Should youths need parental consent to seek mental health support?

Youths, parents and mental health practitioners weigh the benefits and risks of parental involvement, as Singapore considers how consent rules can better support young people seeking mental health care.

Sarah (not her real name), 17, believes youths should have greater control over whether their parents are informed about their mental health care. (Photo: CNA/Wallace Woon)

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SINGAPORE: For 17-year-old Alice (not her real name), seeking mental health support meant having to involve the very people who had dismissed her struggles.

Alice, who has been dealing with an eating disorder and anxiety for years, was on the verge of tears when she realised she needed her parents' consent to attend a mental health programme for youths this year.

Her parents downplayed her difficulties, telling her to “just be happy”, she said. "They are 'old school', so they feel anything related to mental health is just fake. (They think) 'It's all in your mindset, you're just faking it for attention'," she said.

Alice’s experience highlights a wider concern among youths and mental health practitioners that parental consent requirements can deter young people from seeking help, particularly when their parents themselves may be contributing to their distress.

While parental involvement remains important in supporting a child’s mental health, they told CNA that a more flexible approach is needed to ensure vulnerable youths can access care.

Health Minister Ong Ye Kung said on Oct 10 that parental consent requirements can be a barrier to young people seeking mental health support, especially those uncomfortable discussing their struggles with their parents.

He called for "a balanced approach" that lets young people seek help first and involves their families appropriately as care progresses.

The Singapore Medical Council is revising its ethical guidelines to give doctors clearer guidance on parental consent, allowing them to proceed with treatment if it is in the patient's best interests, said Mr Ong. The Ministry of Health is also developing guidelines on parental consent for various service providers.

For Alice, having to involve her parents made seeking help even harder.

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Though parental involvement can support a young person's mental health, youths and experts say requiring consent could deter those who need help from seeking it. (Photo: iStock)

"Someone is already so vulnerable and you're telling them, 'I need to inform your parents about this'. Then it makes the youth feel like, why did I even ask for help in the first place?" she said.

"I feel like it should really be up to the youth. If they want their parents to be involved, then go ahead. If they don't want to, you have to find another way to compromise.”

UNEVEN ACROSS SETTINGS

Parental consent requirements for youth mental health services vary across settings, leaving young people facing different rules depending on where they seek help.

For instance, callers to the national mindline 1771 can stay anonymous and community-based providers generally do not insist on parental consent before offering support. Schools, however, are more likely to require it because of their emphasis on strong partnerships with families.

Dr Jonathan Kuek, a mental health researcher and lecturer at the Singapore University of Social Sciences (SUSS), said most mental health professionals seek parental consent for clients under 18, given the absence of a general statutory age for medical consent.

Practitioners may exercise discretion depending on the circumstances, taking into account a youth's reluctance to involve their parents, the risk of their condition worsening if care is withheld, and safety concerns such as self-harm or abuse.

Some also use assessments such as the Gillick competence test, which evaluates whether a child under 16 has sufficient maturity and understanding to consent to medical treatment independently – taking into account the risk and complexity of the procedure.

At ImPossible Psychological Services, all clients under 18 must obtain parental consent, said its founder and senior clinical psychologist Muhammad Haikal Jamil.

He said parental involvement can be important because progress made during therapy may be difficult to sustain if a child's home environment remains unchanged.

"Below a certain age, it's good to have the parents involved because if in therapy, we address their negative beliefs and all. But when they go home and the environment is the same, it's not going to be beneficial for the kids," said Mr Haikal.

He added that parents typically join at the end of the first session, while those with older children may receive updates every five sessions as their child continues therapy independently.

Mr Haikal also cautioned that allowing youths to access mental health services without parental involvement could expose them to unethical practices, given the limited regulatory oversight of Singapore’s counselling and psychology sectors .

Yet other practitioners said that requiring consent in every case could shut out some of the most vulnerable youths.

Ms Ooi Sze Jin, founder and psychologist at A Kind Place, said many of her clients wait until they turn 18 to seek help, as they do not want their parents to know about or interfere with their treatment.

"We need to recognise that sometimes, the parents themselves may be contributing to the child's distress,” she said.

“If we require parental consent in every situation, we might end up preventing the very children who need help from accessing it.”

