California AB 665: Minor Consent for Mental Health Care

In California, a minor who is 12 or older can consent to their own outpatient mental health treatment or counseling if the treating professional believes the minor is mature enough to participate intelligently in care. That rule, set out in Family Code Section 6924, is the core of minor consent for mental health treatment in California, and it means a young person can start therapy without a parent’s signature.¹ The same age threshold covers residential shelter services provided on a temporary or emergency basis.

The law is narrower than it sounds, though. It opens some doors and leaves others firmly closed, and the rules about parental involvement, records, and payment carry real consequences for how care actually happens.

What a Minor Can and Cannot Consent To

Section 6924 covers outpatient mental health treatment and counseling. It does not cover everything a mental health system offers. The statute explicitly excludes three things from what a minor can authorize on their own:

Psychotropic medication. A minor cannot consent to psychiatric drugs without a parent or guardian’s approval.
Convulsive therapy, including electroconvulsive treatment.
Psychosurgery.

These exclusions are written directly into the law.¹ A therapist can see a minor for talk therapy without parental involvement, but the moment a psychiatrist recommends medication, a parent or guardian has to be brought in.

Inpatient psychiatric treatment also sits outside the minor’s consent authority. Admission to a psychiatric residential treatment facility generally requires parental decision-making or court authorization.²

How the Maturity Standard Works

The statute does not spell out a checklist. It requires only that the attending professional form the opinion that the minor is “mature enough to participate intelligently” in treatment.¹ The Department of Health Care Services has confirmed that clinicians rely on their own clinical judgment to make this call.³

In practice, a clinician will usually consider whether the young person understands what therapy involves, can describe why they want help, and grasps that confidentiality has limits. This is not a formal competency hearing. A 14-year-old who walks into a community mental health clinic and coherently explains they need help with anxiety will generally clear the bar. A provider with doubts about a younger minor’s understanding should document those concerns carefully, because the maturity assessment carries legal weight if questions come up later.

The professional making that call can be employed by a government agency, an agency under contract with a government entity, a runaway shelter, a crisis resolution center, or a community-funded organization, or can be an individual provider who meets the statutory definition of a “professional person.” Assembly Bill 665, effective in July 2024, expanded that definition to include several categories of supervised trainees and associates.³

Will the Parent Be Told

The law does not simply shut parents out. Family Code Section 6924 creates a default expectation that treatment will include the minor’s parent or guardian, with one exception: the treating professional can leave the parent out after consulting with the minor and concluding that involvement would be inappropriate.¹

Whether or not the parent ends up involved, the professional has to document in the client record whether they attempted to contact the parent, whether that attempt succeeded, or why they decided contact would be inappropriate. That documentation is not optional.

Residential shelter services carry a higher notification standard. The shelter must make its best efforts to notify the parent or guardian that services are being provided.¹

Can Parents See the Records

Generally, no. Under California’s patient records statute, a parent or guardian is blocked from inspecting or copying a minor’s records in three situations: when the minor independently has a right to inspect the records, when the provider decides access would harm the therapeutic relationship or threaten the minor’s physical safety or psychological well-being, and when the records relate to services the minor lawfully consented to under statutes like Family Code Sections 6924 and 6929.⁴ A provider who withholds records faces no liability for that decision unless a court later finds bad faith.

Federal law lines up with this result. Under HIPAA, a parent is normally the minor child’s “personal representative,” but that status disappears when the minor has lawfully consented to treatment and no parental consent was required under state law. A provider may also decline to treat a parent as a personal representative when the provider reasonably believes the child has been or may be subjected to abuse, neglect, or domestic violence, or that giving the parent access could endanger the child.⁵ Where HIPAA and California law overlap, the stricter protection for the minor controls.⁶

California’s Confidentiality of Medical Information Act adds one more piece: a parent cannot authorize the release of records from treatment the minor consented to independently, and the minor themself can authorize that release.⁷

Who Pays

When a minor consents to outpatient mental health treatment without parental participation, the parent or guardian is not financially responsible for the cost. The only exception is if the parent actually participates in the counseling, and even then liability extends only to the services rendered with the parent’s participation.¹

That protection creates a practical problem. A clinic cannot bill the parents without their knowledge and participation, so a privately insured minor often has to pay out of pocket or find a sliding-scale program. An explanation of benefits sent to a parent’s insurance can inadvertently disclose the treatment, which defeats the point of confidential care. Minors on Medi-Cal usually have an easier path because Medi-Cal can cover the treatment directly.

