Various Pennsylvania laws govern the rights of minors to authorize their own health services. Act 10 of 1970 gives minors the ability to consent to medical, dental, and health services. Act 147 of 2004 amended Act 10 to include provisions regarding voluntary inpatient and outpatient mental health treatment for minors. Act 65 of 2020 replaced Act 147 and further amended Act 10 regarding who can provide consent for voluntary mental health inpatient and outpatient treatment for minors - those age 14 to 18 years of age. Act 65 also addresses those who can consent to the release of a minor’s mental health records.
On January 23, 2023, the Office of Mental Health and Substance Abuse Services (OMHSAS) issued Bulletin 23-01 to provide clarity for minors, parents, guardians and mental health treatment providers on Act 65. The details of that bulletin are explained below.
A minor can provide consent to mental health outpatient without the consent of a parent. The parent cannot be notified of the minor’s voluntary consent to outpatient treatment without the written consent of that minor. The Mental Health Procedures Act and Act 65 are silent on whether a parent can object to a minor’s consent to outpatient treatment.
A parent can consent to outpatient mental health treatment without the consent of the minor. The Mental Health Procedures Act and Act 65 are silent on whether a minor can object to the parent’s consent to outpatient treatment.
A parent can consent to outpatient treatment for a minor without the recommendation of a physician.
A minor can consent to inpatient treatment without the consent of the parent. The minor’s consent to treatment must be in writing after being provided with an explanation of the nature of the inpatient treatment and their understanding of the treatment. When a minor consents to inpatient treatment the director of the facility is required, per the Mental Health Procedures Act, to notify the parent or guardian and inform them of their right to file an objection with the consent to inpatient treatment by the minor.
A parent can provide consent to inpatient treatment for a minor without that minor’s consent.
Unlike consenting to outpatient treatment, a parent cannot consent to inpatient treatment for a minor without the recommendation of a physician, licensed psychologist or mental health professional who has examined the minor.
Revoking, Repealing or Objecting to Consent
A parent or minor can revoke their own consent to voluntary inpatient or outpatient treatment at any time. If a minor provides consent, then later revokes it, the parent or legal guardian can provide consent for the treatment to continue, and vice versa.
A parent cannot repeal consent provided by a minor and a minor cannot repeal consent provided by the parent.
A parent or minor can object to inpatient mental health treatment consented to by the other. At admission, the inpatient mental health provider is obligated to advise the minor of the right to object, the process for objecting and provide a form to file an objection. OMHSAS developed a template form for providers to use, attached to the Bulletin.
Control of Medical Records
Generally, the control and release of medical records resides with the person who consented to treatment. Page 26 of the Bulletin provides additional details on this.