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Ordinarily, when children under 18 years old need health or mental health services, the clinician requests consent from their parents or legal guardians (Maslyanskaya & Alderman, 2019; McNary, 2014).[1] Parental consent not only ensures that parents know about the services that their children are receiving, but also that the services are helpful and actively support treatment progress. In some situations, however, children—particularly older teenagers—may wish to engage the services of a clinician without parental knowledge or consent. These situations may arise when:
- there is an emergency situation and parents are not immediately available (e.g., a child with plans for suicide or other self-harmful behavior; a child is experiencing an acute episode of anxiety, panic, or distress);
- a child is embarrassed about a situation and does not want their parents to know about the concern (e.g., a lesbian, gay, bisexual, transgender, or questioning youth who has not come out to their parents and is afraid of their response; a youth with questions about safer sex or possible pregnancy; or a youth experiencing problems with alcohol, drugs, or the criminal justice system);
- a child experiences bullying, abuse, or neglect, but fears rejection or retaliation from their parents if they reach out for help;
- parents may not have health insurance coverage and cannot afford to pay for therapy; or
- a child is aware of societal, cultural, or religious stigma about mental health services and does not want to bring shame or disapproval to the family.
Each of these situations may call for different approaches. This article explores options for children and youth who may have different reasons for seeking mental health services on their own.
Emergency Services
When children experience suicidal thoughts, extreme distress, or other urgent situations, they should know about services specifically designed for such situations. First, they can reach out for help from a national emergency and crisis hotline by calling 988, texting 988, or chatting online at 988lifeline.org. These services are confidential and provided by trained counselors. These services do not require parental consent, although counselors could discuss whether it is feasible and appropriate to notify parents as part of the helping response.
For urgent situations involving medical emergencies, drug overdoses, guns, or other threats of violence, youth may call 911. Operators at this number may send police, ambulances, crisis response teams, or other first responders to assist with immediate threats of harm.
Sometimes, youth feel more comfortable turning to someone that they already know and trust to help them with an urgent situation. This could be a family member, friend, teacher, coach, school social worker, doctor, or other professional with whom they’ve had prior contact. This person can provide immediate support, but may have to notify others if there are serious concerns, such as child abuse or neglect. Teachers, therapists, and other licensed professionals are mandated reporters, meaning that they must contact child protection services for child abuse and neglect concerns. Another valuable resource is the Childhelp National Child Abuse Hotline (1-800-4-A-CHILD / 1-800-422-4453), which provides 24-hour crisis counseling, reporting guidance, and referrals to community-based services for ongoing assistance.
Services That May Not Require Parental Notification or Consent
Children and youth should be aware of helping professionals whom they can speak with, even if they do not want their parents notified. Age requirements vary from state to state, with some states permitting children as young as 12 to consent to mental health services, while other states go up to 18 years as the age of consent. In some states, minors are allowed to see a counselor for a limited number of sessions without parental consent. They may also be allowed to see a counselor if they are deemed a “mature minor.” A mature minor is someone under 18 who demonstrates sufficient maturity and understanding, and may be allowed to consent to care, even though the person is under the ordinary age of consent. Consult a list of consent laws in different states to learn more. Note that the age of consent may vary depending on the type of issue (e.g., concerns about school issues, minor emotional issues, drug abuse, or abortion).
When in doubt, a child—or a trusted adult who assists them—can contact a school counselor or other helping professional to find out whether they can seek help without parental notification or consent. In some school systems, for instance, students can meet with a guidance counselor or social worker without parental consent. In other school systems, they may require notification or consent. In addition to asking about parental consent, it is also useful to ask service providers about confidentiality, including what types of information may need to be shared with parents or others (Chung et al., 2024).
Youth may also consider community-based programs that do not require parental involvement. For instance, LGBTQ+ community centers may have coming-out groups for youth. Faith communities and houses of worship may have clergy who provide pastoral counseling without parental notification. Community centers may have drop-in centers for one-to-one counseling and facilitated youth groups. Schools may have peer-to-peer mentoring, conflict resolution, psychoeducational groups, or wellness programs. Medical clinics may offer certain services to youth without parental consent. For non-emergency situations, youth may call 211 for referrals to appropriate services.
Online and AI-Based Sources of Help
Youth may use technology in various ways to help them with mental health and social issues. Chat programs using artificial intelligence (AI) can be used to request information, engage in problem-solving, or have supportive discussions. But general AI programs are not specifically geared to providing services such as crisis intervention and mental health counseling, so using these tools can be risky—particularly in crisis situations. Some online tools have been created to address particular concerns, for instance, apps that facilitate mediation and stress reduction, problem-solving assistance, and information about specific concerns such as eating disorders, alcohol abuse issues, and family conflict. Given the risks that AI tools may not provide accurate and appropriate feedback and guidance, they are not substitutes for professional mental health care (Clark, 2025). Even when a youth wants to use AI or other technology for emotional support, it may be best to consult first with a mental health provider. This provider can suggest evidence-based programs and oversee their use to ensure that the youth is receiving appropriate feedback, information, and support.
Some online services can link youth with volunteers or trained mental health professionals, using text-based, video, or in-person communication. The quality of online services varies widely and can change over time. Again, it is important to know when online services may be helpful, and when it is important to seek the services of a licensed mental health professional.
Conclusion
Life can be very stressful, particularly for children and youth facing challenges at home, school, and with friends. It is important for youth to have various forms of support to help them navigate family conflicts, peer relationships, dating, bullying, distress, mental health issues, academic pressures, and other issues that may arise. Ideally, children and youth can share their concerns with their parents and jointly decide to access help from appropriate counselors or helping professionals. When children and youth have significant concerns that they do not initially want to take to their parents, it’s also important for them to know where and how they can reach out for appropriate help without parental notification and consent.
[1] To simplify the discussion, the rest of this blog refers to parents, but this term may include legal guardians such as foster parents or other family members who have legal responsibility for a minor.
