Minors' consent to their own mental health treatment: How do therapists implement the maturity and intelligence standards of California health and safety code § 124260?.

摘要

Under the 2011 California Health and Safety Code § 124260, minors may consent to their own mental health services without parental consent if they are 12 years of age and, in the opinion of the attending professional person, mature enough to participate intelligently in mental health treatment or counseling services. An issue related to this law is that it does not define what "mature enough to participate intelligently" means. The present study explored how mental health clinicians evaluate minors' ability to consent to their own mental health treatment without parental consent.;Participants included 75 licensed mental health professionals who work with adolescents in their clinical practice. An online survey containing closed-ended Likert- type items and open-ended questions was completed by participants. A mixed quantitative and qualitative method of data analysis was utilized.;Results showed that clinical judgment was the most frequently utilized method to determine intelligent participation by mental health professionals. Observations made during the clinical interview were cited as the most frequent assessment procedure. Judgment about whether treatment was in the best interest of the adolescent was the most important factor clinicians considered when making a determination of intelligent participation. The severity of the client's presenting problems did not lead clinicians to approach the decision process differently. Of the participants, 79 percent reported that they found the law to be clinically useful. Eighty-six percent of participants reported that they had not used a formal assessment measures to determine intelligent participation. Of the tests that were used, intelligence tests were the most frequently utilized, and projective tests were the least frequently used. There was a strong positive correlation between length of time clinicians had been licensed and their knowledge of the law. Only 41% of participants reported that they had received training related to the law, and of these, 75% reported that training consisted of their seeking out written materials or resources on their own.;Results from this study suggest that clinicians find it difficult to translate some of the law's vague terms into everyday practice. Results also indicate that agencies often do not train clinicians on the utilization and implementation of this law. Formal training related to Health and Safety Code § 124260 would likely increase mental health clinicians' understanding of the law. Recommendations for future research are presented and include a recommendation for the development of assessment measures and procedures specifically aimed at determining intelligent participation. Having access to such assessment tools would likely assist clinicians when working with adolescents who present to mental health treatment without parental consent.