The exceptions are few, however, and prove the rule that the law deems individuals under a certain age (often 18) not sufficiently mature to make treatment decisions. Summary of Laws Related to Child and Adolescent Mental Health. However, only the fact and date of admission, and the date of discharge, the name and address of the treatment provider, if any, and the last known address must be disclosed upon request; (8) To law enforcement officers, public health officers, relatives, and other governmental law enforcement agencies, if a minor has escaped from custody, disappeared from an evaluation and treatment facility, violated conditions of a less restrictive treatment order, or failed to return from an authorized leave, and then only such information as may be necessary to provide for public safety or to assist in the apprehension of the minor. Confidentiality of Substance Use Disorder Records - A federal regulation (42 CFR Part 2) protects the confidentiality of people receiving diagnosis, treatment, or referral for treatment for a substance use disorder at federally assisted SUD programs. Stephen Behnke is director of the APA Ethics Office. . State laws vary dramatically, so it is imperative for behavioral and mental health professionals to be fully aware and up to date on their own states requirements. First, early in the relationship the psychologist should make clear what relationship she will have to each of the parties. It may be, for example, that an adolescent has conflicting wishes about keeping information private. Not all parents have unconditional love for their child. (a) Physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment with resulting physical harm or pain or mental suffering; or (b) The deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering.2 Ethics. Retrieved from In some jurisdictions, the law permits minors who are not emancipated to request and receive confidential services relating to contraception, or to pregnancy testing, prenatal care, and delivery services. 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. 33 Rights of patients ( 33.01-33.27). 4-302. Minnesota Statute 253B.04 subd.1 allows youth who are 16 years of age or older to consent for inpatient mental health services. 19-89a). The law. In general, the right to privacy in treatment is connected to the right to consent to treatment. Does the APA Ethics Code provide guidance? Provision of outpatient mental health treatment to minors without parental consent. The therapist gently explored with Michael the reasons behind this refusal. Therapists should ensure they understand state laws and their licensing boards ethics rules. 2 0 obj 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. Michael's therapist shared her concerns with Michael about these activities and about what she perceived to be his excessive fear that his mother "couldn't know anything about" these activities. Knowledge about ones responsibilities can make decisions easier during a crisis. When the child is emancipated. When a young person accesses services under minor consent laws, those services are to be maintained . Adolescent minors who consent for their own care are entitled to many confidentiality Most states subsequently added laws that allowed minors to consent to one or more of the following: alcohol and substance abuse treatment, mental health care, and contraception. *A minor who is at least 16 years of age can consent to services related to pregnancy, delivery, and postpartum care only after the provider has made a reasonable effort to contact the minor's parents or guardian. (18) Pursuant to a lawful order of a court. For example, the biological parent of an adopted child would not typically have a right to treatment information. Mental health professionals who meet our membership requirements can take advantage of benefits such as: Copyright 2007 - 2023 GoodTherapy, LLC. a\ {qq|&p_2oDLrx.=)zq]g0E3X'b*sDbJGydj0yrV&3f0[r>jN\R\G2}'PXaO@DMjTB cE5}EQxjQ4t?^(rz*{arnZXp_.. o`pl+ZA5PY]oV,CO TJxU.dT$gp4* XoY4e!p)*8 58gOhh4DfAxm~i 45f o-C@&>M+'O_. A. "Minor consent laws" allow minors to consent for their own care in specific situations and for specific services. (10) To appropriate law enforcement agencies, upon request, all necessary and relevant information in the event of a crisis or emergent situation that poses a significant and imminent risk to the public. (Formerly Sec. <> 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. Because I work with many high-conflict divorce families, many of the children and teens I see in therapy have their own minor's counsel. Michael's mother wanted help in deciding whether Michael should go for each scheduled visit. Therapeutic confidentiality is key to effective treatment for numerous reasons, including building and preserving a strong therapeutic alliance. The circumstances under which a therapist would disclose information the child shared in therapy. ( 32.01-32.39). Finally, a psychologist may feel strongly that revealing information to a parent could harm the patient or be destructive to the treatment. <> Similarly, jurisdictions may permit unemancipated minors to request and receive confidential care to prevent, diagnose, or treat sexually transmitted disease, substance use disorders, or mental illness. OCR has organized certain FAQ's related to handling mental health information under HIPAA in two easy-to-access PDFs. Certain exceptions exist, such as in cases of certain medical emergencies to save the life of the patient or to avoid serious bodily injury, if an immediate threat to health or safety is involved, or in cases where child abuse or neglect is suspected, and records that are entirely de-identified and used for research purposes. Minors generally cannot consent to treatment; a parent or guardian consents on the minor's behalf. Minnesota Statute 253B.04 subd.1 allows youth who are 16 years of age or older to consent for inpatient mental health services. 31 Regulation and quality control of services for the mentally. Nevertheless, some are on the edge and require judgment calls. Secure .gov websites use HTTPS Home Terms of Service Privacy Policy Sitemap Subscribe to The GoodTherapy Blog. Sign up and Get Listed. Reinert M, Fritze D, Nguyen T. The State of Mental Health in America 2022. The regulation prohibits disclosure of information that identifies an individual as a patient with an SUD without the patients written consent. Family Educational Rights and Privacy Act (FERPA). Help-seeking behaviour and adolescent self-harm: a systematic review. If a minor is able to consent to their own healthcare under state law, the minor may typically authorize disclosure of their PHI. Washington, D.C. 20201 The agency or its employees are not civilly liable for the decision to disclose or not, so long as the decision was reached in good faith and without gross negligence; (12) To a minor's next of kin, attorney, guardian, or conservator, if any, the information that the minor is presently in the facility or that the minor is seriously physically ill and a statement evaluating the mental and physical condition of the minor as