Medi-Cal Access After AB 665

Before Assembly Bill 665 took effect on July 1, 2024, Medi-Cal had imposed an extra hurdle for minor-consent services: the professional also had to determine that involving the parent or guardian would be “inappropriate.” AB 665 removed that extra requirement so Medi-Cal now uses the same standard as the underlying statute. A minor using Medi-Cal benefits can consent to outpatient mental health treatment or counseling if the professional deems them mature enough to participate intelligently.³

AB 665 did not change the age threshold, did not extend consent to inpatient treatment or medication, and did not alter the existing rules about parental involvement or record access. It was a narrower fix than public debate sometimes suggested.

Drug and Alcohol Counseling

A separate statute, Family Code Section 6929, allows a minor 12 or older to consent to medical care and counseling related to a drug or alcohol problem. The treatment plan should include the parent or guardian if the treating professional considers it appropriate, and the clinician has to document contact attempts or explain why contact would be inappropriate. As with mental health treatment under Section 6924, the parent or guardian is not liable for payment unless they participate in counseling. One important limit: a minor cannot consent to narcotic replacement therapy such as methadone maintenance without a parent or guardian’s consent.⁸

Limits of Confidentiality

Confidentiality is strong but not absolute. A minor starting therapy should expect the clinician to explain, up front, the situations that legally require breaking it.

Mental health professionals are mandated reporters. If a therapist has knowledge of or reasonably suspects that a minor has been the victim of child abuse or neglect, the therapist must make an initial report by telephone as soon as practicably possible, followed by a written report within 36 hours. Reasonable suspicion does not require certainty. A mandated reporter who fails to report is guilty of a misdemeanor punishable by up to six months in county jail, a fine of up to $1,000, or both, and intentionally concealing the failure is treated as a continuing offense.⁹

California law also requires providers to act when a patient poses a serious threat of violence to an identifiable person or presents an imminent risk of self-harm. Those duties can mean warning potential victims, notifying law enforcement, or initiating involuntary psychiatric evaluation. And a court can order the disclosure of records or a therapist’s testimony in a legal proceeding.

How to Actually Get Care

Knowing the law and getting through the door are different things. A young person who wants confidential counseling has to find a willing provider, figure out how to pay, and get to appointments. Community mental health centers, school-based health clinics, and agencies funded by county behavioral health departments are often the most accessible starting points, and many offer sliding-scale fees or accept Medi-Cal directly.

If you are the minor, be ready for the first session to include a conversation about what stays private and what does not. If you are the provider, be ready to document the maturity assessment, log every attempt to contact a parent or guardian, and record the clinical reasoning if you conclude parental involvement would be inappropriate. That paper trail is what holds up if the treatment is ever challenged.

1
California Legislative Information. California Code, Family Code FAM 6924
2
California Legislative Information. California Welfare and Institutions Code 5585.50
3
DHCS – CA.gov. Assembly Bill (AB) 665 Implementation: Minor Consent for Outpatient Mental Health Treatment or Counseling – FAQs
4
California Legislative Information. California Health and Safety Code 123115
5
eCFR. 45 CFR 164.502
6
U.S. Department of Health & Human Services (HHS). HIPAA Privacy Rule and Sharing Information Related to Mental Health
7
California Legislative Information. California Civil Code 56.11
8
California Legislative Information. California Family Code 6929
9
California Legislative Information. California Penal Code 11166