When a teen refuses mental health treatment after they turn 18, it can leave parents feeling frightened and even unsure of what role they are allowed to play. In most situations, an 18-year-old can make their own healthcare decisions, which include whether they continue therapy or psychiatric care.
This does not mean that parents become totally powerless, but it does mean that the goal becomes finding a balance between your child’s growing independence and maintaining attention to ongoing mental health needs.
To help you better understand why a teen might refuse mental health treatment and what you can do, this page explores:
Turning 18 creates an important legal transition. In most states, 18-year-olds are considered adults. This gives the 18-year-old more control over their health care decisions and medical information.
However, the National Institute of Mental Health has identified that poor continuity of care during the transition from adolescence into adulthood is a major barrier to effective youth mental health treatment.[1] It is associated with gaps in mental health care, and there are many reasons why young adults may disengage from treatment.
This change can feel abrupt for parents. One day, you may be speaking directly with your teen’s psychiatrist about medication. And then after their 18th birthday, this provider may need your young adult’s permission before discussing treatment details with you.
The exact rules around confidentiality can vary by state and circumstance, so it is important for families to confirm local laws when legal questions arise.
Below, we also answer some common concerns parents have about their child’s treatment after they turn 18 with a mental health condition.
You can typically contact your young adult’s therapist or other health care providers to share your concerns. But it’s good to be aware that they may not be able to give information back to you.
HIPAA, which stands for the Health Insurance Portability and Accountability Act, protects a client’s information from being shared without the patient’s consent. This means that if your adult child agrees, HIPAA allows providers to discuss relevant medical health information with family members involved in their care.[2]
Usually, in order for a provider to share information about a patient, a written and signed release of information must be in place.
However, if a capable young adult patient specifically states that they do not want information shared with family members, in most cases, providers must respect that preference.
However, exceptions do occur. The U.S. Department of Health and Human Services explains that disclosure may happen when a provider believes there is a serious and imminent threat to the health or safety of the patient or another person.[3]
This means that even if there is no release of information in place, during times of crisis, a provider may still reach out to you.
But in general circumstances, a release of information is required, and your young adult can decide what exactly is included in that release. This may mean that they agree you can receive information about medication while keeping details of therapy sessions private. Or that you can receive information about attendance but cannot receive insights about medical testing.
When a young adult refuses mental health treatment, it helps to understand what this actually means. If they refuse treatment, your young adult may:
When a young adult refuses or withdraws from mental health treatment, it can be helpful to get curious. You may consider asking:
A young adult may decide to stop one form of treatment. However, they may be willing to:
Mental health treatment is usually more sustainable when the young adult has meaningful ownership over their care. This may mean helping them identify a more meaningful form of care or scheduling routine that they can participate in independently and voluntarily.
Medication can create a larger concern because stopping abruptly may lead to withdrawal symptoms or other complications depending on the medication.
If your young adult wants to stop their medication, it may be helpful to encourage them to talk with their prescriber first. Sometimes the answer may be:
Mission Prep is here to help you or your loved one take the next steps towards an improved mental well-being.
When a young adult refuses mental health treatment, parents may have less control over decisions being made, but there are still impactful ways to offer support. Oftentimes, this means shifting the focus from managing treatment to:
Respecting a young adult’s right to make their own decisions about treatment does not mean that parents have to remove consequences related to those decisions.
For example, if your young adult lives at home and untreated symptoms are contributing to aggression, substance use, unsafe driving, or other dangerous behaviors, you are allowed to set boundaries about what happens in your home.
For example, you may determine that your young adult cannot have access to your car when they are unsafe to drive. Or you might decide that there is a consequence for threatening family members.
The purpose of boundaries is to clarify what you will and will not allow or participate in while your young adult makes their own decisions.
A parent might see that their young adult is struggling and that they refuse treatment, but they are not in immediate danger. This may shift the parent’s focus to keeping the relationship open enough so that the teen can ask for help when they are ready.
This approach can allow the parent to set boundaries and express concern without adding constant pressure to the young adult to hide symptoms or avoid their parents. This may sound like, “I know you don’t want therapy right now. I won’t argue with you about it, but if you change your mind, I will help you find someone.”
It’s important to also keep an eye on the mood and behavior patterns to ensure that symptoms do not worsen.
Distance can sometimes make parental concerns feel more intense. Before living away from home at college, it may be helpful to work with your teen to identify:
Watching your child struggle while being unable to control treatment can feel emotionally exhausting. Parents may experience fear, anger, grief, confusion, and hypervigilance.
You deserve support too.
Family therapy, parent support groups, or finding your own therapist may help you separate what is within your control from what is not and learn ways to manage stress.
Treatment refusal itself does not always indicate that a young adult is in immediate danger. But there can be situations where worsening symptoms could raise serious safety concerns and warrant a more urgent response.
Certain state laws establish circumstances in which someone can receive an emergency psychiatric evaluation or involuntary treatment when serious safety or functional concerns arise. The exact criteria and procedures vary by state, but common considerations include someone:
If you are concerned about immediate safety, contact local emergency services or the nearest emergency department for support and guidance. You can also call or text 988 for crisis support.
Further, it is important to seek emergency support if your young adult:
Mission Prep provides treatment for teens experiencing various mental health conditions. Mental Health support is a phone call away – call 866-901-4047 to learn about your treatment options.
See our residences in Southern California’s Los Angeles & San Diego areas.
Take a look at our Minneapolis-St. Paul area homes in Hennepin County.
View our facilities in Loudoun County, VA within the DC metro area.
When your teen refuses mental health treatment, turning 18 can make the situation feel frightening. But you can continue listening, sharing concerns, maintaining boundaries, and exploring treatment options. You can also help your young adult move toward greater independence without expecting them to suddenly master an unfamiliar healthcare system.
At Mission Prep Teen Treatment, we offer a variety of treatment programs and therapy services to help manage concerns with anxiety, trauma, depression, or other mental health concerns. Treatment can help teens understand their symptoms, improve coping strategies, build communication skills, and prepare for the transition into adult mental health care. Parents can also receive support in learning when to step in and when to step back.
Whether your teen could benefit from residential treatment at one of our locations in California or Virginia, or something more flexible like an outpatient mental health program or virtual telehealth to treat their mental health concerns, our team can help.
Mission Prep Teen Treatment accepts insurance and is in-network with most major providers. We are happy to help you check your insurance coverage for mental health care.
Contact us online or call 866-901-4047 to speak with a caring member of our team who can answer any questions you might have. Reach out for a free, no-obligation conversation.
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