Teen Mental Health and Privacy [FAQ]

What to know about kids’ rights to consent, confidentiality, anonymity and privacy

We at UpStreet often hear questions about whether sessions are confidential and anonymous. Unfortunately, the answer is not always straightforward and depends on several factors, including the age of the teen seeking help and the state in which they live. For example, chatting with a teen mental health professional through this website can be anonymous; and most states allow for teens to consent to their own treatment. However, if information is shared during therapy that indicates a teen is unsafe, therapists will assess and may be required to disclose the information to appropriate authorities.

First things first. All teens are different, but we generally think it’s a very good thing to give teens autonomy to manage their own health. Parental guidance is always important, but like most other life skills (think money management, organization, peer relations), kids need practice to develop health management skills on their own. 

A parent’s otherwise healthy worry can often evolve into unhealthy control or judgment, which can interfere with a teen’s choice to seek help. Instead, we encourage parents to take pride in seeing their kids recognize health issues and take steps to pursue their best self.

Further complicating things, in What Can Parents Do? A Review of State Laws Regarding Decision Making for Adolescent Drug Abuse and Mental Health Treatment, researchers found most states do not have clear policies in place for when a parent and child do not agree on the need for treatment.

Here, we use the state of Pennsylvania’s laws as an example for frequently asked questions around teen mental health privacy. We strongly encourage parents and patients to know their rights and local policies. If you are unsure where to start, we recommend asking your healthcare provider, or search the most up-to-date information available at the state-level Department of Health or the local affiliate of American Civil Liberties Union (ACLU). 

FAQs – Pennsylvania and Teen Mental Health Rights

1.)   Who can consent to mental health treatment?

A minor age 14 or older may consent, without parental consent, to both inpatient and outpatient mental health treatment.

A parent or legal guardian may consent, without the consent of the minor age 17 or younger, to mental health treatment. However, inpatient treatment requires recommendation of a physician who has examined the minor.  

Neither the parent nor the minor may override the other’s consent.

2.)   Can minors receive mental health treatment without notifying a parent/guardian?

Generally, the right to consent entitles the patient to confidentiality. In Pennsylvania there is an exception: parents/guardians receive notice when minors between the ages of 14 and 17 admit themselves for inpatient mental health treatment.

3.)   Can a minor object to mental health treatment?

In Pennsylvania, there is no law that allows a minor to object to their parents’ consent for outpatient treatment.

A minor can object to inpatient treatment by requesting for modification of or withdrawal from inpatient mental health treatment. The law requires a hearing to review the request within 72 hours.

4.)   Who can access teen mental health records?

If the minor’s parent or guardian consents to inpatient mental health treatment, the parent or guardian can access mental health records and can authorize the release of past records to the minor’s current mental health provider and, in some cases, to the minor’s primary care provider.

If a parent/guardian had not initially consented to the mental health treatment, records are deemed confidential.

Of note, researchers have found there may be gaps in protected information with the adoption of online portals and apps that grant parents/guardians access to adolescent records. 

About

UpStreet is a mental wellness program that offers free drop-in consultations with therapists, scheduled therapy appointments, text-based peer support, and support groups for teens ages 12-22. UpStreet aims to reduce the stigma of seeking mental health support, to avoid escalation of symptoms to a crisis stage, and enhance teens’ quality of life. Reach out to an UpStreet team member now using the chat bot located at the bottom of the page.