Understanding Adolescent Consent and Confidentiality Rules in NY, NJ, and PA for Mental Health Professionals
Mental health professionals who work with adolescents often face complex questions about when a minor can consent to treatment and who controls access to their mental health records. Each state balances youth privacy with parental involvement differently, and understanding these rules is essential for ethical and compliant practice.
In Pennsylvania, minors aged 14 and older can consent to their own outpatient mental health treatment. Once a minor gives consent, they generally control the confidentiality of their treatment records. Parents may still initiate treatment for a minor under 18, but if the youth sought care independently, a parent’s right to access the records is limited. In those cases, providers may share information only as needed to support treatment or when required by law.
New Jersey allows minors aged 16 and older to consent to outpatient mental health services on their own. Treatment initiated by a minor is considered confidential, and clinicians are not required to notify parents unless they believe doing so would support the young person’s care. The law gives practitioners discretion to share or withhold information, which requires careful judgment when balancing therapeutic trust and family involvement.
New York provides one of the most flexible frameworks. A minor may receive outpatient mental health treatment without parental consent when the provider determines that the youth is voluntarily seeking care, that the treatment is clinically appropriate, and that involving a parent would be harmful or impractical. In those cases, the clinician documents the rationale and proceeds with treatment. Records from these sessions remain confidential unless disclosure is necessary to protect the patient or others from serious harm.
Across all three states, the guiding principle is similar: when minors lawfully consent to their own mental health care, they generally control access to their records. Parents do not have an automatic right to review those records, though providers may share limited information for safety reasons or to facilitate ongoing care. Clinicians should also remember that federal privacy rules, including HIPAA, reinforce these protections and may preempt conflicting state laws.
Understanding these distinctions helps providers honor both the rights of young patients and their obligations to families. When uncertainty arises, careful documentation and consultation with legal counsel can help ensure compliance.
If you have questions, please contact Evan Sampson, Counsel within the firm’s Health Care Practice Group, at esampson@postschell.com or 856.301.2561 to assist you.
Disclaimer: This post does not offer specific legal advice, nor does it create an attorney-client relationship. You should not reach any legal conclusions based on the information contained in this post without first seeking the advice of counsel.
About the Author
Evan M. Sampson is Counsel in the firm’s Health Care Practice Group, where he advises health care providers and organizations on a broad range of regulatory, transactional, and litigation matters.