If your child may be in immediate danger, call 911 or go to the nearest ER. To reach a trained counselor at any hour, call or text 988 (988 Suicide & Crisis Lifeline).
Part of our guide: A Parent’s Guide to Child and Teen Mental Health
In outpatient programs licensed or operated under New York State Office of Mental Health (OMH) rules, a parent or guardian's consent is generally required for a minor's non-emergency mental health care. There are exceptions. Under Mental Hygiene Law section 33.21, a minor may receive outpatient services at those programs without that consent if specific conditions are met. OMH says psychotropic medication still requires a guardian's consent in outpatient care. Offices outside that system are a separate question, covered below.
Because the law applies differently in different settings, ask any provider how it applies to them. This is general information, based on the statute and an OMH memo. It is not legal advice, rules can change and vary by situation, and a lawyer can advise on your family's circumstances.
Who counts as a minor
Section 33.21 and OMH's August 2025 guidance define a minor as a person under 18. Some people under 18 are not treated as minors under this law and can consent to their own treatment:
- A youth who is the parent of a child
- An emancipated youth
- A married youth
- A youth on voluntary status on their own application under Mental Hygiene Law section 9.13
- A homeless youth, or a youth receiving services at certain approved runaway and homeless youth or transitional living programs
A separate law is not tied to OMH programs. Public Health Law section 2504 says a person under 18 who is the parent of a child, has married, is a homeless youth, or receives services at an approved runaway and homeless youth crisis program or transitional independent living program may consent to their own medical, dental, health and hospital services, including behavioral health services. Its list is shorter than the one above: it does not name emancipated youth or section 9.13 status.
Does this law apply to every provider?
This point is easy to miss. Section 33.21 itself defines the outpatient services it covers as those provided in an outpatient program licensed or operated under OMH regulations, and OMH says its memo does not address providers that are not licensed or operated by OMH. So neither the section's exceptions nor the memo's statements can simply be assumed to apply to an office outside that system, and neither source says what rule applies there.
Many private therapy and psychiatry offices may not be OMH programs, so a private office may have different requirements. Ask directly: "Are you OMH-licensed? When would you see a minor without a parent's consent?"
The statute also defines who counts as a mental health practitioner: a physician, a licensed psychologist, or a person providing services under a physician's supervision in a facility operated or licensed by OMH. OMH says the supervised group can include social workers, mental health counselors and others working within their scope. Being a physician or psychologist does not by itself settle the question, since the services must still fall within the program definition above.
Outpatient care without parental consent
The law starts from the view that parents or guardians should be actively involved when clinically appropriate. Under the statute and OMH's memo, a practitioner in a covered program may provide outpatient services to a minor without parental consent if both of these are true:
- The minor knowingly and voluntarily seeks the services.
- The services are clinically indicated and necessary to the minor's well-being.
And at least one of these applies:
- A parent or guardian is not reasonably available, meaning they cannot be reached with diligent efforts.
- Requiring parental consent or involvement would have a detrimental effect on the course of outpatient treatment.
- A parent or guardian has refused consent, and a physician determines that treatment is necessary and in the minor's best interests.
A minor may also meet with a practitioner without prior parental consent to find out whether these conditions are met. The statute calls for the reasons to be documented and for a statement signed by the minor in the clinical record. When treatment goes ahead because a parent refused, the statute calls for notice to the parent as clinically appropriate.
In a covered program, if the conditions are not met, OMH says New York law requires parent or guardian consent. Neither the statute's text nor the OMH memo names a minimum age for this outpatient route. Older guidance or websites may say otherwise, so check the date on anything you read.
Medication
Medication has its own rules. OMH says that in any outpatient circumstance in which psychotropic medication is recommended, the consent of the minor's legal guardian is required. OMH reads the outpatient exception above as covering services and not these medications. That comes from a memo addressed to OMH-licensed providers. The outpatient paragraph of section 33.21 does not itself name medication, so ask any prescriber outside that system how they handle consent.
