Important Clarification of PA's Mental Health Consent Law

#papafa #mentalhealthconsent #mentalhealth #treatment #consenttotreat

Dishes pile up, work emails seem to come at a faster pace than ever before, and you can't remember the last time you had a meal that consisted of anything more than caffeine. However - none of this is on your mind, none of it matters to you in that moment. The moment where one of the people that means more to you than the world itself needs help but no matter how many hoops you jump through, or sleepless nights you spend illuminated by the light of your laptop screen, you can't seem to get it for them. This utterly hopeless feeling of not being able to protect and help your child is one that no parent should have to feel, but sadly it is all too familiar to too many. As a parent of a child with a social, emotional, behavioral, or mental health challenge you may have experienced varying degrees of this feeling when advocating for your child.

We at PA Parent and Family Alliance set out with the intention of easing those feelings of isolation and hopelessness that some of our parents' experience. One of the very first things that we, as an organization, created was our tip sheet (in both English and Spanish) to help make then Act 147 now 2020 Act 65, Pennsylvania's Mental Health Consent Law, easier to read and understand for both families and providers. Before establishing a presence on social media, connecting with our families, and even before we had the name and logo you see on our website today; we knew this needed to be addressed. It was clear that this was a tricky issue as the document has been shared over 15,000 times by families, providers, and agencies all across the state of Pennsylvania.

Since then we have continued to expand our resources for parents who are seeking inpatient and outpatient treatment for their children. We have added two additional tip sheets on; how to select a treatment facility for your child, and things to keep in mind while your child is there. This and the corresponding blogs (how to select, while they are there) both feature tips and suggestions that come straight from parents who have already navigated finding their children these services in the hope that it saves other parents time and heartache, as well as letting them know they are not alone. One of the main takeaways from sitting down with the parents who helped us create these resources was how many providers did not interpret the mental health consent law correctly. One mother in particular even mentioned that she emailed our tip sheet on the law to her child's therapist to show them that their child was not in fact allowed to opt-out of services once mom agreed.

If you have not heard of the Mental Health Consent Law known as Act 147, it is a piece of legislation from 2004 that if it had been followed correctly would be a huge win for children's mental health. It breaks down who needs to consent to mental health treatment for a child between the ages of 14-17. Children these ages are still minors so before this law they had no way to obtain mental health services if their parents didn't want them to. An ugly stigma still surrounds mental health and mental health treatment and some parents and or families may not be as open and understanding if their child wants help. This groundbreaking law was supposed to give children in those situations the ability to get help in spite of their parents' refusal.

Unfortunately, this law has been misinterpreted and has been doing more harm to children's mental health than good. A number of providers from across the state have mistakenly taken the law to mean that now children ages 14-17 can consent to not receive mental health treatment regardless of whether or not their parents want them to. This is absolutely not how the law was intended to work as you can see from the state's guidance here and here and here it puts children in that age bracket in danger because many are being told they have the ability to opt-out of help they very much need. If you resonated with the first paragraph of this blog and have had those sleepless nights trying to get your child help you know the last thing you need is another hoop to jump through. It puts the parents in an incredibly difficult situation when someone in a position of authority (i.e. a doctor or therapist) falsely tells their child they have the ability to turn down these services.

We spoke with Bonnie, an experienced Licensed Social Worker, and asked why this incorrect information continues to be followed. She shared her experience, "I believe that the mental health community, me included, practice without clarifying the law for themselves. When you start your first job in the mental health field and you are "trained" on consent. You never look up the law specifically for yourself.  No one has that time or legal expertise. Until you question the validity of a specific case or are challenged by a parent with accurate information, you will continue doing what you have been taught. That is what happened to me years ago. Once I learned what the actual law said I brought it to my supervisor's attention.  She would not even look at it. 'This is how it has always been done' was her response and the agency policy." 

While we are saddened that this misunderstanding has put even more on the plates of already overwhelmed parents for a long time; we are happy that our elected officials in Harrisburg saw the same struggle that we did. They have replaced Act 147 by clarifying the language to eliminate any confusion and passed 2020 Act 65. Representative Jason Ortitay of Allegheny and Washington County was one of the cosponsors of the act. We asked Rep. Oritay for his thoughts on the importance of this clarification;

"This new law is the culmination of six years of hard work. A mother came to me after her daughter tragically died as a young adult after she tried to get her mental health treatment while in her teens. Unfortunately, providers have been misinterpreting a 2004 law. This new law will definitely save lives and allow parents to guide their children’s mental health needs. It was a team effort to get this legislation over the finish line."

This quote is incredibly hard to read; however, it shows the gravity of the issue. This is not a matter of politics it is a matter of protecting children and their mental health. Our thoughts are with the mother who was brave enough to share her story with Ortitay and we are grateful that she did because it has made real systemic changes for all of the children who will be helped under this new, clarified, guidance. It is wonderful to know that Representatives like Ortitay, and the other Representatives involved; (Hahn, Snyder, Ryan, Pickett, Brown, Pyle, Dunbar, Grove, Longietti, Kirkland, Digirolamo, Bernstine, Millard, Masser, B. Miller, Neilson and Schlegel Culver) are advocating for children's mental health. Below is the official memorandum.

"Are you one of the many members who has heard from frustrated and frightened parents who have been told that their children over age 14 have a right to decide for themselves whether or not to engage in mental health treatment? If so, you know the level of concern these folks are going through and how terrible it is to recognize that you are powerless to help your own child who may be in the throes of a mental illness and desperately in need of life-saving care.

Our observation, based on constituent inquiries is that we need to further simplify things to eliminate any confusion. Children from the age of 14 to 18 need parental guidance for decisions of this magnitude, especially when they are struggling with a mental health concern. Therefore, our legislation will repeal the sections of the act that are creating confusion and replace them with words that are less likely to be misinterpreted. "

Please share the new legal update with friends, neighbors, colleagues, or any provider you may know. It is important that the awareness of the Mental Health Consent Law continues to grow.

Click here to share our easy to access the tip sheet.

Click here to read and share the bill itself.

Are you still unsure how the law impacts your family, are you dealing with a provider who still doesn't understand the law, or do you just need someone to talk to? Our Family Support Partners (FSPs) are here for you. This free and confidential service can be reached via telephone or online.


PA Parent and Family Alliance

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