Derry Oliver was in fifth grade when she first talked her mother into seeing a therapist.
She lived in Georgia with her uncle and grandparents while her mother was in New York to find work and apartments before moving the family. It was a difficult gap year. Oliver, now 17, was feeling depressed. A school employee brought up the idea of a therapist.
Oliver’s mother, also named Derry Oliver, questioned the school’s assessment and did not consent to therapy. “You’re so young,” the mother recalled thinking. “There is nothing wrong with you. These are growing pains.”
The issue boiled over again during the COVID-19 pandemic when the younger Oliver, struggling with the isolation of distance learning, turned to her high school in Brooklyn for help. School-based mental health professionals such as social workers may offer some counseling without parental permission. But in New York, referring a student to more intensive therapy almost always requires parental consent. In Oliver’s case, this led to more conflict.
“It was very emotional for both of us because I could understand her frustrations and her fears,” recalls the younger Oliver. “But at the same time, sometimes it’s better for your child to be able to access that than to keep it away from them.”
As schools across the country respond to a youth mental health crisis accelerated by the pandemic, many are grappling with the sharp legal, ethical and practical challenges of getting parents on board with treatment. The issue has become politicized, with some states seeking to improve access as conservative politicians elsewhere propose further restrictions, accusing schools of trying to indoctrinate students and cut off parents.
Differing perspectives on mental health are not new for parents and children, but more conflicts are emerging as young people feel more comfortable talking about mental health openly and treatment becomes more available. Schools have invested pandemic relief money in hiring more mental health specialists, as well as telehealth and online counseling to reach as many students as possible.
“It’s this disconnect,” said Chelsea Trout, a social worker at a Brooklyn charter school. “Kids are all on TikTok or online and they understand the talk of therapy and that it’s something that can be beneficial for their mental health and they’re interested in it, but they don’t have clear buy-in from their parents. “
Research suggests that the need to obtain parental permission may be a significant barrier for adolescents to access treatment.
Access to therapy can be critical, especially for LGBTQ+ youth, who are far more likely than their peers to attempt suicide and whose parents may not know or approve of their sexual orientations or gender identities. Jessica Chock-Goldman, a social worker at Bard Early College High School in Manhattan, said she has seen many cases where mental health problems become severe in part because teenagers did not have early access to therapy.
“Many children would end up in hospital with suicidal ideation or intent because the prevention work wasn’t done,” she said.
The issue of when young people may accept mental health treatment is receiving increasing attention from policy makers. States like California and Colorado have recently lowered the age of consent for treatment to 12. But in some states like North Carolina, the issue has become embroiled in larger political debates about parental input into the curriculum and the rights of transgender students.
There’s also a big hurdle outside the law: therapy is rarely free, and paying for it or filing insurance claims often requires parental support.
Teenagers in New York can accept therapy starting at age 16, and a provision allows doctors to authorize treatment for younger children if they judge it to be in their best interest. But there are caveats: Consent laws only apply to state-licensed outpatient settings, and they don’t extend to prescription drugs.
New York City Mayor Eric Adams recently announced a partnership with the Talkspace platform to provide free online counseling to all of the city’s teens through a program known as NYC Teenspace. It doesn’t require insurance, but parental consent is required, “except in special circumstances,” according to the program’s website.
For Oliver and her mother, years of talking have brought some progress, but not as much access to therapy as the younger Oliver wants.
A few years ago, the Olivers agreed to a compromise. They found a black female therapist who was important to both of them as a black family. The elder Oliver has felt the sting of being called “aggressive” for expressing normal emotions as a black woman and has had negative experiences with therapists and medication for depression, which she says made her feel like a “zombie.”
The elder Oliver agreed that her daughter could begin therapy – as long as she sat through the sessions. But the therapist changed jobs after about a month, and Oliver hasn’t seen a therapist since.
“It has to be someone trustworthy,” the elder Oliver said of a potential therapist for her daughter.
Trout, the school social worker at the Brooklyn charter school, said she has met with a number of parents who, like Oliver, distrust the school’s recommendations and wonder why their child would need therapy if they are successful. academically and socially.
“If we’re thinking about predominantly black and brown communities, if your interactions with social workers or mental health services or anything in that area so far haven’t been positive,” she said, “how can you trust them with kids yours?”
The statistics show a racial divide. According to a survey by the Centers for Disease Control and Prevention.
Without access to therapy, the younger Oliver has sought advice on managing her emotions through friends, school social workers and the Internet. But she is convinced she can do much more with continued professional help.
Oliver has already gotten into a number of colleges — much to her mother’s pride — and is weighing her options for next year.
One thing she is looking into: how much access they provide to therapists.
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