"I was on the phone with a facility and they didn't even know the name of the law. The person I was speaking with called it 'Gabby's Clause'. I informed them 'No, it can be referred to as Gabby's Law but it is Act 65 of 2020.' I think some providers don't even know what the law is, what it says, or what it protects." said Parent Alliance Family Support Partner, Tracy Palazzotto. Tracy is one of our incredible FSPs who shared with us that well over half of her current caseload of families are experiencing challenges with the misinterpretation of PA's Mental Health Consent Law; Act 65 of 2020. "This isn't just one facility that's misinterpreting or even just one part of the state. It's happening everywhere."
"I have families who physically drive their child to the hospital and then call for an update later on and they are being told that the hospital cannot confirm that their child is even there. The parents are so confused, like; 'What do you mean you can't say they are there? Where did they go? They were just admitted!'" said Tracy. "All of this is just pitting parents and children against each other during an already very stressful time. When you are dealing with a mental health crisis you do not need someone in a position of authority (doctor, administration at a facility) giving inaccurate information to your child. Parents do not need anything else that holds up an admission process that has already been endlessly held up." said Tracy.
One of the very first things that we, as an organization, created was our Mental Health Consent tip sheet (in both English and Spanish) to help make then Act 147 now Act 65 of 2020, Pennsylvania's Mental Health Consent Law, easier to read and understand for both families and providers. Before establishing a presence on social media, connecting with families, and even before we had the name and logo you see on our website today; we knew this needed to be addressed. It was clear that this was a tricky issue as the document has been shared over 150,000 times by families, providers, and agencies all across the state of Pennsylvania.
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Since then we have continued to expand our resources for parents who are seeking inpatient and outpatient treatment for their children. We have added two additional tip sheets on; how to select a treatment facility for your child, and things to keep in mind while your child is in an RTF. This and the corresponding blogs (how to select, while they are there) both feature tips and suggestions that come straight from parents who have navigated the inpatient admission process in the hope that it saves other parents time and heartache, as well as letting them know they are not alone. One of the main takeaways from sitting down with the parents who helped us create these resources was how many providers did not interpret the mental health consent law correctly. One mother in particular even mentioned that she emailed our tip sheet to her child's therapist to show them that their child was not in fact allowed to opt-out of services once mom agreed.
If you are unfamiliar with Act 65 of 2020 it breaks down who can consent to mental health treatment for a child between the ages of 14-17. Children this age are still minors so before this law, they had no way to obtain mental health services if their parents didn't want them to. An ugly stigma still surrounds mental health and mental health treatment and some parents and or families may not be open and understanding if their child wants help. This groundbreaking law is supposed to give children in those situations the ability to get help in spite of their parent's refusal. Unfortunately, somehow understanding of this law has been misinterpreted that if a child can consent once they turn 14, they can also refuse. This is absolutely incorrect. This law only allows children to consent, it does NOT take away a parent's right or obligation to provide consent to mental health treatment when needed. In Act 65 of 2020 they use the word abrogate which is a legal term for 'override.' The law doesn't allow anyone to abrogate or override consent once it's given. This means a child 14 and older cannot abrogate the consent a parent provides. This also means parents between themselves cannot abrogate consent given by another parent or the child.
We spoke with Bonnie, an experienced Licensed Social Worker, and asked why incorrect information continues to be followed. She shared her experience, "I believe that the mental health community, me included, practice without clarifying the law ourselves. When you start your first job in the mental health field you are "trained" on consent. You never look up the law specifically for yourself. No one has that time or legal expertise. Until you question the validity of a specific case or are challenged by a parent with accurate information, you will continue doing what you have been taught. That is what happened to me years ago. Once I learned what the actual law said I brought it to my supervisor's attention. She would not even look at it. 'This is how it has always been done' was her response and the agency policy."
While we are saddened that this misunderstanding has put even more on the plates of already overwhelmed parents for a long time; we are happy that our elected officials in Harrisburg saw the same struggle that we did. In September of 2020, they replaced Act 147, the old misunderstood law, and clarified the language to eliminate any confusion and passed 2020 Act 65. Representative Jason Ortitay of Allegheny and Washington County was one of the cosponsors of the act. We asked Rep. Oritay for his thoughts on the importance of this clarification;
"This new law is the culmination of six years of hard work. A mother came to me after her daughter tragically died as a young adult after she tried to get her mental health treatment while in her teens. Unfortunately, providers have been misinterpreting a 2004 law. This new law will definitely save lives and allow parents to guide their children’s mental health needs. It was a team effort to get this legislation over the finish line."
This quote is incredibly hard to read; however, it shows the gravity of the issue. This is not a matter of politics it is a matter of protecting children and their mental health. Our thoughts are with Gabby's mother who was brave enough to share her story with Ortitay and we are grateful that she did. Below is the official memorandum.
"Are you one of the many members who has heard from frustrated and frightened parents who have been told that their children over age 14 have a right to decide for themselves whether or not to engage in mental health treatment? If so, you know the level of concern these folks are going through and how terrible it is to recognize that you are powerless to help your own child who may be in the throes of a mental illness and desperately in need of life-saving care.
Our observation, based on constituent inquiries is that we need to further simplify things to eliminate any confusion. Children from the age of 14 to 18 need parental guidance for decisions of this magnitude, especially when they are struggling with a mental health concern. Therefore, our legislation will repeal the sections of the act that are creating confusion and replace them with words that are less likely to be misinterpreted. "