Some mental health organisations have adopted more flexible approaches, providing initial support without parental involvement in certain cases while working towards bringing families in where appropriate.

Mental health charity Limitless, which has supported more than 6,000 youths over the past decade, was among the early organisations to pilot support without mandatory parental consent.

Its executive director Asher Low said parental consent is required for children under 14, in line with protections under the Children and Young Persons Act.

For those aged 14 to 17, the organisation first tries to obtain consent.

Where youths are unable or unwilling to involve their parents for valid reasons – such as abuse or an increased risk of harm – practitioners use the Gillick competence test to assess their maturity and ability to consent independently.

Executive director of youth mental health organisation Limitless Asher Low on Oct 27, 2026. (Photo: CNA/Wallace Woon)

Ms Ling Anne Hsieh, co-founder of non-profit organisation Project Green Ribbon, said parental consent can deter youths from troubled family backgrounds from seeking help, particularly if they fear their parents will use their struggles against them.

The organisation provides initial support to youths in crisis without making parental consent a prerequisite, while working with social service agencies to involve families where appropriate.

Natasha (not her real name), a 17-year-old who ran away from home because her father was physically abusive, received immediate support from Project Green Ribbon without her parents' involvement.

"If my parents were to get involved, I don't really think it would be helpful … because they are hard to talk to and they'd fight back. Plus they will be mad and disappointed," she said.

At Impart, a non-profit organisation working with youths facing adversity, practitioners explain confidentiality and its limits to young people, and may provide initial support without immediately involving their parents, said Dr Raksha Kartik, outgoing head of its mental health arm and a clinical psychologist.

"For some of our youths, the question 'Will you inform my parents?' comes even before 'Can someone help me?' If that first question isn’t answered clearly and honestly, youths tend to shy away from continuing the conversation with the triage workers."

Where risks are minimal, Impart works towards securing parental consent, said Dr Kartik. If involving a parent could put a youth's safety at risk, practitioners will instead turn to other trusted adults for support.

WHAT YOUTHS AND PARENTS WANT

Some youths may be reluctant to tell their parents about their mental health struggles for fear of being judged or dismissed, burdening their families or worsening tensions at home.

Seventeen-year-old Sarah (not her real name) stopped going to school and skipped classes this year as she felt "really sick" and anxious every day. When her grades began to slip, her teachers spoke to her father about her mental health, but Sarah felt he was unsupportive.

"He said, 'It's nothing that I've not gone through. Why are you making such a big hassle about it?'," she recalled.

When she wanted to attend a mental health programme, Sarah (not her real name) worried that her parents’ “bad impression” of mental health issues would make things harder at home (Photo: CNA/Wallace Woon).

When she wanted to attend a mental health programme at Impart, Sarah approached an adult former coworker to sign the consent form instead, worried that her parents’ “bad impression” of mental health issues would make things harder at home.

Impart eventually facilitated a conversation with her parents and got their consent for her to attend programmes, including those focused on coping skills to manage emotions.

Even so, Sarah believes youths should have greater control over whether their parents are informed about their mental health care. “If the child doesn't feel comfortable, it's going to be hard for them to open up," she said.

Even youths with supportive parents may prefer to seek help privately.

Leon (not his real name), now a 25-year-old undergraduate, told his parents about his depression and anxiety partly because he needed their financial support for treatment.

He still feels young people should have "complete privacy" when seeking support, except where self-harm or safety concerns are involved.

"I found it helpful to work on myself first without their involvement. Speaking to someone new also gave me an opportunity to start fresh, without feeling judged," he said.

Some parents acknowledged that requiring their consent from the outset could discourage youths from getting help, even as they expressed a desire to be involved in their children’s care.

Ms Moonlake Lee, a mother of two and CEO of Transforming Lives, a social enterprise focusing on neurodiversity, said she would rather her child seek qualified mental health support than "suffer in silence" if they are not ready to confide in her.

"Wanting to be involved and insisting on being involved from the outset are two different things. My priority is that my child gets help, even if I am not the first person they turn to," she added.

Parents interviewed agreed that they hope to be informed if their children faced significant risks of self-harm, serious deterioration in mental health or other safety concerns.

