This article was first published in November 2023
There are some circumstances where CRPO registrants are required by the Regulated Health Professions Act, 1991, to report information. For example, CRPO registrants are required to report certain information about themselves or their practice to CRPO. In other situations, registrants have a duty to report other regulated health professionals to their professional colleges or another authority.
CRPO registrants have a legal obligation to report certain information about themselves or their practice to CRPO. This includes things like registration with another regulatory body; findings of guilt or professional misconduct; or a change of name or contact information. See our webpage about Mandatory Self-Reporting for a list of items that registrants must disclose to CRPO.
In other situations, registrants have a duty to report other regulated health professionals to their professional colleges or another authority. Registrants should also be aware of other reporting obligations, such as the duty to make a report under the Child, Youth and Family Services Act, 2017, where a registrant has reasonable grounds to suspect that a child is in need of protection due to physical harm, neglect or sexual abuse by a person having charge of the child.
Registrants have an enhanced duty to report child abuse and neglect and are expected to review training as part of their biennial professional development requirements. For information, see “Duty to Report Training Review”.
The situations described above are clearly outlined in the document Mandatory Reporting Obligations for Registered Psychotherapists and several examples are provided in the Professional Practice & Jurisprudence for Registered Psychotherapists Manual under Standard 1.3 Mandatory Reporting.
Confidentiality concerns
A mandatory reporting obligation may require registrants to include confidential information.
When providing a mandatory report that includes client personal health information, registrants are advised to disclose only as much personal health information as is reasonably necessary to meet the purposes of the disclosure. See Standard 3.1 Confidentiality linked in Related Resources below.
Below are answers to some frequently asked questions.
If I am reporting another regulated health professional to their College for alleged sexual abuse of a client, do I need to let CRPO know?
If the professional is not a CRPO registrant, the answer is no.
As noted in Standard 1.3, Mandatory Reporting, registrants must report sexual abuse of a client by another RP or health professional. You do not need to notify CRPO if you are reporting to another College.
If you are aware of allegations of sexual abuse by a CRPO registrant, or if you became aware of another CRPO registrant’s unsafe practice or behaviour, you would have a legal obligation to report that individual to CRPO.
In all cases described above, a client’s identity must not be submitted in the report unless their written consent is given or otherwise permitted by law (such as when there is risk of ongoing and serious harm).
My client has described another regulated health professional’s (i.e, not a CRPO registrant) unsafe behaviour. Do I have a duty to report?
When a client has concerns about the care they have received from another regulated health professional, the client has the right to file a complaint with the relevant health college.
In situations when a mandatory report is not required, a registrant could choose to make a discretionary report to the relevant College. It would be up to the College’s screening committee to determine if the alleged conduct represented a risk to clients/patients and to respond according to that risk assessment.
In a discretionary situation, a registrant should obtain the client’s written consent before disclosing information to any other party. (See Standard 3.1 Confidentiality linked in the Related Resources)
Where there is no legal obligation to report, decision-making should be guided by what is in the best interest of the client’s well-being.
Do I have a duty to report if another healthcare provider or the client has already made a report?
In general, another person having made a report does not relieve an individual of their own reporting obligation, if that individual has reasonable grounds to make the mandatory report.
When in doubt, registrants are encouraged to consult with the organization to which the report may be required.
I heard information about alleged sexual abuse by a CRPO registrant or other regulated health professional in my personal life / in another role. Do I have a duty to report?
No. As noted in the Professional Practice & Jurisprudence for Registered Psychotherapists Manual under Standard 1.3 Mandatory Reporting:
This mandatory report is required when regulated health professionals, including RPs, have reasonable grounds to believe that an Ontario regulated health professional has sexually abused a patient or client. The mandatory reporting duty applies to information obtained in the course of practising the profession. That is, it does not apply to information learned in the RP’s personal life. RPs should refer to the definition of sexual abuse (covered later in this manual), so they know what conduct is reportable.
My client is a registrant of another regulated health college. I have concerns about their substance use in their personal life. Do I have a duty to report this to their College?
As noted in Standard 3.1, Confidentiality, “a registrant may only disclose personal health information with the consent of the client or their authorized representative. However, legally, there are a limited number of circumstances where consent is not required for the disclosure of personal health information.”
The mandatory reporting obligations described in this article are not the only limits to client confidentiality.
CRPO’s Professional Practice Guideline: Disclosing Information to Prevent Harm provides guidance for these situations. As noted in the Guideline, “Registered Psychotherapists have an obligation to maintain client confidentiality. In some circumstances, however, disclosure of client information is permitted or required by law. The Personal Health Information Protection Act, 2004 (PHIPA) allows health information custodians to disclose personal health information about an individual, without that individual’s consent, if the custodian believes on reasonable grounds that the disclosure is necessary for the purpose of eliminating or reducing a significant risk of serious bodily harm to a person or group of persons.”
The guideline linked above includes brief explanations of the key concepts quoted above:
Reasonable grounds
- A concern that is based on more than suspicion, rumour or speculation.
Necessary
- There is no other reasonable way (such as continuing therapy with the client) to prevent the risk of harm to the client or others. If disclosure is necessary,
- as little information as possible is disclosed to eliminate or reduce the risk of harm;
- that is, extraneous information is not shared.
Significant risk
- Requires a case-by-case evaluation of both the likelihood and magnitude of harm. “Significant risk” falls in between the extremes of low risk and certainty.
Serious bodily harm
- Death or “any hurt or injury, whether physical or psychological, that interferes in a substantial way with the integrity, health or well-being of a victim.”
Person or group of persons
- The victim(s) are identifiable or their characteristics are described Specifically.
The guideline also provides a series of reflection questions to support decision-making:
- Does this situation present a significant risk of serious bodily harm to a person or group?
- Is the therapist’s assessment or opinion based on reasonable grounds?
- Is disclosure necessary to prevent or reduce the risk of harm?
- Is this a situation that would benefit from consultation?
- If not required by law, would disclosure put the person (client or third party) at risk?
Conclusion
As with all complex situations, registrants are encouraged to consult with peers, a supervisor, legal advisor, the CRPO Practice Advisory Service or the organization to which the report may be required.