Mandatory Reporting, Confidentiality, and Statutory Duties
Child abuse and neglect
Under §210.115 RSMo, health and mental health professionals must report when they have reasonable cause to suspect abuse or neglect of a child. You do not investigate, and you do not need proof. Report immediately to the Children's Division toll-free hotline and provide a written report if one is requested. The trap is the standard: "reasonable cause to suspect" sits far below "reasonable belief" or "confirmed."
Abuse of eligible adults
Section 630.115 RSMo requires any person with reasonable cause to suspect abuse, neglect, or exploitation of an eligible adult - age 60 or older, or 18–59 with a qualifying disability - to report to the Department of Health and Senior Services. Adult reports go to DHSS, not the Children's Division.
Confidentiality and privilege
Confidentiality is the default, not an absolute. Disclosure is permitted or required for written client consent; the mandatory reports above; imminent serious harm to self or others; a court order obtained after you assert privilege; and administrative or insurance purposes. Missouri has no statutory Tarasoff-style duty-to-warn provision; any duty to protect derives from case law and is fact-specific, so consult, document, and disclose the minimum necessary.
Subpoenas and minors
A subpoena is not a court order. Assert privilege or obtain consent or a valid order before producing records. With minors, confirm who may consent to treatment and what a parent may review.
Rule of thumb
When in doubt, call the hotline, document the consultation, and disclose only what is necessary to accomplish the legal purpose.