Parent coach Joline Lim, a mother of two, said she would want to be as involved as possible in her child's decision to seek professional help. Beyond offering emotional and financial support, parents can also help assess whether a professional is suited to their child's needs, she added.

"Not every child has a safe adult, or adults who are able to support their distress," said the 41-year-old. “Even in a loving family, a child might worry about upsetting their parents, being judged or adding to their stress.”

Rather than applying the same parental consent requirements across all mental health services, observers called for clearer guidelines that take into account a young person's maturity, safety and the level of care required.

They also suggested that a formal process for nominating a trusted adult, such as a sibling or relative, could help youths from unsafe homes access support without involving their parents.

Dr Kuek from SUSS said practitioners currently operate in a "grey zone" across schools, community agencies and hospitals, with some concerned about complaints from parents or potential legal liability if they provide support without consent.

He recommended aligning consent requirements with Singapore's four-tier mental health care model, allowing youths under 18 to access lower-risk services such as basic counselling and mental health screening without parental consent.

RESIGNATING IMH AS A NATIONAL SPECIALITY CENTRE

In a message marking World Mental Health Day on Oct 10, Health Minister Ong Ye Kung announced that the Institute of Mental Health (IMH) will be expanded and redeveloped at its current site by 2040 , as Singapore boosts its capacity to meet demand for mental healthcare.

IMH will also be redesignated as a national specialty centre and renamed the National Centre for Mental Health Singapore in 2027.

Ms Ooi Sze Jin, founder and clinical psychologist at A Kind Place, welcomed the move, saying it could help reduce the stigma surrounding mental health.

"The word 'institute' may give some people the impression of a place where people are sent because something is wrong with them, or a place that feels cold and institutional," she said.

By positioning it as a specialised medical facility, the move could help normalise mental healthcare and make people less hesitant to seek help, she added.

Mental health researcher Jonathan Kuek of the Singapore University of Social Sciences said there is still "too little information" to determine how the redesignation would affect IMH's existing services.

However, he noted the changes so far are promising, potentially paving the way for expanded services and better funding for a wide range of mental health research in Singapore.

The move could also lead to improvements in the training and deployment of professionals to meet the sector’s evolving needs, said Dr Kuek.

"But I hope these changes go beyond symbolism and that the new centre is empowered, with more oversight and power, to direct and effect changes in how mental healthcare is provided at a tertiary level.”

For more structured psychotherapy, those assessed to have sufficient maturity and understanding could begin treatment independently, although practitioners should work towards involving a parent or trusted adult, said Dr Kuek.

Parental consent should remain the default for higher-risk psychiatric treatments, including medication and hospitalisation, with exceptions where parents cannot be contacted or refuse urgent care out of stigma, he noted.

"It's also important to remember that escalation in severity or risk can also happen quite rapidly within lower tier services, and proper channels of handover and updating of consent should be in place as well," said Dr Kuek.

He also flagged the lack of mandatory statutory regulation of psychologists and counsellors as a "critical blind spot". Easing parental consent requirements should go hand in hand with stronger regulation to protect vulnerable youths from unqualified practitioners, he said.

Mr Low from Limitless said the guidelines should also provide greater clarity and legal protection for practitioners who may otherwise hesitate to intervene without parental consent.

"When we think about the safety of clients, involving the parents is not always the solution. It's not always that (having parents involved) equals to safe,” he added.

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新加坡正在考虑如何通过同意规则更好地支持寻求心理健康护理的年轻人，青少年、家长和心理健康从业人员正在权衡家长参与的好处和风险。

17岁的莎拉（化名）认为，青少年应该对父母是否了解自己的心理健康状况拥有更大的自主权。（图片：CNA/Wallace Woon）

这段音频由人工智能工具生成。

新加坡：对于 17 岁的 Alice（化名）来说，寻求心理健康支持意味着不得不与那些曾经对她的困境不屑一顾的人打交道。

多年来一直饱受饮食失调和焦虑症困扰的爱丽丝，在意识到自己今年需要父母的同意才能参加青少年心理健康项目时，几乎要哭出来了。

她说，她的父母轻描淡写地看待她的困难，告诉她“开心点就好”。“他们思想很老派，觉得任何跟心理健康有关的事情都是装的。（他们认为）‘这都是你心态问题，你只是为了博取关注才装的’，”她说。

