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California Teens Given Right to Consent to Their Own Mental Health Treatment

California recently made it much easier for teens to seek mental health treatment on their own. In a landmark bill proposed by State Senator Mark Leno (D-San Francisco) and signed into law by Governor Arnold Schwarzenegger on September 30, SB 543 gives adolescents between the ages of 12 and 17 the ability to consent to their own counseling, provided their therapists deem them mature enough to participate in their own healthcare and notification to parents would put them at risk.

Before this law passed, California only allowed youth to receive limited emergency mental health treatment without parental consent when they proved to be a risk to themselves or others. This is a model followed by many states around the country, however limiting or problematic it may be.

The Bill’s author points out, “It seems at odds with the public policy of our state to require minors to reach a state of crisis before allowing them to seek treatment without the consent of their parents, especially when the parents themselves may be contributing to the minor's mental distress.”

The case for prevention is extremely timely, given a recent spate of suicides by LGBT youth across the country. In September, Rutgers University freshman Tyler Clementi jumped to his death from a bridge after his roommate broadcast his intimate encounters with his boyfriend live over the internet (Watch TV host Ellen Degeneres’ response about teenage bullying here.)

If we provide youth the opportunity to deal with their problems early on, it stands to reason that SB 543 can save lives, or at the very least improve well-being for scores of young people.

When this bill goes into effect in January, it is expected to offer youth an outlet to express their concerns and get the help they need without fear of stigma or persecution. Benji, a gay high school graduate, lauded the bill, stating:

“It is so important for LGBT youth to be able to seek mental health services on our own. There are so many beautiful, intelligent young people who honestly don’t know what to do, and I know too well that this kind of desperation causes us to do things we later regret.”

While there seems to be widespread appreciation for SB 543 by the mental health, LGBT, and law communities – many entered their official support for the bill – there are some echoes of panic. One blogger called this the “anti-parent” bill. The only formally documented complaint against the bill was made by the National Alliance on Mental Illness (NAMI) of California, which stated, “It should be a be a rare case in which a professional person would not want to involve the people who know most about the child.”

This bill, by design, is for youth in that “rare case” category – the homeless, runaways, abused, undocumented, neglected, marginalized, and silenced young people who often have no one to turn to. As the former executive director of a homeless youth outreach program in Miami (StandUp For Kids) and as a pre-doctoral therapist, I’ve had to toe the line, thinking cleverly about getting youth the help they need without violating law or putting them in danger by notifying the parents they’re fleeing. Most often, these clinical decisions are not easy, and professional codes of ethics offer little help for complex situations like these.

The legal definition of consent requires that one’s permission be given knowingly, intelligently, and voluntarily. Thomas Grisso, a well known adolescent psychologist and forensic researcher, reviewed these terms and concluded that there must be a balance between children’s right to exercise self-determination and the implications of participating in treatment.

SB 543 definitively increases the discretion of professionals who work with young people. Moreover, it recognizes that if youth can consent to substance abuse counseling, STD treatment, and reproductive services – and even enter pleas in criminal cases – they can be given the right to consent to their own counseling. This bill supports youth self-determination, which is not only a milestone, but quite possibly a lifesaver.
October 27, 2010

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Posted in: News on October 28, 2010 @ 4:52 PM

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