4 December 2019

There’s really no need to be afraid, says AHPRA

AHPRA Medicolegal Mental Health

New resources released by AHPRA today will explain the changes to mandatory reporting requirements that will come into effect early next year.

The fear of being reported to the Medical Board of Australia has held many doctors back from seeking help in the past.

But changes to the mandatory reporting laws across most states in Australia should give doctors greater peace of mind when seeking treatment for health concerns, AHPRA said.

“Having a health issue is not in itself a reason to make a mandatory notification,” Martin Fletcher, the CEO of AHPRA, said. “If a practitioner has taken steps to deal with it, such as taking time away from work, or are engaged in an effective treatment plan then we don’t need to know about it.”

AHPRA has released a suite of resources on what health practitioners need to know about mandatory reporting on its website.

In a video, psychiatrist Dr Kym Jenkins gives three examples of mandatory reporting under the new laws, including one scenario where a notification is required, one where it is not required and one borderline case.

If doctors are unsure about whether they are required to make a notification, AHPRA advises doctors to consult with a colleague or to contact their indemnity insurer.

Doctors can also call AHPRA (anonymously if they wish) for more information or for clarification.

What are the changes?

From early next year, the thresholds for mandatory reporting will increase.

Across all states, except Western Australia, treating doctors will only be required to report their health practitioner patients if there is a “substantial risk of harm” to the public from impairment, intoxication or from practising in a way that constitutes a significant departure from accepted professional standards.

“A substantial risk of harm is a very high threshold for reporting risk of harm to the public,” AHPRA said.

The threshold for reporting sexual misconduct will remain low, however. Treating health practitioners will be required to report past and present sexual misconduct concerns, as well as future risk concerns to AHPRA.

“Mandatory reporting doesn’t kick in until there is impairment and substantial risk of harm,” said Dr Jenkins, a psychiatrist based in Victoria and the immediate past president of the Royal Australian and New Zealand College of Psychiatrists.

“I see a lot of patients who have depression and anxiety and they’re not putting their patients at risk at all. Being concerned about your mental health or feeling stressed and wanting to do something about it is not a condition for mandatory reporting.

“Being on treatment for a mental illness is not a condition for mandatory reporting. Nor is seeking treatment. And actually, if you’ve had a mental illness in the past, that’s not a condition for mandatory reporting in itself, nor is having time off work, or even being hospitalised for mental illness.

“If I was seeing a patient who was acutely psychotic and had really unusual beliefs that were putting their own patients at risk, then it’s pretty sort of obvious in that case that that is a big risk of harm to that patient.

“Or somebody was acutely manic and behaving terribly inappropriately and couldn’t make decisions or was saying really inappropriate things to their patients or behaving in a disinhibited way, then that would invoke mandatory reporting.

“But somebody who is depressed and really caring and conscientious about their patients and wanting to get treatment, then mandatory reporting wouldn’t be appropriate.”

The mandatory reporting laws in Western Australia will not change next year. Western Australia exempts treating practitioners from mandatory notifications when treating a registered health practitioner. Treating practitioners in Western Australia can make voluntary notifications based on their professional and ethical obligations to notify about matters that may place the public at risk of harm.

Around 1.6% of all registered practitioners were the subject of a notification in 2017-2018 (not all notifications are mandatory).

Out of the 7,276 notifications that year, 908 were mandatory notifications. Around 45% of mandatory notifications resulted in some form of regulatory action being taken against a practitioner.

“There are many registered health practitioners who really overestimate the likelihood of getting a mandatory notification and have an unnecessary fear about it,” Dr Jenkins said.

“And then people can avoid seeking health treatments for things like mental health issues or burnout or stress when they really need it.”

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