Noonan: Bipartisan bill takes on age of consent for mental health care for children
Author: Paula Noonan - April 12, 2017 - Updated: April 11, 2017
Parents generally make medical decisions for their children. A bipartisan House bill addresses at what age children can make mental health care decisions for themselves, lowering the age of consent for a child to receive outpatient therapy from 15 years to 10 years.
Bill sponsors cite a 50 percent rise in the occurrence of suicide among pre-adolescent children over the last three decades. According to a ground breaking survey of suicide literature in the Academic Emergency Medicine Journal (2007), suicide rates for children 12 and younger is 0.8 per thousand, up from 0.3 per thousand in the 1970s. The article states that suicide was the 12th leading cause of death among children 12 and younger in 2003. Suicide was the fourth leading cause of death for 12-year-olds. The numbers go up as children get older.
Licensed mental health care providers are protected in the bill. Parents cannot go after outpatient psychotherapists who provide care to children seeking help without their parents’ permission for reasons other than negligence.
Research suggests that young children most vulnerable to suicide and similar self-harming problems are boys. Many young children do understand the idea of suicide but they may not grasp “finality, lethality, or outcomes,” according to the AEMJ article. That’s why studies in this area can be muddled. It can be difficult to determine if a child poisoning, for example, is accidental or purposeful, or if a child fell out of a window or jumped.
What is clear is that children can hurt a lot and not say anything. They may suffer from mental illness or have mental illness in their family. Their family members may be violent, both physically and verbally abusive. Someone close to the child may have committed suicide. They are “unwanted” children and some are victims of sexual abuse.
Young children will express themselves indirectly through their behavior. Girls are depressed. Boys exhibit disruptive behavior, anxiety, mood disorder and substance abuse. For help to come to these kids, someone has to observe the problems, put the facts together, and take appropriate action, and that “someone” in some cases will not be the parent.
The age of consent varies greatly across the country. New Jersey teenagers pushed a bill in 2015 that lowered age of consent to 13, but Gov. Chris Christie forced the age up to 16. According to Youth Today (March 2016), 35 states have laws that give minors consent to outpatient mental health therapy. The U.S. Department of Health and Human Services finds that “half of mental health problems start before a person turns 14 years old.”
The New Jersey teenager who brought the New Jersey bill to the legislature was 16 when he realized he needed help and his parents wouldn’t give consent to treatment. The challenge in HB17-1320 is whether lowering the age of consent to 10 addresses the great need.
Schools, adult friends, the courts and human services are the likely decision-making contacts for children with self-harming thoughts or impulses. But the research says that pre-pubescent children, especially boys, make their self-harming decisions impetuously.
When impetuous action comes up against difficult decision-making concerning children as young as 10 years, will this bill make a difference? It will protect the mental health professional who steps in. But it also raises many questions about parents’ rights and children’s rights. It starts the conversation.