爱丽丝的经历凸显了青少年和心理健康从业者普遍担忧的问题，即父母同意的要求可能会阻碍年轻人寻求帮助，尤其是当他们的父母本身可能加剧他们的痛苦时。

虽然家长的参与对支持孩子的心理健康仍然很重要，但他们告诉 CNA，需要采取更灵活的方式来确保弱势青少年能够获得护理。

卫生部长王乙康于10月10日表示，父母同意的要求可能会成为年轻人寻求心理健康支持的障碍，尤其是那些不愿与父母讨论自己困境的年轻人。

他呼吁采取“平衡的方法”，让年轻人首先寻求帮助，并在治疗过程中适当地让他们的家人参与进来。

王先生表示，新加坡医学理事会正在修订其伦理准则，以便为医生提供更清晰的家长同意指导，允许他们在符合患者最佳利益的情况下继续进行治疗。卫生部也在为各类医疗服务提供者制定家长同意指南。

对爱丽丝来说，不得不让父母参与进来，反而让寻求帮助变得更加困难。

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虽然父母的参与有助于青少年的心理健康，但青少年和专家表示，要求父母同意可能会阻碍那些需要帮助的人寻求帮助。（图片：iStock）

“一个人本来就非常脆弱，你却告诉他‘我需要把这件事告诉你的父母’。这会让年轻人觉得，我当初为什么要寻求帮助呢？”她说道。

“我觉得这应该完全由年轻人自己决定。如果他们希望父母参与，那就让他们参与。如果他们不愿意，那就得找到其他折衷的办法。”

不同设置下的表现不均衡

不同机构对青少年心理健康服务的家长同意要求各不相同，导致青少年在寻求帮助的不同地点面临不同的规则。

例如，拨打全国心理健康热线1771的来电者可以保持匿名，社区服务机构通常不会在提供支持前坚持要求获得家长同意。然而，学校由于重视与家庭建立紧密的合作关系，更有可能要求获得家长同意。

新加坡社会科学大学 (SUSS) 心理健康研究员兼讲师郭乔纳森博士表示，鉴于目前没有关于医疗同意的法定年龄，大多数心理健康专业人士都会为 18 岁以下的客户寻求父母的同意。

根据具体情况，从业人员可以酌情决定，考虑到青少年不愿让父母参与、如果停止治疗病情可能会恶化，以及自残或虐待等安全问题。

有些人还会使用吉利克能力测试等评估方法，该测试评估 16 岁以下的儿童是否具有足够的成熟度和理解力，能够独立同意接受医疗治疗——同时考虑到手术的风险和复杂性。

ImpPossible心理服务中心的创始人兼高级临床心理学家穆罕默德·海卡尔·贾米尔表示，该中心所有18岁以下的客户都必须获得父母的同意。

他表示，家长的参与非常重要，因为如果孩子的家庭环境保持不变，治疗期间取得的进步可能难以维持。

海卡尔先生说：“在一定年龄以下，让父母参与进来是件好事，因为在治疗过程中，我们可以解决他们的负面想法等等。但是当他们回家后，环境依旧如此，这对孩子就没有好处了。”

他还补充说，家长通常会在第一节课结束时加入，而对于年龄较大的孩子，家长可能会每五节课收到一次更新，因为他们的孩子将继续独立接受治疗。

海卡尔先生还警告说，鉴于新加坡咨询和心理学领域的监管有限，允许青少年在没有父母参与的情况下获得心理健康服务可能会使他们接触到不道德的做法。

但也有一些从业者表示，要求每例病例都必须获得同意可能会将一些最弱势的青少年排除在外。

A Kind Place 的创始人兼心理学家 Ooi Sze Jin 女士表示，她的许多客户等到 18 岁才寻求帮助，因为他们不想让父母知道或干预他们的治疗。

“我们需要认识到，有时候，父母自身也可能加剧孩子的痛苦，”她说。

“如果我们要求每一种情况下都必须获得父母的同意，最终可能会阻止那些真正需要帮助的孩子获得帮助。”

