BILL ANALYSIS SB 543 Page 1 SENATE THIRD READING SB 543 (Leno) As Amended September 3, 2009 Majority vote SENATE VOTE :22-12 JUDICIARY 7-3 ----------------------------------------------------------------- |Ayes:|Feuer, Brownley, Evans, | | | | |Jones, Krekorian, Lieu, | | | | |Monning | | | | | | | | |-----+--------------------------+-----+--------------------------| |Nays:|Tran, Knight, Silva | | | | | | | | ----------------------------------------------------------------- SUMMARY : Expands the rights of minors to receive outpatient mental health treatment or counseling services. Specifically, this bill : 1)Defines "professional person" who can provide mental health treatment or counseling services to a minor age 12 or over pursuant to this legislation to include: a) A designated mental health professional under specified regulations; b) A marriage and family therapist, as defined; c) A licensed educational psychologist, as defined; d) A credentialed school psychologist, as defined; e) A clinical psychologist, as defined; f) A licensed clinical social worker, as defined; g) A marriage and family therapist registered intern, as defined, working under the supervision of a licensed professional, as defined; and, h) A board certified, or board eligible, psychiatrist. SB 543 Page 2 2)Notwithstanding any other provision of law, authorizes a minor who is 12 years of age or older to consent to outpatient mental health treatment or counseling, if the minor, in the opinion of the attending professional person, is mature enough to participate intelligently in the mental health treatment or counseling services. 3)Provides that the mental health treatment or counseling authorized by this bill shall include involvement of the minor's parent or guardian, unless the professional person, who is treating the minor, after consulting with the minor, determines that such involvement would be inappropriate. Requires the professional person to state in the client's record about the contacts with the parent or guardian or why such contact is inappropriate. 4)Provides that the minor's parent or guardian is not liable of payment for the mental health treatment or counseling provided by this bill, unless the parent or guardian participates in the treatment or counseling and then only for such services rendered with that participation. 5)Specifies that this bill does not authorize a minor to receive convulsive therapy or psychosurgery, as defined, or psychotropic drugs without the consent of the minor's parent or guardian. EXISTING LAW : 1)Authorizes a minor who is 12 years of age or older to consent to mental health treatment or counseling, except as specified, on an outpatient basis, or to residential shelter services, if the following two conditions are satisfied: a) The minor, in the opinion of the attending professional person, is mature enough to participate intelligently in the outpatient services or residential shelter services; and, b) The minor presents a danger of serious physical or mental harm to himself or herself, or others, without the treatment, counseling, or residential shelter services, or the minor is an alleged victim of incest or child abuse. 2)Requires that a professional person offering residential SB 543 Page 3 shelter services make his or her best efforts to notify the parent or guardian of the provision of those services. 3)Provides that the mental health treatment or counseling of a minor must include the involvement of the minor's parent or guardian unless, in the opinion of the professional person who is treating or counseling the minor, the involvement would be inappropriate. 4)Defines "professional person" who may provide mental health treatment or counseling to minors. FISCAL EFFECT : None COMMENTS : In 2004, California voters passed Proposition 63, the Mental Health Services Act (MHSA), which provides increased funding, personnel, and other resources to support county mental health programs and monitor progress toward statewide goals for children, adolescents, adults, and families. Community stakeholder groups consisting of consumers, families, and service organizations identified various barriers to various populations accessing not only for MHSA programs, but for all mental health services. The groups identified that, among other things, requiring parental consent when a youth seeks mental health counsel or treatment is a barrier to the youth getting needed assistance. This bill, sponsored by the National Association of Social Workers, California Chapter, Mental Health America of Northern California, GSA Network and Equality California, seeks to address that barrier to needed services. According to the author, parental consent for mental health services can create a barrier, especially in prevention and early intervention programs where the youth may not be experiencing serious physical or mental harm. The author asserts that this barrier is especially harmful to certain populations of youth from abusive or neglectful homes, lesbian, gay, bisexual, and transgender youth, youth from immigrant families, homeless youth, and youth whose cultural backgrounds do not condone mental health services. The author states that this bill will help ensure that youth do not have to wait until their mental health deteriorates and their safety is compromised by suicide, substance abuse, or violence to receive needed services. Under existing law, minors age 12-17 may consent to mental health treatment or counseling without parental involvement in SB 543 Page 4 particular instances. The minor must be mature enough to participate intelligently in the treatment or counseling, and present a danger of serious physical or mental harm to self or others, or be the alleged victim of incest or child abuse. This exception to the general requirement of parental consent is fairly narrow in scope. This bill expands the existing precedent in current law slightly to allow youth to consent to outpatient mental health treatment if the attending professional believes the youth is mature enough to participate intelligently in the services. Accessibility to mental health treatment or counseling can be critical to youth who are struggling with difficult, emotionally-damaging life circumstances. Early intervention, evaluation, and counseling can make a crucial difference in the mental well-being of a minor. It seems at odds with the public policy of the state to require minors to reach a state of crisis before allowing them to seek treatment without the consent of their parents, especially when the parents themselves may be contributing to the minor's mental distress. Allowing minors who are mature enough to engage intelligently in treatment and counseling seems consistent with the other exceptions the Legislature has already made in statute for minors to seek services vital to maintaining their health and well-being. Regardless of the maturity of the youth, this bill specifically provides that the youth may not, without the consent of his or her parent or guardian, receive convulsive therapy (electroshock therapy), psychosurgery (which has historically included prefrontal lobotomies, but more recently includes less invasive techniques) or psychotropic medication (any medication capable of affecting the mind, emotions, or behavior). This limitation ensures that while youth are able to receive necessary treatment or services, there are clear and very reasonable restrictions as to what may be done in the absence of parental consent. Under current law, the mental health treatment or counseling of a minor must include involvement of the minor's parent or guardian unless, in the opinion of the treating professional, that involvement would be inappropriate. This bill requires that the professional person, when considering the appropriateness of the involvement of the child's parent or guardian, must consult with the youth. This will help ensure that the professional has the necessary information from the youth on which to base the decision. This bill still favors SB 543 Page 5 parental involvement unless the involvement would be inappropriate. However, by knowing that the professional must consult with them before seeking parental involvement, this bill should help more youth be comfortable seeking needed mental health services. This bill also provides, like existing law, that a parent or guardian is not liable for any costs of the treatment or counseling, except to the extent that the parent or guardian participates in the treatment or counseling. Analysis Prepared by : Leora Gershenzon / JUD. / (916) 319-2334 FN: 0002839