Adolescent (12-17 years)

This documentation provides extracts from relevant sections of the National PHN Guidance - Initial Assessment and Referral for Mental Health Care; Section 2 Section 2 – Adolescent Lift Out (12-17 years) (to be published) which has been designed to assist general practitioners and clinicians to recommend the most appropriate level of care for an adolescent seeking or requiring mental health support. The adolescent version focuses on adolescents aged 12-17 years of age.

Whilst the Guidance uses age to indicate the overall appropriateness of each tool, the final decision about the most appropriate version is based on the clinical judgment of the user, taking into account contextual and developmental considerations.

Practice point – informed consent

Clinicians have legal and ethical obligations to obtain informed consent before performing any healthcare intervention. To give informed consent, a person (or the person making decisions for them if they cannot make decisions for themselves) should be sufficiently informed of the risks and benefits of any treatment (including, where relevant, the risk associated with no treatment).

The process of gaining consent for the treatment of children and adolescents (under the age of 18) differs significantly from that of adults and is more complex and varied. In some instances, consent must be given by the relevant parent or guardian, whereas in others, it may be possible for a person under 18 who is a ‘mature minor’ to give consent. A mature minor is a child or adolescent assessed as having the capacity to make specific decisions based on various factors, including the nature of the treatment, age, maturity, medical/social history, degree of independence, understanding, and intelligence. If a child or adolescent is a mature minor, consent for treatment is not required from a parent or guardian.

Depending on the circumstances, involvement of both the parent/guardian and a child/adolescent in providing consent for assessment, referral and intervention can be preferable.

Where, on balance, the risk of engagement of the parent will lead to a potential negative impact on the child or adolescent, consideration may need to be given to the involvement of an alternative guardian if the child or adolescent is not a mature minor and cannot make treatment decisions for themselves.

Some states or territories have specific legislation governing the informed consent of children and adolescents in healthcare. It is the responsibility of all healthcare providers to know and understand their legal obligations in whichever state or territory they are practising. For further information, consult your state/territory legislation and/or consult your professional indemnity insurer or professional association.