The law is a blunt instrument, as the issue of minors and confidentiality well illustrates. Stephen Behnke is director of the APA Ethics Office. This article explores confidentiality in the context of child and adolescent mental With adolescents, though, I sometimes struggle with whether to share information with a parent. Clinical practice. What to do when an adolescent becomes sexually active, of course, is often a difficult issue. The concepts of informed consent and confidentiality are complex when the patient is an adolescent. eCollection 2014. By STEPHEN H. BEHNKE, JD, PHD, ELIZABETH WARNER, PSYD. Michael insisted that his mother not hear any of this. Three points emerge. Among adolescents with mental health needs, 70% do not receive needed care. Use of this framework may increase clinician comfort in discussing confidentiality and mental health topics with adolescents, and thus reduce barriers to the management of mental health problems in adolescent primary care. 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. Adolescents face considerable potential harms to their health from mental health disorders, interpersonal violence, substance use, and unprotected sexual activity. Lack of adequate insurance coverage: — Adolescents represented more than 25% of the estimated 8.3 million uninsured children in 2005.— Nearly half of State Child Health Insurance Program (SCHIP) programs place limits on inpatient and outpatient mental health services. Confidentiality protections allow adolescents and young adults to seek the health care they need and protect their privacy for these services. adolescent years. When treating young children, the issue rarely arises. Over the past several decades, adolescents have gained many opportunities to receive confidential health care services, particularly for concerns related to sexual activity, pregnancy, HIV and other sexually transmitted diseases (STDs), substance abuse and mental health. Michael's mother, to support Michael's relationship with his father, adhered to the visitation plan strictly, but her son's anxiety and physical complaints worried her. During adolescence, youth confront new issues that affect their physical, reproductive, and mental health. First, while it is clinically and ethically indicated to make clear how the relationship is structured and how information will be shared, a psychologist cannot promise a minor that information will be kept from a parent who has legal custody. For specific concerns or questions regarding The relationship between confidentiality of health information and consent for health care is important. Consider also three standards under "Privacy and Confidentiality." Guidelines from several national professional groups and a patchwork of state laws support the option to provide confidential mental healthcare for adolescents as a way to reduce barriers to treatment. Fourth, at times a psychologist will be mandated to disclose information. 2005 Jan;115(1):e97-104. Her parents do not know she is sexually active, and she does not want her mother to know that a Some adolescents are minors—under age 18—and some are young adults—age 18 or older. From a clinical perspective, the situation is more complex. is a complex and often challenging matter. Lack of adequate insurance coverage: — Adolescents represented more than 25% of the estimated 8.3 million uninsured children in 2005.— Nearly half of State Child Health Insurance Program (SCHIP) programs place limits on inpatient and outpatient mental health services. Monahan stated that therapists should caution parents and children about the limitations of confidentiality. The specific provisions of consent laws and confidentiality laws also vary and are not identical to each other. is designed for healthcare providers, social workers, counselors, teachers, and other professionals who . Curr Opin Pediatr. Center for Adolescent Health & the Law INTRODUCTION Confidentiality protections encourage adolescents and young adults to seek the health care they need and safeguard their privacy when they receive services.