As more Alabama schools prepare to bulk up mental health supports this year, parents can expect one more task to add to their back-to-school list: counseling permission slips.
And if parents don’t sign them, some districts warn, their child might not receive one-on-one counseling, crisis intervention or academic and career guidance.
“Without this form, most mental health and guidance services will not be provided to your child unless there is an imminent threat to the health of the student or others or when your child meets with guidance counselors solely related to course selection, course registration, or similar activities,” read one form, distributed to Huntsville parents last weak.
Another form, from Shelby County Schools, asks parents of children younger than 14 to opt in to various counseling services, such as classroom lessons on academic planning or career exploration, small group guidance, mentoring programs and surveys and assessments related to “behaviors and feelings.”
The changes follow a June directive from the Alabama State Department of Education, which requires schools seeking mental health funding to develop opt in and opt out policies for parents of students seeking counseling services.
Worried the new guidance could prevent students from receiving life-saving services, Birmingham school leaders decided to delay a vote on a new policy until they could get more stakeholders at the table.
“We’re dealing with the urgency of now,” board member Neonta Williams said in policy committee aired by WVTM News on Monday.
According to the National Alliance on Mental Illness, 50% of all lifetime cases of mental illness begin by age 14. In Alabama, approximately 37% of high school students surveyed by the CDC in 2019 reported feeling sad and hopeless and 20% reported that they seriously considered attempting suicide.
A new law, signed by Gov. Kay Ivey in April, requires every district to add a mental health services coordinator – a trained social worker or therapist who can connect students with school and community based counseling and mental health services – by the 2023-24 school year. In order to receive the services, however, students under 14 must receive permission from a parent.
Lawmakers added the parental consent provision in the final hours of the legislative session this year, following an amendment, offered by Rep. Sam Givhan, R-Huntsville, that required all parents to provide consent for students, regardless of age.
The new, bipartisan mental health care law states that consent forms must be specific about treatment and services offered, should be clear about their purpose, and note that permission may be rescinded at any time. It also requires schools to provide parents with ways to review materials to be used in guidance and counseling programs.
Currently, state education leaders are considering a new rule that would require even more buy-in from parents than the current law specifies.
“It would be an automatic ‘no’ unless the parent specifically asked for their child to or gave permission for their child to take those services,” Alabama State Superintendent Eric Mackey told board members at a July 12 board meeting. “That’s our proposal, for those children to be opt-in, not opt-out.”
Children under 19 years old are considered minors in Alabama, but age restrictions for various medical and mental health treatments can vary. The state’s minor consent law, for example, allows minors older than 14 to consent to medical or mental health treatment.
That comes with a few exceptions, such as testing for sexually transmitted diseases, which lowers the age of consent to 12, or when services are needed to treat pregnancy or alcohol or drug toxicity, which don’t require parental consent. Those rules were historically developed to help children without reliable family members access emergency care.
Few states have parental consent laws pertaining specifically to school-based services like guidance counseling.The federal Protection of Pupil Rights Amendment, however, does allow parents to opt out of surveys that may collect student mental health information.
Experts say school counselors have a fine line to walk between confidentiality and parental involvement. It can be tricky to determine whether parents should know what their children share in a one-on-one session. But they generally recommend informing parents of services offered, and say that schools should offer them a chance to opt-out.
In a 2009 article for the Alabama Counseling Association, Auburn University and University of West Georgia researchers wrote that counseling relationships with minor clients present “counselors with unique challenges, particularly in relation to consent, assent and confidentiality.”
“Because the very act of gaining consent from parents or guardians means that the counseling relationship is not confidential, issues of confidentiality become paramount,” they wrote, noting that minor clients should always be advised of the potential limits on their privacy.
The state school board plans to formally adopt a rule in compliance with the new state law at its September board meeting in Montgomery. A public hearing is scheduled for 10 a.m. on Sept. 8 at the Gordon Persons Building on 50 North Ripley St. Those who want to speak at the hearing must sign up to do so at least 30 minutes prior to the start of the meeting.
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