The Role of Guardianship
in Adolescent Mental Health Care
The importance of the guardian role in teen psychiatric hospitalization can’t be overstated. There are many different ways guardians can help guide their teens through mental health problems and encourage them during recovery. For instance, they can assist them in making shared decisions on medication, the length of their treatment, the accommodations they need, and the type of support they want.
But who can consent to mental health treatment for minors? How can guardians best advocate for their teen’s needs in a mental health facility? A mental health professional can talk to you about parental rights in mental health decisions so that you feel informed in making the best choices for your child’s well-being. This guide also breaks down the role of guardianship in adolescent mental health care by covering:
- What guardianship in mental health care is
- Who can consent to mental health treatment for minors
- The role of court-appointed guardians and mental health power of attorney
- The legal responsibilities of a guardian in mental health treatment
- How to support a child in mental health care
- How Mission Prep can help you find out more about guardianship and mental health care
What Is Guardianship in Mental Health?
Guardianship and teen mental health often go hand in hand because of legal situations. Let’s start by understanding the difference between a guardian and a parent.
Guardianship is a legal term that means someone has been appointed by a court to care for a minor, often because a parent isn’t available.1 Some parents might even want to explore court-appointed guardians for teens if they know they won’t be able to care for their children. For instance, they may not be able to support them due to medical issues, military duties, or mental health conditions.
Guardianship laws for teen mental health care vary widely from state to state. However, one thing is certain – guardians have a right (and a duty) to make the best decisions for a child’s care, including those around mental health and medical treatment.2
Who Can Consent to Mental Health Treatment for Minors?
Guardian and parental rights in mental health decisions start to lessen as a child gets older. While laws vary in different states, ultimately, a minor has the right to consent to their mental health treatment if they are mature enough to understand the treatment they’re getting. In California, for instance, under the Health and Safety Code, minors can consent to their own outpatient mental health care. However, they can only do so if they are over 12 years old and mature enough to participate knowledgeably in treatment.3
Minors, just like adults, deserve to have their rights and wishes for treatment respected. This being said, there are certain circumstances where minors might not be able to make informed decisions about their mental health care. This is when a mental health power of attorney for adolescents, also known as a psychiatric advance directive (PAD) or emergency hold, can help protect your teen’s safety.4
In these emergency situations, a guardian with a PAD or another treatment provider can decide if a minor needs life-saving inpatient treatment to protect them.
Court-Appointed Guardians and Mental Health Power of Attorney
Custody and mental health treatment decisions aren’t necessarily one and the same. For instance, a guardian might decide that a child can be in the custody of their parents for a short time during the day. However, the guardian may still have the right to decide what medical or mental health treatment the child needs.
There are many legal grey areas when it comes to mental health guardianship vs. parental rights. For this reason, it’s important to know the differences between a guardianship and a mental health power of attorney, temporary and permanent guardianship for psychiatric care, and state laws.
Let’s start with understanding how guardianship is appointed.
Steps to Appointing Legal Guardianship for Minors in Treatment
1. Filing paperwork
This usually requires a petition to be submitted to a court, along with supporting documents such as medical records and proof of guardianship eligibility. In some states, only foster parents and first relatives can be guardians.
2. Conducting a background check
A court may require a background check on the potential guardian to make sure they don’t have any disqualifying criminal convictions.
3. Notifying interested parties
Interested parties such as parents, siblings, and even the child themselves, if they’re 12 years or older (in some states), must be notified of the guardianship petition. This way, they will have the opportunity to respond in court.
4. Setting a court hearing
A judge will review the case and make a decision based on what is in the best interest of the teen.
5. Arranging ongoing responsibilities
If granted guardianship, the guardian will have ongoing legal responsibilities for caring for the teen’s physical and emotional well-being. These responsibilities typically continue until the teen reaches adulthood or the guardian is relieved of their duties by the court.
This guardianship process can be incredibly lengthy, especially if you’re concerned about a teen’s well-being or have parents battling you every step of the way. However, if you’re concerned about a child’s mental health, you can submit for a temporary guardianship.
When teens need a guardian for treatment but don’t have a parent, a temporary guardianship gives you rights to make shared decisions with the teen until your next court date.6 As mentioned, someone with a mental health power of attorney can also make mental health decisions for a teen in distress. Both guardianship and mental health power of attorney can be incredibly helpful in case of a mental health crisis.
Legal Responsibilities of a Guardian in Mental Health Treatment
There are often misconceptions surrounding guardianship and involuntary commitment. It’s important to clarify that obtaining a guardianship does not automatically grant you the power to involuntarily commit a teen for mental health treatment.
While a temporary or permanent guardianship can give you legal decision-making authority for medical treatment, you still may not be able to force a teen into treatment against their will. However, if you have a PAD, signed by the teen before they became ill, you might have more rights as legal guardians in psychiatric care.
Let’s discuss the rights of guardians in psychiatric hospitalization in more detail.
Guardianship and Psychiatric Hospitalization
In most cases, involuntary mental health treatment requires a separate process and evaluation by mental health professionals. In California, the involuntary hold for mental health is known as a 5150, and can be issued by:7
- A peace officer
- A professional in charge of a county-designated mobile crisis team or evaluation and treatment facility. This facility has to be approved by the county Department of Healthcare Services.
