the therapist may report but is not required to.¹ ⁸ If it comes with isolation, withheld care or money taken, the duty is mandatory.¹

Q: My brother has schizophrenia and our mother controls his disability cheque. Is he a dependent adult? A: If his condition restricts his ability to carry out normal activities or protect his rights, yes;⁴ taking or retaining his property "for a wrongful use" is financial abuse.⁷

Q: Does the therapist have to investigate first? A: No. The statute says the exception "shall not impose upon mandated reporters a duty to investigate."¹ The trigger is reasonable appearance or reasonable suspicion.¹

Q: Can I be told what was reported? A: Reports are confidential and "may be disclosed only as provided" in the statute.¹¹ Ask your therapist what they are able to tell you; the statute limits who the report itself can be shared with.

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Sources

  1. Cal. Welfare & Institutions Code §15630 — (a) "A person who has assumed full or intermittent responsibility for the care or custody of an elder or dependent adult … or any elder or dependent adult care custodian, health practitioner, clergy member, or employee of a county adult protective services agency or a local law enforcement agency, is a mandated reporter"; (b)(1) "A mandated reporter who, in their professional capacity, or within the scope of their employment, has observed or has knowledge of an incident that reasonably appears to be physical abuse, as defined in Section 15610.63, abandonment, abduction, isolation, financial abuse, or neglect, or is told by an elder or dependent adult that they have experienced behavior, including an act or omission, constituting physical abuse, as defined in Section 15610.63, abandonment, abduction, isolation, financial abuse, or neglect, or reasonably suspects that abuse, shall report the known, suspected, or alleged instance of abuse by telephone or through a confidential internet reporting tool, as authorized by Section 15658, immediately or as soon as practicably possible. If reported by telephone, a written report shall be sent, or an internet report shall be made through the confidential internet reporting tool established in Section 15658, within two working days"; (b)(1)(F) "If the abuse has occurred in any place other than a long-term care facility, a state mental hospital, or a state developmental center, the report shall be made to the adult protective services agency or the local law enforcement agency"; (b)(3)(A) "A mandated reporter who is a physician and surgeon, a registered nurse, or a psychotherapist, as defined in Section 1010 of the Evidence Code, shall not be required to report, pursuant to paragraph (1), an incident if all of the following conditions exist," (i)–(iv) as quoted; (b)(3)(B) "This paragraph shall not impose upon mandated reporters a duty to investigate a known or suspected incident of abuse and shall not lessen or restrict any existing duty of mandated reporters"; (c)(1) the permissive report as quoted; (f) "The reporting duties under this section are individual, and no supervisor or administrator shall impede or inhibit the reporting duties, and no person making the report shall be subject to any sanction for making the report"; (h) the misdemeanor as quoted and "if that abuse results in death or great bodily injury, shall be punished by not more than one year in a county jail, by a fine of not more than five thousand dollars ($5,000), or by both" — california.public.law.
  2. Cal. Welfare & Institutions Code §15610.37 — "'Health practitioner' means a physician and surgeon, psychiatrist, psychologist, dentist, resident, intern, podiatrist, chiropractor, registered nurse, dental hygienist, licensed clinical social worker or associate clinical social worker, marriage and family therapist, licensed professional clinical counselor, or any other person who is currently licensed under Division 2 (commencing with Section 500) of the Business and Professions Code … a psychological assistant registered pursuant to Section 2913 of the Business and Professions Code, a marriage and family therapist trainee … an unlicensed marriage and family therapist intern … a clinical counselor trainee … a clinical counselor intern … or a substance use disorder counselor" — california.public.law.
  3. Cal. Welfare & Institutions Code §15610.27 — "'Elder' means any person residing in this state, 65 years of age or older" — california.public.law.
  4. Cal. Welfare & Institutions Code §15610.23 — (a) as quoted; (b) "'Dependent adult' includes any person between the ages of 18 and 64 years who is admitted as an inpatient to a 24-hour health facility, as defined in Section 1250, 1250.2, and 1250.3 of the Health and Safety Code" — california.public.law.
  5. Cal. Welfare & Institutions Code §15610.57 — (a)(1)–(2) and (b)(1)–(5) as quoted; (c) "Neglect includes being homeless if the elder or dependent adult is also unable to meet any of the needs specified in paragraphs (1) to (5), inclusive, of subdivision (b)" — california.public.law.
  6. Cal. Welfare & Institutions Code §15610.43(a) — (1)–(4) as quoted; (b) a rebuttable presumption that acts "performed pursuant to the instructions of a physician and surgeon" caring for the person are not isolation; (c) acts "performed in response to a reasonably perceived threat of danger to property or physical safety" are not isolation — california.public.law.
  7. Cal. Welfare & Institutions Code §15610.30(a) — (1) "Takes, secretes, appropriates, obtains, or retains real or personal property of an elder or dependent adult for a wrongful use or with intent to defraud, or both"; (2) "Assists in" the same; (3) the same "by undue influence, as defined in Section 15610.70" — california.public.law.
  8. Cal. Welfare & Institutions Code §15610.53 — "'Mental suffering' means fear, agitation, confusion, severe depression, or other forms of serious emotional distress that is brought about by forms of intimidating behavior, threats, harassment, or by deceptive acts performed or false or misleading statements made with malicious intent to agitate, confuse, frighten, or cause severe depression or serious emotional distress of the elder or dependent adult" — california.public.law.
  9. Cal. Welfare & Institutions Code §15610.07(a) — "'Abuse of an elder or a dependent adult' means any of the following: (1) Physical abuse, neglect, abandonment, isolation, abduction, or other treatment with resulting physical harm or pain or mental suffering. (2) The deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering. (3) Financial abuse, as defined in Section 15610.30" — california.public.law.
  10. Cal. Welfare & Institutions Code §15634(a) — "No care custodian, clergy member, health practitioner, mandated reporter of suspected financial abuse of an elder or dependent adult, or employee of an adult protective services agency or a local law enforcement agency who reports a known or suspected instance of abuse of an elder or dependent adult shall be civilly or criminally liable for any report required or authorized by this article" — california.public.law.
  11. Cal. Welfare & Institutions Code §15633(a) — "The reports made pursuant to Section 15630, 15630.1, 15630.2, and 15631 shall be confidential and may be disclosed only as provided in subdivision (b). Any violation of the confidentiality required by this chapter is a misdemeanor punishable by not more than six months in the county jail, by a fine of five hundred dollars ($500), or by both that fine and imprisonment" — california.public.law.

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