Schools are trying to get more students therapy. Not all parents are on board
NEW YORK — Derry Oliver was in fifth grade when she first talked to her mother about seeing a therapist.
She lived in Georgia with her uncle and grandparents, while her mother was in New York looking for jobs and apartments before moving with the family. It was a difficult year. Oliver, now 17, felt 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 remembered thinking. ‘There’s 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 remote learning, sought help at her Brooklyn high school. School-based mental health professionals, such as social workers, may provide counseling without parental consent. 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 understood her frustrations and fears,” the younger Oliver recalls. “But at the same time, sometimes it’s best for your child to have access to this rather than withholding it from them.”
As schools across the country respond to a youth mental health crisis accelerated by the pandemic, many face the difficult legal, ethical and practical challenges of getting parents on board with treatment. The issue has become politicized, with some states seeking to streamline access while conservative politicians elsewhere propose further restrictions and accuse schools of indoctrinating students and excluding parents.
Different perspectives on mental health are not new to parents and children, but more and more conflict is arising as young people become more comfortable talking openly about mental health and treatments become more readily available. Schools have invested pre-pandemic money in hiring more mental health specialists, telehealth and online counseling to reach as many students as possible.
“It’s this disconnect,” says Chelsea Trout, a social worker at a charter school in Brooklyn. “The kids are all using TikTok or the internet and understand the language of therapy and that this is something that could be helpful for their mental health and that they are interested in but don’t have the explicit support of their parents.”
Research shows that obtaining parental consent can be a significant barrier to teens accessing treatment.
Access to therapy can be critical, especially for LGBTQ+ youth, who are significantly more likely than their peers to commit suicide, and whose parents may not know or approve of their sexual orientation or gender identity. Jessica Chock-Goldman, a social worker at Bard Early College High School in Manhattan, said she has seen many cases where mental health problems became serious, in part because teens did not get access to therapy earlier.
“Many children would be hospitalized due to suicidal thoughts or intentions because the preventive work is not paying off,” she said.
The question of when young people can consent to mental health treatment is receiving increasing attention from policymakers. States such as California and Colorado recently lowered the age of consent for treatment to 12 years old. But in some states, such as North Carolina, the issue is embroiled in larger political debates over parental input on curriculum and the rights of transgender students.
There’s also a major hurdle beyond the law: Therapy is rarely free, and paying for it or filing insurance claims often requires parental support.
Teenagers in New York can consent to therapy starting at age 16, and a provision allows doctors to approve treatment for younger children if they deem it in their best interests. But there are caveats: The consent laws only apply to outpatient facilities licensed by the state, and do not apply to prescribing medications.
New York Mayor Eric Adams recently announced a partnership with the platform Talkspace to provide free online counseling to all teens in the city, through a program known as NYC Teenspace. Insurance is not requested, but parental consent is required, “except in the case of special circumstances,” according to the program’s website.
For Oliver and her mother, years of conversations have yielded some progress, but not as much access to therapy as the younger Oliver wants.
Several years ago, the Olivers agreed to a compromise. They found a black female therapist, which 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 depression medication, which she says left her feeling like a “zombie.”
The eldest Oliver agreed that her daughter could start therapy as long as she attended the sessions. But the therapist changed jobs after about a month, and Oliver hasn’t seen another 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 Brooklyn Charter School, said she has encountered some parents who, like Oliver, don’t trust the school’s recommendations and wonder why their child would need therapy if they are succeeding academically and socially.
“When we think about predominantly Black and brown communities, if your interactions with social workers or mental health services or anything else in that area have not been positive thus far,” she said, “how can you trust them with your children?”
Statistics show a racial divide. In 2021, 14% of white children reported seeing a therapist at some point that year, compared to 9% of Black children, 8% of Hispanic children and just 3% of Asian American children, according to a survey by the Centers for Disease Control and Prevention.
Without access to therapy, the younger Oliver has sought advice on dealing with her emotions through friends, school social workers and the internet. But she is confident she could do much more with consistent professional help.
Oliver has already attended a number of universities – much to her mother’s pride – and is considering her options for next year.
One thing she is considering is how much access they provide to therapists.
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This story has been corrected to reflect that Derry lived in Georgia with her uncle and grandparents, and not her brother.
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