September 5


At What Age Can Kids Say ‘No’ to Mental Health Treatment?

By Joshua Turner

September 5, 2023

Mental health treatment for children is a sensitive topic that requires careful consideration. Parents and guardians play a critical role in decision-making, but when can a child refuse treatment?

The answer is not straightforward, as it depends on various factors, such as the child’s age, the type of care, and the state’s legal requirements.

Understanding a child’s mental health is necessary to decide the proper options. Such conditions can manifest differently and may require different approaches. Recognize the signs in children and seek professional help when necessary.

Key Takeaways

  • The age at which a kid can refuse treatment depends on various factors, including the type of therapy and state laws.
  • Parents and guardians help in decision-making, but understanding a child’s mental health is essential to making the best decisions.
  • They can manifest in different ways and may require different treatment approaches.

Understanding Child Mental Health

Child mental health refers to children and adolescents’ emotional, behavioral, and social well-being. Understand that these problems are real and can be severe. They may experience difficulties in various areas of life, including school, family, and social relationships.

They can also manifest in different ways, including behavior disorders, anxiety disorders, mood disorders, and developmental disabilities. Symptoms can vary depending on the type of disorder. Diagnosing mental disorders as early as possible is necessary to provide appropriate service and support.

Being aware of mental disorders can be challenging, as they may not be able to express their emotions and feelings adequately. However, it is critical to thoroughly understand a child’s mental health to identify the signs and symptoms.

Parents and caregivers should be aware of the risk factors contributing to problems, such as family history, trauma, abuse, and neglect. They can provide a supportive and nurturing environment that promotes positive mental health.

The Role of Parents and Guardians

Parents and guardians must ensure their child receives the necessary care and support. They should be comfortable with the plan and communicate any concerns.

Legal guardians have the legal authority to decide on the type of therapy. However, they need to involve the kid in decision-making as much as possible. Education is key, and parents and guardians should take the time to learn about the different options available.

When they refuse care, parents and guardians should try to understand the reasons behind their child’s decision. Create a safe and supportive environment where the kid feels comfortable discussing their concerns. They should also consider seeking the advice of a professional to help navigate the situation.

Age and Consent for Treatment

Age is necessary for determining consent for treatment. In most states, the age of majority is 18, meaning that individuals 18 or older can legally consent to their therapy without parental involvement.

However, for minors, the rules are a bit more complicated. In general, minors cannot consent to their treatment, and their parents or legal guardians must provide consent.

There are some exceptions to this rule, though. In some cases, minors may consent to their care if they are considered a “mature minor” or have been emancipated.


Even when parents or legal guardians consent to a minor’s treatment, the patient still has the right to be informed and provide their own input and feedback. This is known as informed consent, a part of any plan.

Teenagers approaching the age of majority should start thinking about their healthcare decisions and communicate their preferences and concerns. This can help ensure they receive the care they need while still feeling in control of their healthcare decisions.

Types of Mental Health Treatments

Several types of mental health treatments are available, each with unique benefits and drawbacks. Therapy choice depends on the specific condition and needs.


Therapy involves talking to a professional to address emotional and behavioral issues. Types of treatment include cognitive-behavioral therapy, psychoanalytic therapy, and family therapy. It can help them build coping skills, improve communication, and develop healthy relationships.


Medication is often prescribed to treat depression, anxiety, and ADHD that can help alleviate symptoms and improve the kid’s welfare. However, medication should be used in conjunction with therapy and counseling to achieve the best outcomes.


Counseling involves addressing specific concerns or issues to help them cope with stress, anxiety, and other emotional problems. It can also help improve communication skills and develop healthy relationships.

Inpatient Treatment

Inpatient treatment involves a child being admitted to a hospital or facility for intensive care and monitoring. It is typically recommended for those with severe conditions that require close monitoring and supervision.

A child’s choice of therapy depends on their specific needs and condition. Work with a professional to develop a plan to help them achieve optimal mental health.

Refusal of Treatment

They are not legally allowed to refuse mental health treatment until they reach the age of majority, which is typically 18 years old. However, consider the kid’s opinions and feelings when making decisions.

