New Mexico

Teens and Mental Health Consent in New Mexico: What Changes at 14

By Dr. Stacey Forbes, DNP, APRN, PMHNP-BC

Parents moving to New Mexico, or raising teenagers here, are often surprised to learn how much say a young person has over their own mental health care. At 14, the law treats a teenager as able to agree to counseling and even to medication without a parent signing first. That can feel unsettling to a parent and freeing to a teenager. Understanding what the law actually says — and what it asks of clinicians — makes it much easier for a family to use it well.

What a 14-year-old can consent to

NMSA 32A-6A-15, part of the Children’s Mental Health and Developmental Disabilities Act, allows a child 14 or older to consent to a wide range of treatment without the consent of a legal custodian: individual and group psychotherapy, guidance counseling, case management, behavioral therapy, family therapy, counseling, substance abuse treatment, and other forms of verbal treatment that do not involve aversive interventions.

That is a real difference from some neighbouring states. In Texas, for instance, a minor can consent to counseling only in narrow circumstances, and psychiatric medication generally requires a parent — see the Texas guide for comparison.

Medication at 14 and older

The same section addresses psychotropic medication directly. It may be given to a child 14 or older with that child’s informed consent. When it is, the clinician must notify the child’s legal custodian. So a teenager can agree to start a medication, but a parent or guardian will not be kept unaware that medication has been prescribed.

In practice, medication for a teenager works best with an adult at home who knows what to watch for, particularly in the first weeks. Many teens who can legally consent alone still choose to involve a parent once they understand why that helps. A clinician’s job is to make that conversation possible, not to force it.

Under 14: the parent consents, with one exception

For a child under 14, NMSA 32A-6A-14 requires the informed consent of a legal custodian before treatment, including psychotherapy or psychotropic medication. There is an important exception designed for children who reach out on their own: a child under 14 may receive an initial assessment and medically necessary early-intervention services limited to verbal therapy, without a custodian’s consent, for no longer than two calendar weeks. That window lets a clinician meet the child and work out what needs to happen next.

The same section requires a clinician who at any time has a reasonable suspicion that the child is abused or neglected to make a child abuse and neglect report immediately. A child who seeks help because something is wrong at home is therefore not left alone with it.

Family involvement is still the goal

It would be easy to read these rules as shutting parents out. They do not. The Act directs clinicians to promote the healthy involvement of a child’s legal custodians and family members in developing and carrying out the treatment plan, while respecting the rights the law gives an adolescent. The best outcomes usually come from agreeing the ground rules early and out loud.

• What the teen shares that stays private, and what a parent will be told
• How safety concerns are handled — these are shared
• Whether a parent joins part of each appointment, or only some
• How medication decisions are discussed at home

Where telehealth helps

For a teenager in a small town, the most private appointment is one taken from their own room rather than a waiting room where a neighbour might be sitting. Telehealth also makes it easier for a working parent to join part of a visit without taking a day off. Willow & Stone offers teen and adolescent psychiatry by telehealth to patients located in New Mexico.

Common Questions

Sources & Further Reading

• NMSA 32A-6A-15 — Consent for Services; Children Fourteen or Older
• NMSA 32A-6A-14 — Consent for Services; Children Under Fourteen
• New Mexico CYFD — Children’s Code (official compilation)
• NIMH — Child and Adolescent Mental Health
• New Mexico Crisis and Access Line