When the child sex abuse scandal at Penn State erupted last year, public anger was not only directed toward Jerry Sandusky, whose trial begins Monday, but toward the people around him who didn't report their suspicions to police.
In the months that followed, that anger led many states to re-examine and expand their so-called mandatory reporting laws that require people to report suspected abuse or face civil and criminal penalties. Some state laws apply to professionals like doctors and teachers, while others apply universally to all adults.
Child advocates and academics are divided, however, about whether increasing the number of mandatory reporters will make the public more vigilant, or simply overload an already stretched-thin child welfare system and siphon limited resources from children who need help most.
Forty-eight states require at least some professionals to immediately report knowledge or suspicion of child sexual abuse to some authority, according to the National Conference of State Legislatures. The list of professionals varies by state and can include teachers, school nurses, doctors, social workers, police, day care workers, coaches and camp counselors.
Of those states, 18 have laws that require mandatory reporting of suspected child abuse by all adults.
Many states have no specific sanctions for those who fail to comply with such laws, while others have penalties but they are not enforced unless a case is particularly heinous or deadly, said Teresa Huizar of the National Children's Alliance, a Washington-based advocacy group.
"On the surface, [universal mandatory reporting] sounds like an outstanding idea," she said, "but if you make something everybody's responsibility, it can end up becoming no one's responsibility."
About 105 bills on the reporting of suspected child abuse and neglect have been introduced in 2012 legislative sessions in 30 states and the District of Columbia, many of them directly in response to the Sandusky case. Legislation has since been enacted in 10 of those states, according to the latest NCSL tally.
Oregon, West Virginia, Virginia, and South Dakota are among states that expanded their list of professions that are mandatory reporters, while Indiana and Iowa are requiring schools to develop new policies and reporting procedures for responding to suspected child abuse.
Indiana, also in response to the Penn State scandal, passed legislation that requires the state to work with child sexual abuse experts to develop education materials, response policies, and reporting procedures on child sexual abuse. A new Iowa law requires schools to implement policy for employees in contact with children to report suspected physical or sexual abuse.
Also as a direct result of the Sandusky case, Florida has passed what is now the toughest mandatory reporting legislation in the country: Failure to report suspected child abuse is a felony, and universities would be fined $1 million and stripped of state funding for two years if officials don't report child abuse. The law applies to everyone — from university coaching staff to elementary school teachers to students.
"Florida now has the toughest laws in the country for protecting children," said Book, who created a nonprofit foundation for child abuse victims and pushed for tougher sex offender laws with her father, lobbyist Ron Book.
She said the legislation compels individuals and institutions to speak up, the aim of which is to prevent what allegedly happened at Penn State from occurring in Florida.
"Mandatory reporting is a good thing but it's only a Band-Aid for a bigger issue," said Jim Hmurovich, president of Chicago-based child advocacy organization Prevent Child Abuse America. "The right solution is we should ensure as adults that the abuse and neglect ever happens in the first place."
Dozens of universities are also implementing their own reporting requirements. Penn State itself has instituted a new policy requiring all employees to report suspected child abuse to state authorities, while the University of Arkansas requires university employees who suspect child abuse to first call the state's Child Abuse Hotline and campus police.
Hmurovich and Huizar said they support the idea of mandatory reporting laws, even if imperfect.
"When we don't prevent abuse and neglect from happening we spend $80 billion a year trying to remediate it with treatment," Hmurovich said.
Critics contend that such laws force child welfare workers to investigate an endless flow of inconsequential complaints, to separate children needlessly from their parents and wreak havoc on innocent families.
"We don't have a problem of underreporting child abuse. We dramatically over-report already," said New York University law professor Martin Guggenheim, who specializes in legal issues related to child welfare. "We do have a problem of not doing enough for families who come to child welfare agencies and need help."
He said roughly 60 percent of child abuse reports end up being classified as unfounded cases, with no evidence of mistreatment, and predicted mandatory reporting laws may send that number even higher.
"Politicians serve themselves well. ... They recognized that Americans were [angry]" in the aftermath of the Penn State scandal, Guggenheim said, and began proposing legislation without clear understanding of child welfare issues.
He said that reporting laws have "turned child welfare practice into a quasi-criminal enterprise where everyone's out there looking for wrongdoers."
"I know what it can do to caseloads. What's more important, children or caseloads?" Hmurovich said. "The common reaction is, 'It's somebody else's child, I'm not going to intervene, I'm not going to make the matters worse,' but if it's the law you've got to do something about it."
There's not enough evidence to say whether there has been an overall increase in abuse reports nationwide, Huizar said. Some individual states did experience temporary increases in reports after the Penn State allegations surfaced.
New Jersey's child abuse hotline received as many as 750 calls a day in November after a grand jury indicted Sandusky, compared with 400 in the months before the scandal broke. In Pennsylvania, where about 2,300 reports of suspected child abuse are reported every week, there were more than 4,800 reports of suspected child abuse made statewide for weeks after Sandusky's indictment.
Massachusetts-based child advocacy group Stop It Now saw a 130 percent spike in calls during the first two weeks after the sexual abuse allegations at Penn State, services coordinator Jenny Coleman said.
Huizar said standardizing the current patchwork of requirements, agencies and procedures would make reporting abuse less intimidating and difficult — but perhaps more importantly, a national awareness campaign would be an invaluable step to reducing the societal stigma that makes victims and witnesses remain silent.
"In the same way we've taught people about the dangers of smoking, about using seat belts, about drinking and driving, when there's that kind of a commitment, you really see the dial move in the right direction," she said. "Without that level of investment, you're not going to see that kind of result."
Despite the uncertainty about whether legislation brings about better outcomes, Huizar said the Sandusky case has shown that there have been encouraging changes when it comes to the way Americans view child abuse.
"The instantaneous and universal outrage … really is different than what you would have had a decade ago," Huizar said. "People were instantly saying, why didn't the adults do more? That assumption is an enormously positive change in our societal understanding of who has responsibility for reporting abuse. So we're learning."