RD522 - Minor Consent for Voluntary Inpatient Psychiatric Treatment

Executive Summary:

A Joint Commission on Health Care report, Minor Consent Requirement for Voluntary Inpatient Psychiatric Treatment, RD No. 459 (2014) included the JCHC-member approved policy option:

"Include in the 2015 JCHC work plan, a staff review of the implications of allowing a minor to consent for inpatient treatment at a mental health facility without the consent of the minor’s parent. The review shall include consideration of 1) amending Code § 16.1-338 to allow a minor 14 years of age or older to consent for voluntary inpatient mental health treatment without the consent of the minor’s parent, 2) creating a judicial review regarding release under Code § 16.1-339 when the minor desires to continue inpatient treatment and consent for continued admission is withdrawn by the parent who consented to the minor’s admission, and 3) reimbursement issues for services provided when a minor receives inpatient mental health treatment without the consent of the minor’s parent."

Under current Virginia statutes, the parent(s) and the minor aged 14 through 17 must apply jointly in order for a minor to be admitted voluntarily into an inpatient psychiatric treatment center. In instances in which the minor child (aged 14 through 17) consents but the parent does not consent, a range of actions may be taken including the parent taking custody of the child and returning home, a request for an emergency custody order or temporary detention order, and a report to child protective services for medical neglect on the part of the parent.

A variety of perspectives were expressed regarding the need to change admission requirements. These perspectives ranged from the community services board staff who indicated they were never involved in a situation in which the child wanted to be in an inpatient setting and the parents objected, to the private practice clinicians who reported that parental objection disagreements occur on a regular basis in both the admission stage as well as in the continuation of the treatment plan.

Six policy options were offered for JCHC consideration; after considering the study findings and public comments, Joint Commission members voted to take no action.