一些心理健康机构采取了更灵活的方法，在某些情况下提供初步支持而无需父母参与，同时努力在适当的时候让家庭参与进来。

在过去十年中为 6000 多名青少年提供支持的心理健康慈善机构 Limitless，是最早一批在无需强制父母同意的情况下试点提供支持的机构之一。

其执行董事阿舍尔·洛表示，根据《儿童和青少年法》的保护规定，14 岁以下儿童需要获得父母同意。

对于 14 至 17 岁的人，该组织首先会尝试获得他们的同意。

如果青少年由于正当理由（例如遭受虐待或面临更大的伤害风险）而无法或不愿让父母参与，从业人员会使用吉利克能力测试来评估他们的成熟度和独立同意的能力。

2026年10月27日，青年心理健康机构Limitless的执行董事Asher Low。（图片：CNA/Wallace Woon）

非营利组织“绿色丝带计划”的联合创始人凌安妮·谢女士表示，父母的同意可能会阻碍来自问题家庭背景的青少年寻求帮助，特别是如果他们担心父母会利用他们的困境来对付他们。

该组织为处于危机中的青少年提供初步支持，不以父母同意为前提条件，同时与社会服务机构合作，在适当情况下让家庭参与其中。

娜塔莎（化名）是一名 17 岁的女孩，因为父亲对她进行身体虐待而离家出走。在没有父母参与的情况下，她立即得到了“绿色丝带计划”的支持。

“如果我父母介入，我觉得不会有什么帮助……因为跟他们沟通很难，他们肯定会反驳。而且他们还会生气和失望，”她说。

Impart 是一家与面临逆境的青少年合作的非营利组织，该组织的从业人员会向年轻人解释保密性及其局限性，并可能在不立即让他们的父母参与的情况下提供初步支持。即将卸任的心理健康部门负责人、临床心理学家 Raksha Kartik 博士说道。

“对于我们的一些青少年来说，‘你会通知我的父母吗？’这个问题甚至比‘有人能帮帮我吗？’这个问题出现得更早。如果第一个问题没有得到明确和诚实的回答，青少年往往会回避继续与急救人员交谈。”

卡尔蒂克博士表示，在风险极低的情况下，Impart会努力争取获得家长的同意。如果让家长参与可能会危及青少年的安全，从业人员则会寻求其他值得信赖的成年人的支持。

青少年和家长想要什么

有些青少年可能不愿告诉父母自己的心理健康问题，因为害怕被评判或忽视，给家人带来负担或加剧家庭紧张关系。

十七岁的莎拉（化名）今年辍学逃课，因为她每天都感觉“非常不舒服”且焦虑不安。当她的成绩开始下滑时，老师们就她的心理健康问题与她的父亲进行了沟通，但莎拉觉得父亲并不支持她。

她回忆说：“他说，‘这没什么我没经历过的。你为什么这么大惊小怪呢？’”

当莎拉（化名）想参加心理健康课程时，她担心父母对心理健康问题的“不良印象”会使家里的情况更加艰难（照片：CNA/Wallace Woon）。

当莎拉想参加 Impart 的心理健康项目时，她找了一位成年的前同事代为签署同意书，因为她担心父母对心理健康问题的“不良印象”会让家里的情况更加糟糕。

Impart 最终促成了她与父母的对话，并获得了他们的同意，让她参加各种项目，包括那些专注于应对情绪的技巧项目。

即便如此，莎拉认为青少年应该对父母是否了解自己的心理健康状况拥有更大的自主权。“如果孩子感到不自在，他们就很难敞开心扉，”她说。

即使是拥有支持型父母的青少年，也可能更倾向于私下寻求帮助。

现年 25 岁、是一名本科生的莱昂（化名）向父母坦白了自己的抑郁症和焦虑症，部分原因是需要他们的经济支持进行治疗。

他仍然认为，年轻人寻求帮助时应该享有“完全的隐私”，除非涉及自残或安全问题。

他说：“我发现先独自反思自己很有帮助。和陌生人交谈也让我有机会重新开始，而不用担心被评判。”

一些家长承认，从一开始就要求他们同意可能会阻碍青少年寻求帮助，即使他们表达了参与子女护理的愿望。

身为两个孩子母亲，同时也是专注于神经多样性的社会企业“改变生活”的首席执行官李月湖女士表示，如果孩子还没有准备好向她倾诉，她宁愿他们寻求合格的心理健康支持，也不愿让他们“默默承受痛苦”。

