Who has the authority to sign releases of confidential mental health information on behalf of a child?

A: Authorization for the release of confidential information varies depending on the age and placement of the child. If a child is under the age of 12 and living at home, normally the parents or legal guardian would sign the Release of Information (ROI). If a child has been removed from a parent or legal guardian, the parent or legal guardian is prohibited by law from signing the ROI, unless the juvenile court authorized this with an order that includes a finding that it would not be detrimental to the child. Unless there has been such an order, only the child’s “legal representative” can sign the ROI. Although the term legal representative is not otherwise defined by law, if the child is in foster care, the attorney for the child usually assumes that role.

If the child is age 12 or older and mature enough to participate intelligently in therapy, in the opinion of the therapist, the child is then legally able to consent to treatment. Thus, by law, the child has the right to sign an ROI concerning confidential information about their therapy. This is true even when the child is in foster care. Before signing an ROI, the child should be given an opportunity to consult with their attorney. If in the opinion of the therapist, the child is not able to participate intelligently in therapy, the rules for children under the age of 12 apply.

Those who are over the age of 18, including youth in extended foster care, may sign ROIs for release of their own confidential mental health information, unless a court has found they lack the capacity to do so.

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