Misleading information shouldn’t distract from value of mental health bill

We are living in an era of an epidemic of mental health issues. I have been assessing, treating and referring adolescents with mental health issues for over 25 years. I have been in the school setting and private practice among others.

Misinformation abounds in the era in which we find ourselves, including in William B. Deoreo’s guest opinion from Feb. 22 regarding HB 23-1003, which would create the “Sixth Through Twelfth Grade Mental Health Assessment Act.”

First, the age of consent for and availability of mental health was actually changed from 15 years of age to 12 in April 2019 when Children’s Hospital said suicide was the leading cause of death for those from 10 to 24 years old in Colorado, noting that one in six teenagers had a diagnosable mental health condition.

The revised statute in 2019 provided confidential mental health treatment to children from 12 to 15. Permission to speak to parents requires a release of information from the adolescent, which allows the mental health provider to contact parents.

It is extremely important to note that the conditions of confidentiality (explained in a required mandatory disclosure form provided by the specialist) exclude disclosures of imminent, life-threatening harm to self or others and child physical and/ or sexual abuse. It is also important to note Mr. Deoreos’ comment about “pressure” to adolescents to maintain confidentiality is misleading. In fact, for a licensed therapist to apply “pressure” in such cases is unethical. Confidentiality has always been appropriately and stringently protected by federal and state laws, which are clearly defined.

Additionally, Mr. Deoreo misrepresents the conditions for confidentiality and reporting.

All mandatory reporters in Colorado, are required by both federal and state statutes to notify appropriate persons of lifethreatening and/or physically or sexually abusive behaviors (Colorado revised statute section 193-304). This always includes parents or legal guardians. Schools are considered “in loco parentis” (the term is Latin for “in the place of a parent”) and this refers to the legal responsibility of a person or organization to take on some of the functions and responsibilities of a parent.

While this doctrine has undergone court challenges, the court acknowledges that, in a special situation, the school officials have the authority to protect students and themselves.

It is not, as Mr. Deoreo refers to school officials, an “oligarchy.” Nor is it an “effort by the state to replace the family as the guardian of the health and welfare of children.”

Mr. Deoreo’s opinion that a child will be “coerced into consent for mental health clients” is also misleading. The principle-based ethics of coercion is usually only considered regarding involuntary admission into a hospital and, as mentioned previously, in the case of imminent, life-threatening behaviors. The four principles of ethics include respect for autonomy, nonmaleficence, beneficence and justice.

Mental disorders alone without impaired capacity do not justify (coercion) involuntary treatment, which can be considered a misuse of a licensed mental health provider’s services.

Mr. Deoreo’s reference that mental health diagnosis of gender dysphoria is a “favorite” is also troubling. The national and local data support suicidal ideation as the primary mental health issue and diagnosis. In addition, “psychoactive” drugs refer to substances that can be abused or are addictive (nicotine, caffeine, marijuana, etc.) and are not considered psychiatric medications. Psychotropic drugs refer to mental health medications. Psychologists are one of several mental health professionals in the school setting, and they, along with other mental health providers, cannot prescribe medications. Psychiatric treatments are provided in the community, not in the school K-12 setting.

“The opiate of the masses,” he refers to, as “religious indoctrination,” is not a diagnosis in the DSM-V. There is, however, a current crisis and epidemic of opioid addiction and abuse in this country. The suggestion of the “endless possibilities” for conditions and diagnoses regarding the removal of a child from her/ his home, is in fact, clearly defined in the state of Colorado, in 12 CCR 2509-3, the rule manual of child welfare services. Lastly, assessment and diagnostic questionnaires in the mental health field are predominantly, if not always, based on accuracy and data-driven support thereof.

In an era in which adolescents (and adults) are overwhelmed with and by serious issues — war, firearm violence, multiple cancer diagnoses in adolescents within our own community, school shootings, grocery store shootings, and the perils of social media — it is no wonder there are mental health issues. HB 23-1003 does not and could not address all these issues. It is, however, a very important step we can take in our own communities. I vigorously support this bill, and I encourage others to support it as well.