“想要参与和坚持从一开始就参与是两回事。我的首要任务是让我的孩子得到帮助，即使我不是他们第一个求助的人，”她补充道。

接受采访的家长们一致认为，如果他们的孩子面临严重的自残风险、精神健康状况严重恶化或其他安全问题，他们希望能够得到通知。

身为两个孩子母亲的家长教练乔琳·林表示，她希望尽可能多地参与孩子寻求专业帮助的决定。她补充说，除了提供情感和经济支持外，家长还可以帮助评估专业人士是否适合孩子的需求。

这位41岁的女士说：“并非每个孩子都能拥有一个可以信赖的成年人，或者能够帮助他们应对困境的成年人。即使在充满爱的家庭中，孩子也可能担心惹父母生气、被评判或加重他们的压力。”

观察人士呼吁，与其在所有心理健康服务中采用相同的家长同意要求，不如制定更清晰的指导方针，考虑到年轻人的成熟度、安全以及所需的护理水平。

他们还建议，通过正式的程序提名一位值得信赖的成年人，例如兄弟姐妹或亲戚，可以帮助来自不安全家庭的青少年在不让父母参与的情况下获得支持。

新跃社科大学郭医生表示，目前从业人员在学校、社区机构和医院之间处于“灰色地带”，一些人担心如果在未经同意的情况下提供支持，可能会遭到家长的投诉或承担潜在的法律责任。

他建议将同意要求与新加坡的四级心理健康护理模式保持一致，允许 18 岁以下的青少年在没有父母同意的情况下获得风险较低的服务，例如基本咨询和心理健康筛查。

取消心理卫生学院作为国家专科中心的资格

在10月10日世界精神卫生日之际，卫生部长王乙康发表致辞宣布，新加坡将在2040年前扩建和重建心理卫生学院（IMH），以提高其满足精神卫生保健需求的能力。

2027 年，IMH 将被重新指定为国家专科中心，并更名为新加坡国家心理健康中心。

A Kind Place 的创始人兼临床心理学家 Ooi Sze Jin 女士对这一举措表示欢迎，称这有助于减少人们对心理健康的偏见。

她说：“‘研究所’这个词可能会让一些人觉得，这里是一个把有缺陷的人送来的地方，或者是一个冷冰冰、官僚主义的地方。”

她补充说，通过将其定位为专门的医疗机构，此举有助于使心理健康保健正常化，并让人们在寻求帮助时不再犹豫。

新加坡社会科学大学心理健康研究员郭建国表示，目前“信息仍然太少”，无法确定重新指定将如何影响心理卫生学院现有的服务。

但他指出，目前为止的变化令人鼓舞，有可能为新加坡扩大心理健康服务范围和为各种心理健康研究提供更好的资金铺平道路。

郭博士表示，此举还有助于改进专业人员的培训和部署，以满足该行业不断变化的需求。

“但我希望这些改变不仅仅是象征性的，而是赋予新中心更大的权力和监督权，以指导和改变三级精神卫生保健的提供方式。”

Kuek 博士表示，对于更结构化的心理治疗，经评估认为具有足够成熟度和理解力的人可以独立开始治疗，但从业人员应该努力让家长或值得信赖的成年人参与其中。

他指出，对于高风险的精神治疗，包括药物治疗和住院治疗，应默认获得父母同意，但如果无法联系到父母，或者父母因耻辱感而拒绝紧急护理，则不在此限。

“同样重要的是要记住，在较低级别的服务中，病情严重程度或风险也可能迅速升级，因此也应该建立适当的交接渠道和更新知情同意书的机制，”郭医生说。

他还指出，目前缺乏对心理学家和咨询师的强制性法律监管是一个“严重的盲点”。他表示，放宽家长同意要求的同时，也应加强监管，以保护弱势青少年免受不合格从业者的侵害。

Limitless 公司的 Low 先生表示，这些指导方针还应为从业人员提供更清晰的指导和法律保护，否则他们可能会在没有父母同意的情况下犹豫是否介入。

“当我们考虑客户安全时，让家长参与并不总是解决办法。家长参与并不总是等同于安全，”他补充道。

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