Mental health challenges are not issues that only adults face. In Ontario, one in five children live with a mental health challenge, and 70% of these issues manifest during childhood. [1]. Therefore, youth must be aware of their rights in the healthcare system and how to seek help. With knowledge comes empowerment, and we can create a culture that accepts seeking help for mental health challenges at a young age. This blog post will discuss the Ontario mental health laws for minors and the legal age of consent, parental involvement, and access to mental health services. 

Age and Capacity to Consent

As minors and young adults, consent is one of the most significant issues in seeking help through the medical or legal system. Consent in the mental health treatment of minors is essential and can often bring up legal issues due to the age and “capacity.” Many people, including parents or guardians, siblings, and other close family members, are involved in minor mental health treatment. Obtaining informed consent for minors includes ensuring that the consent is communicated regarding the treatment, it is received of the patient’s free will, and the patient is aware of all the relevant information and not coerced or obtained fraudulently. Relevant information includes risks, benefits, consequences of doing or not doing the treatment, side effects and other courses of action. Consent also includes providing complete and detailed physician answers if the patient has any questions [2]. 

Capacity for minors to consent or not consent includes ensuring the patient understands all the information provided to them and that they understand the consequences of choosing or not choosing treatment. There is no minimum or legal age for mental health consent, and it is more regarding the youth’s capacity to consent to treatment fully. Young children and babies cannot consent, but for older children, it is up to the physician to determine whether the child can consent or not [2]. 

Young individuals aged 12 to 16 can be admitted to psychiatric facilities as informal patients. As with adult patients, they must be recognized through a certification from the board. The board considers aspects such as if the child needs to receive treatment from a psychiatric facility, if there are alternative options if the child’s state will deteriorate without treatment at a facility, and the child’s wishes. After three months of the initial certification, the board will decide whether or not the patient will be admitted to continue to stay or must be discharged from the hospital [3]. 

Parental Involvement in Youth Mental Health and Confidentiality

 Children and minors can seek help from a physician without involving their parents. If a minor can consent to treatment, the rules of confidentiality must be upheld by the healthcare system, and if you request, doctors cannot share your information with your family. However, if you cannot consent to treatment, physicians can communicate your health information with legal guardians and substitute decision-makers [4]. If the child cannot consent, the decision is made by the substitute decision-maker, usually either a parent or a legal guardian. The Mental Health Act allows someone, including parents and family, to request a psychiatric assessment of a child, which provides for a 72-hour detainment [2]. From there, a physician must complete the certificate of involuntary admission to keep a child in the facility for more than 72 hours. However, if the youth is 16 and over, they can only be involuntarily detained if they cannot consent to treatment. Once the two weeks of involuntary detainment are over, parents cannot force you to stay unless the court or physician orders [4]. 

Access and Resources 

If you or a minor you know is seeking out resources or help with mental health challenges, many government and non-governmental organizations are available for you to access. These healthcare and legal resources can help minors make informed and empowered decisions regarding their mental health care. Your family doctor is also suitable for finding mental health resources close to home and unique to your situation and circumstances. 

Mental health care resources and crisis line support are available here: 

• Kids Help Phone
  1-800 668-6868 
  http://www.kidshelpphone.ca
• Canadian Mental Health Association (CMHA) 
  1-844-HERE-247 (437-3247) 
  http://www.here247.ca/ 
  https://cmha.ca/ 
• EveryMind Mental Health Services
  info@everymind.ca
  905-278-9036 
  https://everymind.ca/ 
• Compass Child and Youth Mental Health Services|
  1-800-815-7126
  https://www.compassne.ca/ 
• Mental Health Helpline
  1-866-531-2600
  http://www.mentalhealthhelpline.ca

Legal Supports Include:

• Justice for Children and Youth: Legal Rights Wiki: https://tinyurl.com/mrefpvhj
• Legal Aid Ontario- Getting Legal Help: http://www.legalaid.on.ca/en/getting/default.asp
• Ontario Hospital Association- A Practical Guide to Mental Health and the Law in Ontario (2012)
• Ministry of Children and Youth Services- Youth and the Law:  https://tinyurl.com/mvmcwxyw
• Navigating the Youth Criminal Justice and Mental Health Systems: https://tinyurl.com/495jbwzr