2021. Michael wished to continue therapy in high school, but did not want his mother involved and did not want his therapist and mother speaking unless he were included in the conversation. However, there are numerous laws that apply to child and adolescent mental health and privacy, creating a complex legal landscape in which federal, state, and local laws overlap. Confidentiality/Minor Consent Laws For Educational Purposes Only PARENT/GUARDIAN CONSENT EXCEPTIONS A parent or guardian must provide consent on behalf of a minor (under age 18) before health care services are . Minors generally cannot consent to treatment; a parent or guardian consents on the minor's behalf. Official websites use .gov The mental health guidance addresses three core areas: Guidance on Responding to an Opioid Overdose. The term "competence" signifies a legal conclusion that an individual is capable of entering into a binding contract, transferring assets, or participating in a legal proceeding. Goeben noted that there is a need for more psychiatric beds in hospitals, particularly in Southern Illinois. (c) Disclosure under this subsection is mandatory for the purposes of the federal health insurance portability and accountability act; (16) This section may not be construed to prohibit the compilation and publication of statistical data for use by government or researchers under standards, including standards to assure maintenance of confidentiality, set forth by the director of the health care authority or the secretary of the department of social and health services, where applicable. Nevertheless, some are on the edge and require judgment calls. A: It is most helpful to consider this question from three perspectives: that of law, of clinical practice and of ethics. The psychologist will thus need to revisit earlier discussions and explain that, for clinical reasons, the structure of the therapy should change. How the law protects confidential services for young people depends on their age (whether a patient is a minor - under 18 years or an adult - 18 years or older), and whether the patient can legally consent to their own care. Resources for help are not limited to EBR's campuses. Confidentiality and Consent in Child and Adolescent Mental Health Care Parents, friends, and other caregivers of individuals with a mental health condition or substance use disorder play an important role in supporting the patients treatment, care coordination, and recovery. 0 endobj Elizabeth Warner practices in Brookline, Mass., and is a member of the Massachusetts Psychological Association Ethics Committee. Organization of Department of Mental Hygiene. ( 36.01-36.03). (c) Disclose or disclosure. Practice Preparation, Identification, Assessment, and Initial Management. Privacy concerns are complex legal issues that rarely have a simple answer. October 2021. For licensed mental health professionals, confidentiality is protected by state laws and the Health Insurance Portability and Accountability Act (HIPAA). The disclosure must be made by the professional person in charge of the public or private agency or his or her designee and must include the dates of admission, discharge, authorized or unauthorized absence from the agency's facility, and only any other information that is pertinent to the threat or harassment. In some cases, a parent may not have the right to information about their childs treatment. The law is a blunt instrument, as the issue of minors and confidentiality well illustrates. Some adolescents are minorsunder age 18and some are young adultsage 18 or older. Another option is to chat with someone via 988lifeline.org or contact . Under Illinois law, minors age 12 through 17 have the right toaccess and authorize release of theirown mental health and developmental disabilitiesrecords and information, and their parents havesuch rights only if the minor does not object orthe therapist does not feel there are compellingreasons to deny parental access. A minor who is 14 years or older may access outpatient mental health, drug, or alcohol diagnosis or treatment (except for methadone) without parental/guardian consent, if those services are administered by a licensed provider listed in ORS 109.675. Third, few things carry such potential to disrupt a treatment as an adolescent's feeling that information was shared without his or her knowledge. Also variable within each of the states is how the state defines who is subject to disclosure laws, the additional existing security obligations that exist in addition to HIPAA, and what constitutes a breach or unlawful disclosure. Clinical Takeaway: Do not disclose information related to past, present, or future mental health status, provision of healthcare, and payment for care without authorization from the patient, unless the patient is incapacitated. Regardless of whether an adolescent assents to have information disclosed to a parent, it makes both clinical and ethical sense to tell the adolescent--beforehand, if possible--what information will be shared, and when. #{}}jc1X6fm;'_9 r:8q:O:8uJqnv=MmR 4 These services may include: Help from a psychiatrist or psychologist This applies whether the patient is an adult or a minor child. * Up to eight, 90-minute mental health counseling sessions for ages 12-16. Some states extend additional privacy protections to minors that go beyond HIPAA. 0460-01-.16 How information related to mental health is treated under HIPAA; When information related to mental health may be shared with family and friends of an individual with mental illness, including parents of minors; and. vPU x3 This confirms that Dora is legally able to receive mental health services without her parents' consent. Some important topics to discuss include: When a therapist believes a child is in danger, they typically have a legal duty to disclose certain information, even when the child otherwise has a right to confidentiality. The law. %PDF-1.6 % (7) To law enforcement officers or public health officers as necessary to carry out the responsibilities of their office. the statutes. A parent generally has the right to request a childs medical record. Rules & Regs. PDF Statement for the Record by Kids in Need of Defense (KIND) "The Biden For example, some parents may abuse or disown a child for their sexual orientation or behavior. OCR