well as a statement of the probable duration of the minor's confinement; (13) Upon the death of a minor, to the minor's next of kin; (14) To a facility in which the minor resides or will reside; (15) To law enforcement officers and to prosecuting attorneys as are necessary to enforce RCW, (a) Only the fact, place, and date of involuntary commitment, an official copy of any order or orders of commitment, and an official copy of any written or oral notice of ineligibility to possess a firearm that was provided to the person pursuant to RCW, (b) The law enforcement and prosecuting attorneys may only release the information obtained to the person's attorney as required by court rule and to a jury or judge, if a jury is waived, that presides over any trial at which the person is charged with violating RCW. HIPAA recognizes that some patients (including those with a mental illness or substance use disorder) may be unable to make their own health care decisions, including decisions related to health information privacy. The law applies from the time a child is referred for special education and related services, but not before. %PDF-1.6 % In some cases, a parent may not have the right to information about their childs treatment. Standard 4.01, "Structuring the Relationship," states that "Psychologists discuss with clients or patients as early as is feasible in the therapeutic relationshipthe natureof therapy, fees, and confidentiality." For more articles and continuing education courses on ethical therapy, join GoodTherapy today! Mental health and the law interact in numerous ways. At the outset of psychotherapy, Michael's mother and his therapist had frequent telephone and in-person consultations. Available at: Accessed October 18, 2022. Adults with a Mental Illness; Minors . The wide net cast by federal privacy, confidentiality, and consent laws, in addition to the vastly differing state landscapes, results in strong protection for children and adolescents in need of mental healthcare. 2001). The ability to be vulnerable in therapy can support a strong therapeutic alliance and can help a person recover more quickly. When Do Minors in Therapy Have a Right to Confidentiality? 50-State Survey of Health Care Information Privacy Laws. $dM@2@B*fd| RH%? GY Professionals take psychotherapy notes to analyze the contents of a conversation. Over time, Michael and his therapist agreed that Michael himself would begin to speak to his mother about these issues, and that the therapist could follow up with a phone call. Clinical Takeaway: If you work with minors in an educational setting, do not disclose a students personally identifiable information without the written consent of their parents. So, the first step for each practitioner in determining their responsibilities related to confidentiality is to ascertain which laws apply in their geographic region, area of practice, and the specific reason for which the data is being shared. For example, mandated reporters must disclose suspected child abuse to child protectiveservices. (2) In the course of guardianship or dependency proceedings; (3) To the minor, the minor's parent, including those acting as a parent as defined in RCW, (4) To the courts as necessary to administer chapter. The records that qualify as PHI vary by state. Liability for costs. Clinical Takeaway: If you work in a public educational setting, do be prepared to provide parents with a written explanation of their procedural safeguards under IDEA. (c) Disclose or disclosure. Additionally, though minors do not have a legal right to privacy from their parents, their right to privacy from third parties (employers, advertisers, etc.) A parent who consents on the minor's behalf generally has the right to know the content of the child's treatment. The mental health guidance addresses three core areas: Guidance on Responding to an Opioid Overdose. 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. These services may include: Help from a psychiatrist or psychologist Third, few things carry such potential to disrupt a treatment as an adolescent's feeling that information was shared without his or her knowledge. Physicians who treat minors have an ethical duty to promote the developing autonomy of minor patients by involving children in making decisions about their health care to a degree commensurate with the childs abilities. "s`[LkH o\&`|8LO This state of affairs changes when the minor reaches the age of majority. This page is intended to be a one-stop resource for guidance and other materials on how HIPAA applies to mental health and substance use disorder information. By law, the attorney-client relationship is a confidential one. Adolescent minors who consent for their own care are entitled to many confidentiality Accessed October 19, 2022. Written consent is required to disclose PHI under IDEA unless records in certain cases to the officials of participating agencies, in cases were FERPA allows disclosure, permissible disclosure to a child welfare agency, or if the information is de-identified. Seyfarth. connection with mental health services. Myth: There is no hope for people with mental health issues. As we see in the top section, Ohio law allows certain minors to consent to services based on their status. 100 0 obj <> endobj disabled ( 31.01-31.37). See G.L. Is 13 Reasons Why Part of the Problem or Part of the Solution? Such boundary renegotiation, while complex with certain adolescents and families, is clinically and ethically indicated. Q: Therapists, parents, and others who have specific concerns about confidentiality may wish to talk to an attorney knowledgeable about the laws in their state. I. Nondisclosure Laws - (Prohibiting Disclosure Without Patient Consent) Statutory Law: Mental Health Records are Confidential - 33-3-103 Substance Abuse Records are Confidential & Privileged - 33-10-408 Regulatory Law: Patient's Right to Confidentiality - TN. 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. endstream endobj startxref However, it also creates a challenging area for clinicians to navigate as they work to do best by their patients and remain compliant with their legal obligations. Right of a non-custodial parent to mental health records of minor child. On several occasions he and a friend shoplifted snacks from a local 24-hour convenience store. #{}}jc1X6fm;'_9 r:8q:O:8uJqnv=MmR 4 Thus, the changing clinical picture will have ethical implications. Published 2020 Jun 11. doi:10.1186/s12888-020-02659-0, Rowe SL, French RS, Henderson C, et al. Confidential information can be used for a wide range of purposesbullying, marketing, even stealing a persons identity. The issue of confidentiality became more complicated during Michael's junior year, when the therapist felt that certain information should be shared and Michael refused. Myth: Mental health issues are a result of personality weakness or character flaws, and people can "snap out of it" if they try hard enough. A: It is most helpful to consider this question from three perspectives: that of law, of clinical practice and of ethics.
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