Are you perhaps saying that trying to teach an understanding of a concept like place value or carrying is more complicated than just getting the answer to an arithmetic problem? I have no idea why that should be the case, where would you get such an idea anyway?

What are the cops going to do? Round here at least, thought crime isn't yet a thing. It'd essentially be the same as if you said "Sometimes, I want to hurt people". If you're actually speaking with a medical professional, what you say is legally privileged information, and AFAIK for the US at least, that continues until there is reasonable belief that you will harm someone or commit a crime.

This totally glosses over the social aspect, but for any legitimate medical provider that shouldn't be a problem. I don't want anyone who needs help to be afraid of seeking it.