For hospital care, the rules differ. A minor 16 or older admitted under minor voluntary status may consent to psychotropic medication without a parent or court order in limited situations, which generally require that the treating physician find capacity and best interests. Where a parent's consent would be harmful or a parent has refused, a second independent psychiatrist must also agree, and a parent who refused must be notified. Younger minors need a parent's consent or a court's authorization for non-emergency medication in a hospital.
Inpatient and residential care
OMH says a minor 16 or over can seek admission to a hospital, CPEP extended observation beds or a Residential Treatment Facility without parental consent if the minor is voluntarily seeking treatment and the director of the facility agrees. Minors 15 and under must have a parent or legal guardian's consent. For more on these levels of care, see when a teen needs more than weekly therapy.
Emergencies
New York's Public Health Law section 2504 allows medical, dental, health and hospital services for persons of any age without a parent's consent when, in a physician's judgment, an emergency exists, the person needs immediate medical attention, and trying to get consent would cause a delay that increases the risk to the person's life or health. In a crisis, do not hold back because of a consent question. Call 911 or go to the ER. Anyone can call or text 988. OMH also notes that outpatient services without parental consent can include an evaluation at a Comprehensive Psychiatric Emergency Program.
Substance use care has separate rules
Treatment for substance use falls under a different section, Mental Hygiene Law section 22.11. It also generally requires parental consent for inpatient, residential and outpatient treatment. Its exceptions include a physician finding that parental involvement would be detrimental, a parent refusing when a physician believes treatment is necessary for the child's best interests, and parents who cannot be located or do not respond within a reasonable time, in which case a program director may authorize treatment. If substance use is part of the picture, ask about that rule specifically. Some background is in addiction treatment for teens and young adults.
Consent is different from access to records
Agreeing to treatment and seeing the records are separate questions. Under Mental Hygiene Law section 33.16, a parent or guardian may request access to records of care for which their consent was obtained or requested, but a facility can deny access where the treating practitioner finds it would harm the practitioner's relationship with the minor, the care, or the minor's relationship with the parents. A patient over 12 may be told of the request, and if they object, the facility may deny it after consulting the treating practitioner. These rules speak to facilities, and other privacy rules may apply. This guide to teen therapy and confidentiality covers what parents are usually told.
Practical steps for parents and teens
For parents
- Ask each provider, in writing if you can: Who must sign? What happens if parents disagree or share custody? What will we be told?
- Bring any custody order or guardianship paper you have. These questions depend on your family's documents, and a lawyer may need to weigh in.
- If you refused consent or were not contacted, ask the provider what rule they followed. Staying involved usually helps, so try to keep the conversation open.
- Consider that a teen's fear about telling you may be a signal. This guide to signs your teen is struggling may help you start a conversation.
For teens reading this
- You can call or text 988 at any time.
- A school counselor, a doctor or another trusted adult can help you find care.
- You can ask a provider at the start what they can keep private and what they would have to share.
Where to read the rules yourself
The statute is at NY Senate's section 33.21 page, and the guidance is in OMH's memo on minors' rights. OMH's memo says it was updated for amendments effective August 7, 2025, so older articles may be out of date.
If your family is considering care here, ask the intake team about consent and paperwork when you request a consultation. See the child and adolescent page and fees and insurance for more.
FAQs
Can my 15-year-old start therapy without telling me?
Possibly, in a covered OMH-licensed or operated outpatient program if the conditions in the law are met. Other settings may have different requirements, so ask the provider. This is general information, not legal advice.
Can a teen get antidepressants without a parent's consent in New York?
OMH's memo to the programs it licenses says the consent of the minor's legal guardian is required when psychotropic medication is recommended in outpatient care. Different rules apply to certain hospitalized minors 16 and older. Outside those programs, ask the prescriber how they handle consent.
Do both parents have to agree?
This article's sources do not settle that. It can depend on custody orders and the provider's rules. Ask the provider, and a lawyer if there is a dispute.
