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Maryland advances bill that lowers age of mental health consent to 12 years old


“The family knew he was troubled. But we don’t really know why because he did not feel comfortable speaking to his parents, my grandparents, or his siblings. And he had nobody to talk to,” Barve (D-Montgomery) said on the House floor. “I wish he had had someone to talk with. And I’m casting this vote in honor of . . . Sudhakar Shankar Gokhale.”

The bill, which passed 92 to 44 and is headed to Gov. Larry Hogan’s desk, lowers the age for consenting to mental health treatment from 16 years old to 12.

California, Georgia, Illinois and West Virginia already allow preteens to decide for themselves whether to receive mental health treatment, according to a National Institutes of Health report provided by Sen. Malcolm L. Augustine (D-Prince George’s), the bill’s sponsor. Washington state and Florida allow it at 13.

Maryland lawmakers approved the measure along with several others on Thursday, with four days left in the 90-day legislative session. Other bills being sent to Hogan (R) include legislation that would create a Governor’s Office of Immigrant Affairs, a measure that would require a licensed or certified health professional to receive implicit-bias training, and a bill that would enable the state’s college athletes to profit from their names, images and likenesses while boosting safety measures in the wake of the 2018 death of University of Maryland football player Jordan McNair.

The emotional, nearly hour-long debate on the consent bill centered on the increasing need for mental health services and the role of parents in determining what is best for children. Opponents said the measure would strip parents of their rights, while proponents said it provides young people who might be afraid to talk to their parents or guardians about their struggles an avenue to get the help they need.

According to the CDC, mental health problems account for a growing proportion of children’s visits to hospital emergency rooms. From March to October 2020, the figure was up 31 percent for those 12 to 17 years old and 24 percent for children ages 5 to 11, compared with the same period in 2019.

Under the Maryland bill, anyone 12 or older who is determined by a health-care provider to be “mature and capable of giving informed consent has the same capacity as an adult to consent to consultation, diagnosis and treatment of a mental or emotional disorder.”

Experts are divided on the issue.

The Maryland Psychiatric Society opposed the bill. In a letter to the Senate and House committees, it said that many children under the age of 16 lack the capacity to make “important mental health decisions. Even in the rare cases, in which a competent child is interested in care and a guardian opposes that decision, involvement of the guardian is a must. The guardian’s absence and family conflict most often is the predominating problem that must be addressed in care.”

But Del. Joseline A. Peña-Melnyk (D-Prince George’s) said there were many providers who testified in favor of the bill, including social workers, health-care workers and others.

“We heard from the Calvert County health officer, who had a 14-year-old in his office that was having mental emotional issues, and how the mom did not consent to her treatment,” Peña-Melnyk said. “He talked about how difficult it was. His hands were tied. . . . What happens when that parent has emotional problems themselves? What happens when you have a 13-year-old that needs help . . . and the parent says ‘No, my religion does not allow it’?”

Like Barve, other delegates spoke about personal experiences. Del. C.T. Wilson (D-Charles), who has previously shared his story of being sexually abused by his adoptive father, spoke of the benefits that counseling could have on abuse victims who don’t talk about their experience out of fear of being removed from their families.

“At 12 I would have loved to have someone just to talk through what I was going through, because the damage that was done from the ages 12 to 16 was incalculable,” Wilson said. “I can’t imagine how much of my humanity might have been salvaged if I had someone to tell me, ‘It’s not your fault.’ ”

Del. Daniel L. Cox (R-Frederick), who opposed the bill, drew a sharp rebuke from Del. Shane E. Pendergrass (D-Howard) when he compared the legislation to the Holocaust. “In the Nuremberg trials, medical professionals interfered with parental rights . . . and that’s what this bill does,” Cox said.

Pendergrass then invoked a “point of personal privilege,” noting that Thursday was Holocaust Remembrance Day. She told Cox she was “enormously affronted as a Jew when you in any way compare this bill to the Holocaust, especially today. Shame on you.”

Del. Ariana B. Kelly (D-Montgomery) said that she spoke to her teenage daughter about the bill, and that the girl told her that ages 12, 13 and 14 were the “hardest years” for her friends. It was when they struggled the most, her daughter said.

“This is not a radical measure; this is a common-sense measure,” Kelly said.

Del. Jason C. Buckel (R-Allegany) said he knows that there is no silver bullet to solve the issue of suicide. He said many of his colleagues said the bill would be worth it if it were to help one child. But he spoke about whether there might be one family that it hurts.

“I’m going to trust the experts,” he said in explaining his vote against the bill. “I’m going to hope and pray that you guys are right, and I’m wrong.”

The bill originated in the Senate and passed that chamber 31 to 16. A similar House bill, sponsored by Del. Heather Bagnall (D-Anne Arundel), is also nearing final approval and could be sent to Hogan as well.

If you or someone you know needs help, call the National Suicide Prevention Lifeline at 800-273-TALK (8255). You can also text a crisis counselor by messaging the Crisis Text Line at 741741.

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