If a child desires to change their plan or stop therapy altogether, have an open and honest conversation to understand their concerns. Balance the child’s autonomy with their safety and welfare.

Suppose the refusal of treatment poses a risk of harm to themselves or others. In that case, involving other professionals, such as a child protective services agency or law enforcement, may be necessary. However, this should be a last resort and only be considered if all other options have been exhausted.

Approach the topic with empathy and understanding. They should be encouraged to take an active stand in how they want to cope with their issues and decision-making process while ensuring their safety.

Legal Aspects in Different States

Below are some of the states and specific ages of minors who can consent to treatment without parental consent:

  • In California: 12 or older
  • In Georgia: 14 or older
  • In Florida: 16 years and older
  • In Maryland: 16 years or older (but only for certain conditions)
  • In Illinois: 12 years or older
  • In West Virginia: 14 years or older
  • In Wisconsin: State law grants minors the right to consent to mental health treatment at any age if they can understand the nature and consequences of the treatment. However, a court order may be required in certain situations.

Legislation and court orders may also affect a child’s ability to refuse care in certain states. Consult with a legal expert in your state to understand the laws and regulations regarding this issue fully.

Issues and Barriers to Mental Health Care

Stigma is a major issue preventing people from seeking mental health care. The negative attitudes and beliefs associated with mental illness can make people feel ashamed and embarrassed to seek help.

Access to care is another barrier, as many people, especially those living in rural or remote areas, do not have access to professionals or facilities. This can make it challenging for individuals to receive timely and appropriate care.

The cost of care can be a significant burden for individuals and families, especially those without insurance or limited financial resources.

Mental health care is often not prioritized over physical health care in public health policies and funding. This can result in a lack of resources and inadequate support for services.

Substance Use and Abuse

Substance use and abuse can seriously affect a child’s mental health. Those who use drugs or alcohol are at a higher risk of developing substance use disorders and addiction later in life. Parents should be aware of the signs of substance use and abuse, including changes in behavior, mood swings, and a decline in academic performance.

It can also be a symptom of an underlying issue, such as anxiety or depression. In these cases, address the root cause of the problem and provide appropriate support.

Parents should also know that some medications can interact negatively with drugs and alcohol. It’s important to discuss any substance use with a professional before starting therapy.

Parents need to have open and honest conversations with their children about substance use and abuse. Education and support can help prevent future problems and promote good mental health.

Role of Healthcare Professionals

Healthcare professionals, including physicians, doctors, and pediatricians, help them and adolescents receive appropriate services. They are often the first point of contact for families seeking services.

Pediatricians and primary care physicians can perform initial assessments, provide referrals to specialists, and monitor progress throughout care. Child and adolescent psychiatrists are trained to diagnose and treat disorders in children and adolescents.

Healthcare professionals must communicate effectively with the child and their parents or guardians. They should explain the benefits and risks of options and involve the child in the decision-making process when appropriate.

They should also know state laws regarding a child’s right to refuse care. In some cases, a child may be deemed mature enough to make their t decisions, while parental consent may be required in others.

Working collaboratively with families and specialists can improve the mental health outcomes of young people.

Research and Evidence

Research in the field of child mental health treatment has been ongoing for decades, with many studies examining the effectiveness of various treatments and interventions. While a wealth of evidence suggests that early intervention is key to successful outcomes, the question of when a child can refuse them is less clear.


Experimental research has shown that children as young as 7 or 8 can understand the nature and consequences of mental health decisions and may be able to make choices about their care. However, many experts agree that a child’s ability to make such decisions should be evaluated on a case-by-case basis, considering their age, maturity level, and capacity to understand the consequences of their choices.

The evidence suggests that children should be involved in the decision-making process regarding their care as much as possible. It may include providing them with information about their condition and options and offering them the opportunity to express their preferences and concerns. Ultimately, the goal should be to empower kids to be proactive in their own care while ensuring their safety.

Adverse Childhood Experiences (ACEs)

Adverse Childhood Experiences (ACEs) are traumatic events before age 18. These events include physical, emotional, or sexual abuse, neglect, household dysfunction, etc. ACEs can affect a child’s mental health, leading to depression, anxiety, and post-traumatic stress disorder (PTSD).

