Addressing Possible Incapacity of a Colleague: A colleague, who is also a member of the College, has disclosed to me that they are suffering from “burnout”. They recognize the risks of this to their clients. I am providing them with peer support, which appears to be helping but wonder if there is a duty to report this situation to the College?
First, it is good to know that you are helping them to address these issues, as a colleague. It does not appear that you have a duty to report this situation.
There are two situations in which you may have a mandatory reporting obligation, but this does not sound like it is one of them. The two situations are set out in Section 85.2 and Section 85.5 of the Health Professions Procedural Code, being Schedule 2 of the Regulated Health Professions Act, 1991. The first applies to operators of facilities in which a health professional provides services:
Reporting by facilities
85.2 (1) A person who operates a facility where one or more members practise shall file a report in accordance with section 85.3 if the person has reasonable grounds to believe that a member who practises at the facility is incompetent, incapacitated, or has sexually abused a patient.
From your description of the situation, it doesn’t sound like you operate a facility in which this colleague practices, therefore this section would not apply.
The second relevant section of the Code applies to reporting by employers, etc.
Reporting by employers, etc.
85.5 (1) A person who terminates the employment or revokes, suspends or imposes restrictions on the privileges of a member or who dissolves a partnership, a health profession corporation or association with a member for reasons of professional misconduct, incompetence or incapacity shall file with the Registrar within thirty days after the termination, revocation, suspension, imposition or dissolution a written report setting out the reasons.
Same
(2) Where a member resigns, or voluntarily relinquishes or restricts his or her privileges or practice, and the circumstances set out in paragraph 1 or 2 apply, a person referred to in subsection (3) shall act in accordance with those paragraphs:
- Where a person referred to in subsection (3) has reasonable grounds to believe that the resignation, relinquishment or restriction, as the case may be, is related to the member’s professional misconduct, incompetence or incapacity, the person shall file with the Registrar within 30 days after the resignation, relinquishment or restriction a written report setting out the grounds upon which the person’s belief is based.
- Where the resignation, relinquishment or restriction, as the case may be, takes place during the course of, or as a result of, an investigation conducted by or on behalf of a person referred to in subsection (3) into allegations related to professional misconduct, incompetence or incapacity on the part of the member, the person referred to in subsection (3) shall file with the Registrar within 30 days after the resignation, relinquishment or restriction a written report setting out the nature of the allegations being investigated. 2014, c. 14, Sched. 2, s. 12.
Application
(3) This section applies to every person, other than a patient, who employs or offers privileges to a member or associates in partnership or otherwise with a member for the purpose of offering health services. 1993, c. 37, s. 23.
Once again it does not appear that you would have a reporting obligation unless you are the colleague’s employer and due to concerns of incapacity you terminated their employment or revoked, suspended or imposed restrictions on their privileges to practice or you dissolved a partnership, a health profession corporation or association with them.
Hopefully, with your collegial support, this individual will be able to mitigate the risks to themself and their clients and find relief from their distress. If it appears advisable for your colleague to obtain professional services, then you should consider referring them to an appropriate mental health professional, to avoid becoming involved in a dual relationship.
Addressing Possible Incapacity of a Client: I am providing therapeutic services to a member of another regulated health profession and think that mental and behavioural impairments may be interfering with their effective or safe practice. Do I have a duty to report if I believe the client is impaired due to a mental health condition?
There are two situations in which members have a duty to report incapacity-related concerns. These are set out are set out in Section 85.2 and Section 85.5 of the Health Professions Procedural Code, being Schedule 2 of the Regulated Health Professions Act, 1991. Neither of these appear to apply to a situation in which the concern regarding incapacity is with a client.
If you believe that this individual is putting members of the public at risk you can always make a report to the professional’s College, with their consent. In addition, Section 40 of The Personal Health Information Protection Act, 2004 also permits you to make a voluntary report, without the client’s consent, if you believe, on reasonable grounds that such a disclosure is necessary as they are putting clients at significant risk of serious bodily harm:
Disclosures related to risks
- (1) A health information custodian may disclose personal health information about an individual 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.
Duty to Take Steps to Avoid Incapacity: We are funders of psychological services and are aware of some College members who appear to provide services for 10 hours a day, on a daily basis with no indication of breaks, lunch, or dinner. This raises concern about “burnout” and, ultimately, client care. Does the College have any rules which limit the number of consecutive sessions members can offer or require members to limit their activities, for their own sake and the sake of their clients?
Section 13, specifically 13.2, of the Standards of Professional Conduct, 2017 requires members to responsibly assess their well-being and avoid impairment:
- Professional Objectivity
13.2 Compromised Objectivity, Competence or Effectiveness Due to Other Factors
A member must not undertake or continue to provide psychological services when personal, scientific, professional, legal, and financial or other interests could reasonably be expected to:
- a) impair his/her objectivity, competence or effectiveness in delivering psychological services; or
- b) expose the client to harm or exploitation.
Members are expected to use their professional judgement in considering their personal workload tolerance. The Quality Assurance Committee had developed a Self-Care Plan to provides some guidance in this area. The Quality Assurance Program requires that every member formally reflect upon their own need for self-care and mitigate the risk of harm to their own well-being and consequently that of their clients.