has organized certain FAQ's related to handling mental health information under HIPAA in two easy-to-access PDFs. When a minor has their own attorney, this lawyer holds the privilege for the child's therapy, and they often work with me to help keep emotional safety a priority for the child's counseling. Available at: aap.org/en/advocacy/child-and-adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-national-emergency-in-child-and-adolescent-mental-health/ Accessed October 18, 2022. Explore the minor patients reasons for not involving his or her parents (or guardian) and try to correct misconceptions that may be motivating the patients reluctance to involve parents. All states require parental consent for most medical care provided to minors, with several exceptions. (2017, September 12). Pediatrics. Therapists, parents, and others who have specific concerns about confidentiality may wish to talk to an attorney knowledgeable about the laws in their state. The therapist should be clear about the law and their own confidentiality policies. The American Academy of Pediatrics has included substantial related guidance in its Guidelines for Adolescent Depression in Primary Care. Understanding the barriers to care that exist due to fear and stigmatization, the guidelines make it clear that despite the importance of including family in treatment when possible adolescents value their sense of privacy and individuality and should be interviewed alone about depressive symptoms, suicidality, and psychological risk factors. Confidentiality protections allow adolescents and young adults to seek the health care they need and protect their privacy for these services. Even when a parent is pressuring me for information, I am able to refer them to the minor's counsel, who will work to protect the childs confidentiality, says Lois Nightingale, PhD, a marriage and family therapist from Yorba Linda, California. Certainly, however, adolescents should be told that serious threats of harm to self or others will not be kept confidential. A .gov website belongs to an official government organization in the United States. Federal policies that pertain to childhood and adolescent mental health include: Health Insurance Portability and Accountability Act (HIPAA) HIPAA sets national standards for health information privacy and security and delineates who may use or disclose protected health information (PHI) without authorization from the individual patient. Consent | California School-Based Health Alliance $dM@2@B*fd| RH%? GY A review of federal and state regulations for psychiatrists and behavioral health professionals trying to serve young patients while remaining compliant with the law. . PDF 22. Medical Records Act--Duty to Hold Confidential and Duty to Disclose Because a child cannot legally consent to treatment, the parent often acts as a personal representative for the child. PDF Illinois Confidentiality/Minor Consent Laws - Adolescent Health Initiative PDF Minors' Rights to Confidentiality, When Parents Want to Know: An We summarized state laws and regulations on minor consent for the following: health services, substance abuse treatment, prenatal care, mental health care, contraceptive management, immunizations, sexually transmitted infection management, human immunodeficiency viruses testing and treatment, dental care, and sexual assault evaluation. These laws tend to fall into two categories - confidentiality laws, which impose an affirmative duty on the provider to maintain the confidentiality of protected information, and privilege laws, which establish an evidentiary privilege for such information that may be exercised by the patient. Available at: www.seyfarth.com/a/web/77459/50-State-Survey-of-Health-Care-Information-Privacy-Laws.pdf Accessed October 20, 2022. state confidentiality laws or 42 CFR Part 2, would need to consider whether there is a similar disclosure . One aspect of independence is privacy. This prohibition applies to surveys and to instructional materials used as a part of the curriculum, though exact requirements differ based on whether or not the school is funded by the US Department of Education. This year to mark Mental Health Awareness Week, we've focused on the official theme of anxiety. Minnesota has state laws that allow youngsters to consent to certain sort of services without parent or guardian request (Minnesota Articles Sections 144.341 - 144.344).That bills help young people seek confidential health care for sensitive issues such as pregnancy or pregnancy prevention, sexually transit infections, additionally substance use or abuse. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> The specific ways the law protects confidentiality depend on whether a patient is a minor or an adult and whether the patient can legally consent to their own care. Does a parent have a right to receive a copy of psychotherapy notes about a child's mental health treatment? The child's greater sense of self and enhanced capacity for autonomy may require greater respect for the child's need for privacy. A minors decision-making capacity depends on many factors, including not only chronological age, but also emotional maturity and the individuals medical experience. FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. services and compulsive gambling services. Title E. General Provisions. Connecticut Law About Rights of Minors Pediatricians, child and adolescent psychiatrists and childrens hospitals declare national emergency in childrens mental health. The issue seems especially pointed when adolescents talk about activities that, while not necessarily dangerous, are illegal, such as shoplifting, the recreational use of alcohol or experimenting with drugs. hb```y ea $BBhv|-9:WN tlwE\g{Z5So{:{jK~9!:2@6a L@IDX n>b H(?912v0 y1=ArpPe`JvSff`g:oA1& *[ Stephen Behnke is director of the APA Ethics Office. ( 32.01-32.39). PDF Indiana Confidentiality/Minor Consent Laws - Adolescent Health Initiative Given the sensitive nature of mental health and substance use disorder treatment information, OCR is providing this guidance addressing HIPAA protections, the obligations of covered health care providers, and the circumstances in which covered providers can share informationas applied to this context.
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