§ 33.21 — Consent for mental health treatment of minors

New York § 33.21

• Jurisdiction: New York
• Law MHY: Mental Hygiene
• Title E: General Provisions
• Art. 33: Rights of Patients

Text

§ 33.21 Consent for mental health treatment of minors.\n (a) For the purposes of this section:\n (1) "minor" shall mean a person under eighteen years of age, but shall\nnot include a person who is the parent of a child, emancipated, has\nmarried or is on voluntary status on their own application pursuant to\nsection 9.13 of this chapter, or is a homeless youth, as defined in\nsection five hundred thirty-two-a of the executive law, or receives\nservices at an approved runaway and homeless youth crisis services\nprogram or a transitional independent living support program as defined\nin section five hundred thirty-two-a of the executive law;\n (2) "mental health practitioner" shall mean a physician, a licensed\npsychologist, or persons providing services under the supervision of a\nphysician in a facility operated or licensed by the office of mental\nhealth;\n (3) "outpatient mental health services" shall mean those services\nprovided in an outpatient program licensed or operated pursuant to the\nregulations of the commissioner of mental health;\n (4) "reasonably available" shall mean a parent or guardian can be\ncontacted with diligent efforts by a mental health practitioner; and\n (5) "capacity" shall mean the minor's ability to understand and\nappreciate the nature and consequences of the proposed treatment,\nincluding the benefits and risks of, and alternatives to, such proposed\ntreatment, and to reach an informed decision.\n (b) In providing outpatient mental health services to a minor, or\npsychotropic medications to a minor residing in a hospital, the\nimportant role of the parents or guardians shall be recognized. As\nclinically appropriate, steps shall be taken to actively involve the\nparents or guardians, and the consent of such persons shall be required\nfor such treatment in non-emergency situations, except as provided in\nsubdivisions (c), (d) and (e) of this section or section two thousand\nfive hundred four of the public health law.\n (c) A mental health practitioner may provide outpatient mental health\nservices, other than those treatments and procedures for which consent\nis specifically required by section 33.03 of this article, to a minor\nvoluntarily seeking such services without parental or guardian consent\nif the mental health practitioner determines that:\n (1) the minor is knowingly and voluntarily seeking such services; and\n (2) provision of such services is clinically indicated and necessary\nto the minor's well-being; and\n (3) (i) a parent or guardian is not reasonably available; or\n (ii) requiring parental or guardian consent or involvement would have\na detrimental effect on the course of outpatient treatment; or\n (iii) a parent or guardian has refused to give such consent and a\nphysician determines that treatment is necessary and in the best\ninterests of the minor.\n The mental health practitioner shall fully document the reasons for\nhis or her determinations. Such documentation shall be included in the\nminor's clinical record, along with a written statement signed by the\nminor indicating that he or she is voluntarily seeking services. As\nclinically appropriate, notice of a determination made pursuant to\nsubparagraph (iii) of paragraph three of this subdivision shall be\nprovided to the parent or guardian.\n (d) A mental health practitioner may provide a minor voluntarily\nseeking outpatient services an initial interview without parental or\nguardian consent or involvement to determine whether the criteria of\nsubdivision (c) of this section are present.\n (e) (1) Subject to the regulations of the commissioner of mental\nhealth governing the patient's right to object to treatment, subdivision\n(b) of this section and paragraph two of this subdivision, the consent\nof a parent or guardian or the authorization of a court shall be\nrequired for the non-emergency administration of psychotropic\nmedications to a minor residing in a hospital.\n (2) A minor sixteen years of age or older who consents may be\nadministered psychotropic medications without the consent of a parent or\nguardian or the authorization of a court where:\n (i) a parent or guardian is not reasonably available, provided the\ntreating physician determines that (A) the minor has capacity; and (B)\nsuch medications are in the minor's best interests; or\n (ii) requiring consent of a parent or guardian would have a\ndetrimental effect on the minor, provided the treating physician and a\nsecond physician who specializes in psychiatry and is not an employee of\nthe hospital determine that (A) such detrimental effect would occur; (B)\nthe minor has capacity; and (C) such medications are in the minor's best\ninterests; or\n (iii) the parent or guardian has refused to give such consent,\nprovided the treating physician and a second physician who specializes\nin psychiatry and is not an employee of the hospital determine that (A)\nthe minor has capacity; and (B) such medications are in the minor's best\ninterests. Notice of the decision to administer psychotropic medications\npursuant to this subparagraph shall be provided to the parent or\nguardian.\n (3) The reasons for an exception authorized pursuant to paragraph two\nof this subdivision shall be fully documented and such documentation\nshall be included in the minor's clinical record.\n