Washington State's Age of Consent Law for Psychiatric Treatment: Children At Risk

A 17 year old teenager I know shared with me that she had scabies. She went to get treated for it at a local medical clinic, but was refused treatment because she did not have a parent with her to provide consent.  I was immediately struck by the fact, that if she was depressed or distressed and had sought help at a  mental health clinic, she would not have needed a guardian to provide Informed Consent for treatment.  Had this teenager gone to a mental health clinic, or to an ER for help in an emotional crisis; she could have been labeled with a psychiatric diagnosis, and prescribed drugs; without a parent or guardian being informed at all. Psychotropic drugs have risks that require an individual taking the drugs be closely observed by others since a person would not always be able to recognize they are experiencing an adverse reaction.

The diagnosis and treatment for scabies is quite different from the diagnosis and treatment of emotional and behavioral difficulties.  Scabies can be objectively diagnosed based upon the presence of  a rash caused by mites, while "mental illness" is diagnosed based upon subjective opinion and observation, which is imprecise, and not scientific.  Scabies is a condition that is contagious, "mental illness" is not contagious. Since a psychiatric diagnosis is a subjective diagnosis, the same person can be labeled with totally different diagnoses by every diagnostician who assesses their symtoms. The treatment for scabies has risks which are minimal, and virtually always cure scabies. The drugs used to treat emotional and behavioral symptoms come with some very serious risks, and do not offer a cure. Conversely, psychiatric treatments have serious risks including increased suicide risk, (particularly for teenagers) with SSRI antidepressants; and neuroleptics, called  "antipsychotics" can cause akathisia, diabetes, obesity, and Tardive Dyskinesia, a neurological impairment, which can be permanent; even if a person stops taking the drug that caused it.

It seems that the Age of Consent being 13 in Washington State has intentionally or not, put children at risk. I have no doubt this law is being misused; effectively placing vulnerable children at further risk.  Are we to assume that adolescents do not need of the protection or the advice and support of a parent or guardian whose concern is primarily for their health and well-being when faced with a mental health diagnosis? Washington State Law allows an adolescent to be legally responsible for providing Informed Consent for mental health and substance abuse treatment; when the average adult would have difficulty knowing what questions to ask about the drugs being prescribed.

This Law is ill-advised primarily because it is established that humans brains are not fully developed until adulthood. Even a bright adolescent would be at a disadvantage due to lack of experience; being a kid means the balance of power puts teenagers at an even a greater disadvantage in effectively asserting their autonomy. The potential for being coerced and/or unfairly influenced by adults, particularly by adults who are often authority figures in and out of the clinical setting is incalculable; but may be profoundly greater than it is for adults. I can attest that coercion has been is used as a matter of course with impunity by the majority of mental health professionals I have dealt with over 20+ years.

How would the average teenager know what questions to ask? Making a decision to take a psychotropic drug to alter their emotions and behavior instead of learning coping skills to deal with the stresses of their day to day lives can be potentially disabling and even fatal; yet Washington State Law does not require a parent or guardian to be consulted. The law in fact prohibits their parents or guardians from being informed about prescribed drugs if a teenager does not consent. Instead of the unconditional love and support they need; kids are told they have a brain disease which requires taking teratogenic drugs to treat it. As stated by Dr. Marcia Angell, in The Illusions of Psychiatry, "At the very least, we need to stop thinking of psychoactive drugs as the best, and often the only, treatment for mental illness or emotional distress. Both psychotherapy and exercise have been shown to be as effective as drugs for depression, and their effects are longer-lasting, but unfortunately, there is no industry to push these alternatives and Americans have come to believe that pills must be more potent."

Parental Rights to protect their children, and to act in a child's best interest are effectively denied.
My rights were denied by Jon McClellan, while my son was at CSTC.  When I brought my seriously impaired son home, George Petzinger and  Philip Rodenberger, two psychiatrists at two different community mental health clinics in the community, also refused to talk about lowering the dosages of drugs each of them prescribed to my son. First prescribed to my son by Jon McClellan; the drugs were not FDA approved for pediatric use; and were known to cause permanent iatrogenic, or physician caused, diseases and impairments. Each of these three psychiatrists told me I had no say. All three used the same excuse: that I had no say because my son was over the age of 13. While at Child Study and Treatment Center, my son was told that he would not get to leave and go home if he did not take the drugs as prescribed; so naturally, he "took them willingly." George Petzinger claimed he had no idea how to lower the dosages, when I asked him; he also stated there was no one he could consult with about lowering the dosages either... Clearly, the decision to use my son as a guinea pig had been made by psychiatrists who also determined consent, informed, or otherwise was never required; an impaired adolescent's coerced assent would suffice...

Using the Age of Consent in this way is not the purpose of RCW. 71.34, as stated in RCW 71.34.010; but it is in fact used to exclude parents in standard clinical practice--I don't believe my son and I were singled out for "special treatment," or treated differently than other people.

RCW 71.34.010
Purpose — parental participation in treatment decisions — parental control of minor children during treatment.

It is the purpose of this chapter to assure that minors in need of mental health care and treatment receive an appropriate continuum of culturally relevant care and treatment, including prevention and early intervention, self-directed care, parent-directed care, and involuntary treatment. To facilitate the continuum of care and treatment to minors in out-of-home placements, all divisions of the department that provide mental health services to minors shall jointly plan and deliver those services.

It is also the purpose of this chapter to protect the rights of minors against needless hospitalization and deprivations of liberty and to enable treatment decisions to be made in response to clinical needs in accordance with sound professional judgment. The mental health care and treatment providers shall encourage the use of voluntary services and, whenever clinically appropriate, the providers shall offer less restrictive alternatives to inpatient treatment. Additionally, all mental health care and treatment providers shall assure that minors' parents are given an opportunity to participate in the treatment decisions for their minor children. The mental health care and treatment providers shall, to the extent possible, offer services that involve minors' parents or family.

It is also the purpose of this chapter to assure the ability of parents to exercise reasonable, compassionate care and control of their minor children when there is a medical necessity for treatment and without the requirement of filing a petition under this chapter.(emphasis mine)
[1998 c 296 § 7; 1992 c 205 § 302; 1985 c 354 § 1.]

via The New York Review of Books:

The Illusions of Psychiatry
the final paragraph:
"In particular, we need to rethink the care of troubled children. Here the problem is often troubled families in troubled circumstances. Treatment directed at these environmental conditions—such as one-on-one tutoring to help parents cope or after-school centers for the children—should be studied and compared with drug treatment. In the long run, such alternatives would probably be less expensive. Our reliance on psychoactive drugs, seemingly for all of life’s discontents, tends to close off other options. In view of the risks and questionable long-term effectiveness of drugs, we need to do better. Above all, we should remember the time-honored medical dictum: first, do no harm (primum non nocere)."    Marcia Angell, M.D. 

A final note: State Law also states that a juvenile's request to no longer assent or consent to taking psychotropic drugs must be in writing---my son repeatedly stated to Child Study and Treatment staff that he did not want to take the drugs; he was ignored. It is a reprehensible really, all things considered. The profound deleterious effects of the drugs Jon McClellan prescribed without Informed Consent almost totally incapacitated my son, he could barely walk or talk; and he couldn't hold up his head. There is no way in hell he could have written a statement...

portions of this post originally published on 1-27-2011 "Washington State Age of Consent Puts Children At Risk"
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