- Other professionals (this varies by California county)
This list of people is short for a reason; it makes it easier for teens to stay protected against cruel and unnecessary treatment. Keep in mind that not even regular physicians have the power to grant a hold, much less a legal guardian. It takes a highly qualified professional to determine if a teen is a danger to themselves or others, or if they’re impaired enough to need involuntary treatment.
However, just because you can’t involuntarily commit a teen to mental health treatment doesn’t mean you don’t have a role to play. For instance, guardians can give medical consent for adolescent therapy after emergency treatment. Once a teen is stable and ready to receive treatment, you can decide to consent to therapy on their behalf.
Additionally, as a parent or guardian, you have a responsibility to create a supportive and safe environment for a teen. This requires shared decision-making, involving the teen in choices about their mental health treatment. For instance, you might want them to explore cognitive behavioral therapy (CBT), EMDR therapy, TMS therapy, art therapy, or other treatment options like those provided by Mission Prep. The legal responsibilities of a guardian in mental health treatment include being informed, giving consent, and taking an active role in the teen’s mental health treatment.
Supporting a Child in Mental Health Care
How to Support a Child With Mental Health Issues in School
Are you concerned that a teen is dealing with bullying, depression, anxiety, or other issues related to school? Some of the best legal support for guardians of mentally ill teens is school-based programs that you can use to support a child. These include:
- On-campus counseling services
- Recreational activities
- Mental health support groups
- Teacher-student mentor programs
Keeping an open mind about these programs is a great way to foster a sense of connection with you, your child, and their school. But if your teen is uninterested in participating in these programs, don’t force them. Instead, try using other supportive methods. These include:
- Giving your teen mental health days
- Encouraging healthy lifestyle habits
- Keeping an open line of communication
- Respecting their boundaries while also playing an active parenting role
- Validating concerns about school
If you’re a new guardian, it might be daunting to know which approach to take – but you’re not alone in this. Many parents and guardians face the same dilemma. Remember that every child is unique, so what works for one may not work for another. The key is to be patient, understanding, and empathetic towards a teen.
Ways to Support a Child in Mental Health Treatment
Once a teen finally opens up to the idea of mental health treatment, there are many ways you can choose to support them. These include:
- Being flexible and offering options like outpatient therapy for teens. Outpatient therapy allows a child to receive treatment while still attending school and participating in their daily activities.
- Encouraging them to attend therapy sessions regularly and offering to accompany them if needed.
- Showing interest and asking questions about their progress in therapy, but also respecting their boundaries if they do not feel comfortable sharing.
- Educating yourself about mental health conditions and possible treatments so you can have a better understanding of what your teen is going through.
Mental health recovery can be a slow and wavering journey. No matter how tough it may be, remember to be patient and know that there are many ways, big or small, to support a teen. Something as small as sharing a meal, a hug, or a conversation might be what your teen needs to feel supported and validated.
Find Out More About Guardianship and Mental Health Care
Learning the ins and outs of legal guardianship for minors in treatment can be tough, especially since they vary by state. But this doesn’t mean it’s impossible. At Mission Prep, we provide options of legal support for guardians of mentally ill teens, including walking you through the consent process.
We’ll inform you and your teen of your rights every step of the way, as well as talk you through mental health treatment options and what to expect on the journey to recovery. Our team provides high-quality inpatient, outpatient, and telehealth mental treatment for teens in California and Virginia.
Don’t hesitate to contact us to arrange a tour of our facilities, explore treatment options like TMS and family therapy, and more. We’re excited to join you on this journey and help your teen achieve mental wellness.
References
- Administration for Children and Families. (2024, October 10). What does it mean to be a legal guardian? Where can I find information? https://acf.gov/cb/faq/custody3
- California Alliance of Child and Family Services. (n.d.). FAQ – Minor consent for mental health care — Implementing Assembly Bill 665. Retrieved April 24, 2025, from https://www.cacfs.org/news/faq-minor-consent-mental-health-care-implementing-assembly-bill-665
- California Courts. (n.d.). How to become a guardian | Self Help Guide. Retrieved April 24, 2025, from https://selfhelp.courts.ca.gov/guardianship/process
- California Courts. (n.d.). Serve a petition to become a temporary guardian | Self Help Guide. Retrieved April 24, 2025, from https://selfhelp.courts.ca.gov/guardianship/serve-temporary-request
- California Courts. (n.d.). What you must do as a guardian | Self Help Guide. Retrieved April 24, 2025, from https://selfhelp.courts.ca.gov/guardianship/duties#:~:text=Generally%2C%20you%20can%20make%20decisions,child%20(teen)%20car%20insurance.
- Cooperative of American Physicians. (n.d.). To have and to hold: Clearing up misconceptions about 5150 holds in healthcare. Retrieved April 24, 2025, from https://www.capphysicians.com/articles/have-and-hold-clearing-misconceptions-about-5150-holds-healthcare
- Jennifer. (2023, February 16). The unique role of the guardian in inpatient psychiatric care. New York State Bar Association. https://nysba.org/the-unique-role-of-the-guardian-in-inpatient-psychiatric-care/?srsltid=AfmBOop9LNAkAOjmZMz_47bsiuew1U2FfST_VitikwbPrqxm-VBjeoR5
- NAMI Santa Clara County. (2025, January 14). Psychiatric advance directive. https://namisantaclara.org/resources-2/psychiatric-advanced-directive/
