Knock and Talk

By Marc Black

If you, a caregiver, are not fully executing the requirements of your loved ones’ meal plan (or holding firm with other boundaries) because you fear your child with an eating disorder (ED) may contact a mandated reporter with maltreatment claims, then I’d like to engage you with a brief “Knock and Talk.”

I am urging you to not be intimidated by your child’s ED threatening maltreatment claims (or other claims) against you to mandated reporters…or those mandated reporters then notifying law enforcement or child protective services.

That’s a pretty bold statement for me to make. I make it authoritatively because I’m a retired law enforcement detective who investigated cases of child exploitation, and I’m the dad of a daughter diagnosed at 14 years of age during the Covid pandemic with Anorexia Nervosa. Today, my daughter has a positive outlook on life and has overcome the eating disorder, but as a parent I’m always on guard and watching for signs the ED may return. I want to provide you with actionable insight to guide possible interactions with  law enforcement and child protective services on occasions when you might encounter a “Knock and Talk,” law enforcement parlance for an investigative process brought to your doorstep.

My bottom line:  execute the meal plan and have your child meet the expectations of their nutrition prescription. As long as you, the parent or family member caregiver, are proceeding legally and not causing harm, you do not have reason to fear law enforcement or child protective services involvement, and it is your goal to challenge the ED, foster supportive care, and ensure your loved ones’ safety. Since many caregivers have had limited, or no, experience with law enforcement or child protective services and are not sure how to conduct themselves when meeting these entities, it’s effective to prepare for these interactions by enlisting the support of your trusted ED providers (doctors, psychiatrists, therapists, family mentors, and dietitians).

Have one or more of your providers briefly describe (on company/office letterhead) the eating disorder diagnosis, the nature of the treatment being provided, and your role in supporting effective clinical care and challenging the eating disordered thoughts/behaviors. This letter serves several purposes (keep a hard copy at home and a copy on your cell phone):

This letter is also a good tool if your child requires emergency room care or inpatient care. It provides ER staff with a statement from the medical provider along with their contact information.

Child Protective Services’ (CPS) job is to ensure all children at your residence are safe and not maltreated. An investigative case is opened when a mandated reporter or an individual makes a report of a child potentially (or allegedly) being maltreated. In the United States, CPS has investigative protocols determined by the state child welfare office. A case worker should inform you of the type of complaint, the date it was made, and how an investigation will proceed. The case worker may ask to see your ED child, any siblings, the children’s rooms, and may want to speak with any or all of them. This is to ensure the well-being of your child(ren).

In most U.S. states you are under no obligation to allow CPS to enter your residence or speak with your children, and you can retain an attorney for legal assistance. However, keep in mind CPS has a job to do, so if the case worker is denied access to your children in your home, they may seek contact with them at your children’s school (or other locations) to confirm the child’s well-being.

Now let’s take our “Knock and Talk” in another direction. What happens if you call 911 (or emergency services) and need the assistance of law enforcement at your home due to a volatile/distressing situation involving your ED child? Here are some steps to follow:

Please understand once police arrive, the decision regarding your child’s ability to remain safely in your home will be based on their assessment of the scenario, not on your preferences. They will determine if transport to a medical facility will be undertaken. Of course, in most cases, if the caregiver desires transport for their ED child to a medical facility, the police will be accommodating.

Also understand police officers are not social workers. Their main concern is for their own safety, their partner’s safety, your family’s safety, and your ED loved one’s safety. If officers feel your child is acting in an unsafe manner, they will restrain them for the safety of everyone in the environment. This is non-negotiable.

You will find that many law enforcement and child protective services professionals have very little knowledge of Anorexia Nervosa and other eating disorders. Prepare yourself to educate these professionals on eating disorders. When you present yourself as a subject matter expert to these professionals, you will gain their confidence and support.

Stay focused on your mission: the safety of your child. Do not become distracted and intimidated by the ED. Deep down, in your heart, you know (and your ED child knows) everything you are doing is to ensure their safety and save their life.