Teens & Mental Health Rights:
Understanding Confidentiality & Consent
Teen mental health confidentiality rights are vital for adolescents looking for a safe, private space to receive treatment.
Unfortunately, there can be some confusion about confidentiality in therapy for minors. For instance, parents and teens may wonder what rights minors have when they seek mental health treatment. While parents will want to make sure that their teens’ privacy is respected, how can they also stay informed of mental health issues?
We know that it can be scary for teens to seek help, and also understand that worried parents want what’s best for their child – including playing an active role in treatment. A mental health professional can explain teen mental health rights concerning confidentiality and consent in ways that make sense. This guide also breaks down:
- What confidentiality in therapy for minors is
- What consent in teen mental health care is
- The legal rights of teens in therapy
- How to manage confidentiality as a parent or guardian
- How Mission Prep can help protect teen mental health rights
What Is Confidentiality in Therapy for Minors?
Confidentiality can be defined as the practice of keeping personal information shared between a therapist and client private – unless there is a legal or safety reason to share. Confidentiality rules for adolescent psychiatric care are almost the same as those for adults, with a few exceptions. These rules are determined by HIPAA, or the Health Insurance Portability and Accountability Act, which sets the standard for protecting sensitive patient information.
Like adults, teens have the right to keep their personal and medical information safe and their privacy respected. This is especially true for teens enrolled in therapy and those who reach the age of majority (often 18 years old) and no longer need to share information with parents.1 When it comes to teens below the age of majority (usually below 18 years old), a mental health professional can discuss parents’ and teens’ concerns about their right to privacy.
Guidelines on Doctor-Patient Confidentiality for Teens
The American Psychological Association has certain guidelines for psychologists when it comes to confidentiality.2 In short, they recommend that psychologists find a balance between respecting teens’ and parents’ wishes, since confidentiality is not always guaranteed for minors due to HIPAA privacy rules.3 Because of this, a therapist should always be upfront about confidentiality and what they can share during treatment.
If you’re starting mental health treatment, don’t be afraid to ask about mental health privacy for youth during initial therapy sessions. Your therapist will openly discuss topics such as:
- A teen’s level of comfort level with sharing certain information with their parents
- Treatment plan options that involve parents
- Situations where they might have to share information disclosed in sessions, such as if they think a teen is a harm to themselves or others4
- Abuse reporting laws
- State or other laws that might affect a teen and their right to confidentiality
It’s also important for parents and caregivers to understand confidentiality laws around their child’s treatment. For instance, they may have concerns or misunderstandings about the information that can be shared in their childs’ therapy sessions. However, by keeping updated on doctor-patient confidentiality for teens, parents can better understand the boundaries of confidentiality and how it affects their role in their child’s mental health treatment.
Common Myths About Teen Mental Health Confidentiality Rights
Mental health issues are common and can affect anyone regardless of age, gender, race, or social status. Seeking help shows courage and strength, and it’s the first step towards improving your mental well-being. However, many teenagers can be put off from seeking treatment due to misunderstandings about how their records or what they say will be shared. Hopefully, the following information puts any concerns about confidentiality to bed.
While privacy rules might mean parents can access a teen’s medical records, this doesn’t necessarily mean they can find out everything about treatment. For instance, if you’re wondering, Can parents see teen therapy records?, the answer is “not always”. For example, therapy notes and issues related to parental abuse are usually off-limits to parents (especially if a teen reports the abuse to a therapist). However, if a therapist suspects that abuse is ongoing, they may legally have to report their concerns.
Another misunderstanding teens might have about confidentiality is that parents can demand any of their records at any time. This isn’t the case. Many state laws, like those in California, require parents to sign a consent form before accessing their child’s mental health records if they’re over age 12.5
What Is Consent in Teen Mental Health Care?
Aside from confidentiality, understanding medical consent for teens is also important for parents and adolescents. Consent means that someone agrees to medical treatment, whether it’s minor consent for therapy, treatment through medications, or even hospitalization.
When Can Teens Consent to Mental Health Care?
For the most part, parents have the ultimate say in what treatment their teens receive, since they typically know what’s best for their children. Additionally, minors are usually not seen as being able to make informed decisions about their own care. However, state laws can vary widely regarding mental health treatment.
The right to consent to treatment is just one of the many legal rights of teens in therapy that are constantly changing. For instance, some states only allow parents to consent to mental health treatment, while others have no laws at all or allow children as young as 12 to consent.6 While the good news is that most states allow teens to consent to mental health treatment, it’s important for parents and teens alike to understand the laws in their state.
Legal Rights of Teens in Therapy
Like adults, teens deserve to have their mental health rights for minors respected by their parents and providers. There are many rights for teens in inpatient treatment, including access to their own money, letter-writing, and even the right to storage and to wear their own clothes.7,8
But what about the legal rights of teens in outpatient therapy? Do these teens also have rights? The answer is “yes.” Teens in both inpatient and outpatient treatment have rights when it comes to both confidentiality and consent to mental health treatment, although these might vary by state and circumstances.
Let’s explore the legal rights of teens in therapy further by explaining the HIPAA protections for adolescent therapy.
HIPAA and Adolescent Mental Health Care
HIPAA protections for adolescent therapy don’t include guaranteed privacy. Parents will have the right to view their children’s medical records unless:
- A teen is the one who consents to care, and the consent of the parent is not required under State or other applicable law. These laws vary greatly, so it’s a good idea to know what the consent laws are in your state.
- A minor is receiving care under a court order
- The parent agrees that the minor and the health care provider may have a confidential relationship
HIPAA laws, the discretion of therapists, state laws, and the specific situation of a teen in therapy all determine confidentiality. It can be confusing, but with the right teamwork and communication, confidentiality can be protected while still making sure teens stay safe and get the best mental health treatment available. A mental health professional can discuss confidentiality in therapy for minors further if you’re still unsure of the process.
