Reference — Mental Health
Mandatory Reporting Reference
Nurses are mandatory reporters, and the rules are testable precisely because they feel counterintuitive: you report suspicion, not proof; you usually don’t need consent; and a competent adult’s situation is handled differently from a child’s or vulnerable adult’s.
Educational use only. Reporting laws vary by state and by population. This reference is educational and not legal advice — always follow your jurisdiction’s statutes and facility policy. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
What Nurses Generally Must Report
| Category | Report To (typical) |
|---|---|
| Suspected child abuse or neglect | Child Protective Services / designated agency |
| Suspected elder / vulnerable-adult abuse | Adult Protective Services / designated agency |
| Reportable communicable diseases (e.g., TB) | Public health department |
| Certain injuries (e.g., gunshot/stab wounds) | Law enforcement (per state law) |
| Credible threat of harm to an identifiable person | Duty to warn/protect per jurisdiction (Tarasoff-type) |
The Core Rules
Reasonable suspicion, not proof
You report when a reasonable person in your position would suspect abuse — you are not the investigator, and waiting for certainty defeats the purpose.
Consent is not required
For protected populations (children, vulnerable/older adults), you report regardless of the patient’s or family’s wishes.
Good-faith reporting is protected
Reporters acting in good faith are shielded from liability; failing to report when required carries legal and licensure consequences.
The report is personal
The duty typically falls on the individual who formed the suspicion; “I told my charge nurse” may not discharge your obligation — know your facility’s process.
The Competent-Adult IPV Exception
Intimate partner violence against a competent adult is the key distinction: in most states you cannot report it against the person’s wishes, because a capable adult has the right to make their own decisions. The nursing role becomes assessment, documentation, resource provision, and safety planning — supporting autonomy. (Some states mandate reporting specific injuries even in competent adults; know yours.) Children and incapacitated/vulnerable adults do not get this autonomy exception — their abuse is reported.
NCLEX Pearls
- ✦Report suspected abuse of children and vulnerable/older adults on reasonable suspicion — no proof, no consent needed.
- ✦A competent adult experiencing IPV decides; support and resources, not reporting against their will (state exceptions apply).
- ✦Good-faith reports are legally protected; failure to report carries liability.
- ✦Certain communicable diseases (like TB) and some injuries (gunshot/stab) are independently reportable.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with American Psychiatric Association (DSM-5-TR) · American Psychiatric Nurses Association (APNA) · SAMHSA. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →