I am required to report where disclosure is necessary to eliminate or reduce a significant risk of serious harm to the yourself. Please note that passive suicidal ideation is not uncommon (i.e., "I do not feel a desire to live, to keep going") and does not fall under my duty to report. Self-harm alone without significant risk of serious physical harm also does not fall under this criterion. However, if it is reasonable for me to believe that you may be a danger to yourself, I am then required to get you to a clinician who can assess you: for my practice, this means getting you to an emergency department myself (a loved one may accompany you with me at your request) or if a client runs away, to contact emergency services to (potentially involuntarily) transport you to hospital.

I am required to report where disclosure is necessary to eliminate or reduce a significant risk of serious harm to another (e.g., express desire to kill or hurt someone else, which can include an individual, an organization, a building with people in it, etc.). (1) I am then required to get you to a clinician who can assess you: for my practice, this means getting you to an emergency department myself (a loved one may accompany you with me at your request) or if a client runs away, to contact emergency services to (potentially involuntarily) transport you to hospital. (2) If there is any potential of significant, imminent risk of serious bodily harm to someone else, I: (a) am legally required to contact police directly, and; (b) have a professional and legal duty to warn the intended victim directly myself.

I am required to disclose information if I am responding to an investigation or inspection authorized by a warrant or by any provincial or federal law (e.g., a criminal investigation against me, my staff, or a client).

I am required to report by law for particular legal proceedings (e.g., court order, valid subpoena).

If you become injured, incapacitated, or ill and unable to give consent personally, I am required to contact a relative, friend, or your substitute decision-maker.

I am required to disclose information to my regulatory college when so directed for the purpose of administration or enforcement of the Regulated Health Professions Act, 1991 (e.g., when a complaint has been made about a clinician or if my regulatory college does a quality assurance review of my work/records).

I am required to report sexual abuse of a client by another regulated health professional or personal support worker (PSW)/health care aid (HCA) to their regulatory college or relevant oversight body. For example, most regulatory colleges have a prescribed period after treatment where sexual contact or relations (even if the client advises they gave consent) constitutes sexual abuse on the part of the clinician. This means that even if the client feels it was consensual, I am still required to report this clinician to the appropriate regulatory body.

I am required to report any professional misconduct of another Registered Psychotherapist to our regulatory body (the CRPO).

I am required to report to a children's aid society any child that may need protection. This includes where:

• The child has suffered physical harm inflicted by the person having charge of the child or caused by or resulting from that person’s, i. failure to adequately care for, provide for, supervise or protect the child, or ii. pattern of neglect in caring for, providing for, supervising or protecting the child.

• There is a risk that the child is likely to suffer physical harm inflicted by the person having charge of the child or caused by or resulting from that person’s, i. failure to adequately care for, provide for, supervise or protect the child, or ii. pattern of neglect in caring for, providing for, supervising or protecting the child.

• The child has been sexually abused or sexually exploited by the person having charge of the child or by another person where the person having charge of the child knows or should know of the possibility of sexual abuse or sexual exploitation and fails to protect the child.

• There is a risk that the child is likely to be sexually abused or sexually exploited as described in paragraph 3. 4.1 The child has been sexually exploited as a result of being subjected to child sex trafficking. 4.2 There is a risk that the child is likely to be sexually exploited as a result of being subjected to child sex trafficking.

• The child requires treatment to cure, prevent or alleviate physical harm or suffering and the child’s parent or the person having charge of the child does not provide the treatment or access to the treatment, or, where the child is incapable of consenting to the treatment under the Health Care Consent Act, 1996, refuses or is unavailable or unable to consent to, the treatment on the child’s behalf.

• The child has suffered emotional harm, demonstrated by serious, i. anxiety, ii. depression, iii. withdrawal, iv. self-destructive or aggressive behaviour, or v. delayed development, and there are reasonable grounds* to believe that the emotional harm suffered by the child results from the actions, failure to act or pattern of neglect on the part of the child’s parent or the person having charge of the child.

• The child has suffered emotional harm of the kind described in subparagraph 6 i, ii, iii, iv or v and the child’s parent or the person having charge of the child does not provide services or treatment or access to services or treatment, or, where the child is incapable of consenting to treatment under the Health Care Consent Act, 1996, refuses or is unavailable or unable to consent to, treatment to remedy or alleviate the harm.

*Reasonable grounds: When a concern is based on more than suspicion, rumour, or speculation. (Please note that while proof of any of the above is not required for me to report, it is considered a vexatious complaint/report for me to disclose where there are not reasonable grounds to do).

I am required to report any improper care or treatment of a patient/resident (personal, financial, etc.) in a long-term care home or retirement home to the Ministry of Health and Long Term Care or the Registrar of the Retirement Homes Regulatory Authority, whichever applies.

Confidentiality after death: The right to confidentiality does not end upon the death of a client. In Ontario, the right to consent to the collection, use, and disclosure of personal health information about a deceased individual is held by their estate trustee or administrator.

Please feel free to ask a question anytime about my duty to report. Once a disclosure is made, my hands are tied and I am required to disclose information to respective authorities in these cases.