Managing Confidentiality as a Parent or Guardian
HIPAA protections for adolescent therapy give parents access to a teen’s medical records in the majority of circumstances. But just because a parent can see a teen’s records doesn’t mean they should.
Confidentiality is an important part of treatment success. As a parent or guardian, it’s important to respect your teen’s privacy and personal boundaries while still being involved in their care. The following are some tips for managing confidentiality as a parent or guardian:
- Talk openly with your teen about therapy and what they feel comfortable sharing with you
- Ask your teen if there are any topics that are off-limits for discussion with you
- Discuss how much involvement you want to have in their treatment plan and decision-making process
- Respect the therapist-patient relationship by not asking the therapist to disclose private information without your teen’s consent
- Understand that therapy is a safe space for your teen to express themselves without fear of judgment or consequences
Know that your child’s therapist is trained in confidentiality rights and understands when and how to break confidentiality if they feel your child is in danger. A good mental health counselor will always balance putting parents at ease with keeping teens safe and respecting their autonomy.
Parent Access to Teen Medical Records
Medical records involving treatment plans, medications, and symptoms are usually available for parents to see according to HIPAA laws. However, there are certain confidential limits to what parents are allowed to see. For instance, therapy notes, which therapists often use to document information during sessions, usually aren’t available to parents.9
These therapy notes can contain information like:
- Specific things teens said during therapy
- Observations of a teen’s body language or mood during a session
- The teen’s personal goals and issues discussed
- Specific situations a teen may be facing at school
How Mission Prep Honors Teen Mental Health Rights
Mission Prep knows how tough it can be to navigate mental health issues as a teenager, and we also appreciate how stressful it can be as a parent. We’ve seen families encounter issues with proper communication time and time again, or see them exhausted from treatments that don’t work.
Our approach is to use effective forms of talk therapy, goal-setting, and recovery-oriented exercises to help our clients regain control and develop strategies to manage their mental health. At Mission Prep, we prioritize the rights of teens when it comes to their mental health – and can help teens and their families better understand these.
We believe that every teen has the right to receive proper treatment and support for their mental well-being. This is why we offer tailored treatment plans based on each person’s needs and goals, including:
- Intensive 24-hour inpatient treatment to help stabilize teens
- Outpatient treatment
- Aftercare services
- Telehealth services
Each of these services can include family involvement every step of the way, while also respecting teens’ rights to privacy and confidentiality. Our therapists are open, friendly, and will always inform clients about their rights and limits to confidentiality.
Teen Mental Health Treatment You Can Rely On
Mental health confidentiality, consent, and treatment laws are always changing for teens. At Mission Prep, we take pride in following state laws, the latest guidelines, and best practices for mental health treatment. This way, we can ensure the confidentiality of our teen clients and make them feel comfortable opening up in therapy.
If you’re a parent who wants your child to have access to effective mental health services and confidential, yet balanced, care, contact us today to schedule a consultation. Our inpatient mental health treatment centers in California and Virginia, and outpatient mental health services, could be just what your child needs to get on the road to recovery.
References
- Legal Information Institute. (n.d.). Age of majority. Cornell Law School. https://www.law.cornell.edu/wex/age_of_majority
- Behnke, S., & Warner, E. (2002, March). Confidentiality in the treatment of adolescents. Monitor on Psychology, 33(3). https://www.apa.org/monitor/mar02/confidentiality
- U.S. Department of Health and Human Services. (n.d.). Can I access a medical record if I have power of attorney? https://www.hhs.gov/hipaa/for-professionals/faq/227/can-i-access-medical-record-if-i-have-power-of-attorney/index.html
- Office for Civil Rights. (2022, December 28). 227 – Does the HIPAA Privacy Rule allow parents the right to see their children’s medical records? U.S. Department of Health and Human Services. https://www.hhs.gov/hipaa/for-professionals/faq/227/can-i-access-medical-record-if-i-have-power-of-attorney/index.html
- BulletPoints Project. (2021, May 24). Tarasoff statute. https://www.bulletpointsproject.org/tarasoff-statute/
- National Center for Youth Law. (2014). California minor consent and confidentiality laws. https://www.careinnovations.org/wp-content/uploads/2017/10/CA_Minor_Consent__Confidentiality_Laws.pdf
- Kerwin, M. E., Kirby, K. C., Speziali, D., Duggan, M., Mellitz, C., Versek, B., & McNamara, A. (2015). What can parents do? A review of state laws regarding decision making for adolescent drug abuse and mental health treatment. Journal of Child & Adolescent Substance Abuse, 24(3), 166–176. https://doi.org/10.1080/1067828x.2013.777380
- Turn Behavioral Health Services. (n.d.). Rights for minors in mental health facilities. https://turnbhs.org/wp-content/uploads/2022/08/MHSPRAS_105E-06.20_Rights-for-Minors-in-Mental-Health-Facilities_English.pdf
- Office for Civil Rights. (2021, September 22). 2094 – Does a parent have a right to receive a copy of psychotherapy notes about a child’s mental health treatment? U.S. Department of Health and Human Services. https://www.hhs.gov/hipaa/for-professionals/faq/2094/does-parent-have-right-receive-copy-psychotherapy-notes-about-childs-mental-health-treatment.html
- American Counseling Association. (n.d.). Confidentiality comes first: Navigating parent involvement with minor clients. https://www.counseling.org/publications/counseling-today-magazine/article-archive/article/legacy/confidentiality-comes-first–navigating-parent-involvement-with-minor-clients
