Information on Consent
At Independence Counselling, we follow the provincial guidelines and consent legislation regarding a child/youth’s right to have their mental health decisions respected. In Nova Scotia, the age of majority is 19 years old; any person under this age is considered a minor. However, there is no law that grants or denies any decision-making entitlement to minors; therefore, if they are able to understand the risks and benefits, they are legally entitled to make decisions regarding their own health care.
What is Informed Consent?
-
It must be provided by the individual
-
It must be knowledgeable and the individual must have all relevant information to make an informed decision
-
It must be related to the specific information at issue
-
It must be voluntary
-
It must be ongoing (and can be revoked at any time)
What is Capacity to Consent?
For the consent of an individual to be valid, it must first be determined that said individual has the capacity to consent. In the context of The Personal Health Information Act (PHIA), capacity refers to:
-
the ability to understand information that is relevant to the making of a decision related to the collection, use or disclosure of personal health information, and
-
the ability to appreciate the reasonably foreseeable consequences of a decision or a lack of a decision. (Section 3(b))
PHIA recognizes the common-law principle of “mature minors,” which recognizes that the capacity to consent is both incremental and situational. The capacity of each individual minor must be considered in the context of each episode of care. For example:
-
A 17-year-old may have the capacity to consent to (or withhold) disclosure of information related to one issue while lacking the capacity to consent to disclosure related to another.
Read more about PHIA Consent, Capacity, and Substitute Decision Makers (.pdf) >>
In Nova Scotia, as there is no set age a child/youth must reach before they are able to provide consent for treatment, assessment or release of information; instead, the clinician/therapist must determine, on a case-by-case basis, whether the child/youth is capable of making an informed decision.
Factors to be considered include: emotional regulation, ability to self-reflect, ability to place peer influences and age specific values in perspective, ability to learn from experiences and willingness to seek advice. They must be able to understand the nature and purpose of the treatment and/or assessment and the consequences of giving or refusing consent.
What does this mean for my teen's therapy?
Generally speaking, the younger your child, the more involved you will likely be in the treatment. To the best of our abilities, we want parents to see themselves as part of their child’s treatment team. However, it also means that your older child or teen may have the legal right to refuse to engage in treatment. It may mean that they have the legal right to request a different kind of treatment than the one you would prefer, or that they have the legal right to refuse to consent to us talking to you about their treatment.
Practically speaking, we manage this by trying to engage our youth clients actively in the decision-making around their treatment. We do this from the beginning. During intake, we will speak with your teen as well as speak with you, to find out how they view the problem and what goals they have for therapy or assessment. This results in youth who are much more engaged, and in better therapeutic outcomes. This doesn’t mean you as a parent are left out! Our clinicians understand the importance of family for the well-being and progress of all teens, and we endeavour to include parents as much as possible in your child’s treatment, where and when appropriate.