Those who experience ACEs are more likely to develop mental health issues later in life. Studies have shown that individuals who have experienced four or more ACEs are at a higher risk of developing disorders. Not all who experience ACEs will create issues, but addressing these experiences is necessary to prevent long-term consequences.

Child abuse and neglect are two of the most common ACEs. These events can profoundly impact a child’s mental health, leading to symptoms such as low self-esteem, difficulty forming relationships, and poor academic performance. Parents, caregivers, and educators must know how to recognize the signs of abuse and neglect and take action to prevent further harm.

Adversity can come in many forms; each child’s experience is unique. Addressing ACEs early on and providing appropriate care can help kids build resilience and prevent long-term consequences.

Mental Health and Other Health Issues

Depression and anxiety can lead to physical symptoms such as headaches, fatigue, and muscle tension. On the other hand, physical health issues such as chronic pain or illness can also significantly impact mental health.

Addressing mental and physical health concerns is important, as they can often be intertwined. For example, if a child struggles with depression, they may also be more likely to engage in risky behaviors that could lead to contracting a sexually transmitted disease or becoming pregnant. Similarly, a child struggling with ADHD may be more likely to engage in impulsive behaviors that could lead to injury or illness.

Approach these issues holistically, considering all aspects of a child’s health. This may involve working with a team of healthcare professionals.

Overall, it’s important to prioritize a child’s health and welfare and to address any concerns as early as possible. By taking a proactive approach to mental and physical health, we can help them to lead happy, healthy lives.

Treatment Planning and Options

A solid treatment plan is necessary, which should be tailored to the child’s specific needs and preferences and involve input from both the child and their caregivers.


Various options are available, including therapy, medication, and alternative therapies such as art or music therapy.

Appointments with professionals should be scheduled regularly to ensure that the plan is working effectively. These appointments can be adjusted based on the child’s progress and changing needs.

When a child is ready to be discharged, have a plan for ongoing care and support. This may involve continued therapy or medication and regular check-ins with specialists.

Records should be kept confidential and secure. However, caregivers need to have access to these records to stay informed about their child’s progress and plan.

The most important part of care for children is ensuring that the child feels comfortable and supported throughout the process. Working with professionals to develop a personalized plan can receive the care and support they need to thrive.


Children have the right to decide about their mental health treatment, but this right has limitations. As we have seen, the age at which a child can refuse care varies from state to state and depends on several factors, including the child’s age, maturity, and ability to understand the consequences of their decision.

Involve the child in decision-making as much as possible and provide age-appropriate information about their condition and support options. Parents and healthcare professionals should work together to ensure that the child’s best interests are always considered.

If a child refuses it, explore the reasons behind their decision and provide them with alternative support, such as counseling or therapy. Children can learn to manage their mental health and lead fulfilling lives with the right support and guidance.

Frequently Asked Questions

What are the laws regarding minors and mental health treatment in California?

In California, minors can receive treatment without parental consent or knowledge. However, there are some exceptions to this rule. For example, professionals may be required to inform parents or guardians if a minor is in danger of harming themselves or others.

At what age can a child decide about mental health treatment?

The age at which a child can make their own decisions about treatment varies by state.

What is the age of consent for mental health treatment in different states?

The age of consent for care varies by state. In some states, minors as young as 14 can consent to treatment without parental consent or knowledge. In other states, minors must be 18 years old to decide.

Can a parent refuse mental health treatment for their child?

Parents or guardians cannot refuse it for their child if the child is in danger of harming themselves or others. However, in non-emergency situations, parents or guardians may be able to refuse it for their child.

Can minors receive therapy without parental consent in California?

Yes, minors in California can receive therapy without parental consent or knowledge. However, there are some exceptions to this rule. For example, specialists may be required to inform parents or guardians if a minor is in danger of harming themselves or others.

Can a 16-year-old refuse antidepressants?

In California, minors who are 12 years or older can consent to care without parental consent or knowledge. This includes the use of antidepressants. However, professionals may recommend involving parents or guardians in decision-making.

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