Georgia: minor consent, confidentiality, and custody

Who consents to treatment

A person reaches the age of majority in Georgia at eighteen. Under O.C.G.A. § 31-9-2, a married minor may consent to their own care, and a minor who is a parent may consent to care for their child. A minor sixteen or older may petition the juvenile court for emancipation (§ 15-11-720 and following). An emergency exception allows treatment without consent where delay would endanger the patient. Outside those cases, a parent or guardian consents.

Outpatient mental health treatment

Georgia has no statute letting a minor consent to outpatient mental health treatment, and the Mental Health Code's consent provisions treat the parent or guardian as the person who consents for a minor (§ 37-3-20). The emancipation code's list of what an unemancipated minor may not do on their own includes consenting to mental health care (§ 15-11-727). In practice, outpatient treatment of a minor in Georgia proceeds on a parent's consent, and a clinician who treats a minor without it does so under the emergency exception or an institutional policy that accepts the risk. Medication needs the parent.

The one statutory exception is substance use, below.

Drug and alcohol treatment: § 37-7-8

A minor may consent to their own medical treatment for drug abuse, and the parent's consent is not required. The treating physician has discretion to inform the parent. Records of a program that meets the federal definition are also subject to 42 CFR Part 2, which requires the patient's consent for most disclosures.

Inpatient treatment: § 37-3-20

A parent or guardian may apply for the voluntary admission of a minor to a facility for evaluation and treatment, and consents to treatment on the minor's behalf. The Mental Health Code also provides for an individual twelve or older to apply for observation and diagnosis at a facility; confirm the current scope of that provision before relying on it for an unaccompanied minor. Emergency and involuntary admission of a minor follow Chapter 37-3 and are outside the scope of this page.

What a parent is entitled to know

A parent who consents to treatment is the minor's personal representative under HIPAA and may access the record. Georgia's mental health records statute (§ 37-3-166) makes a patient's clinical record confidential with listed exceptions, including release to the parent or guardian of a minor.

Two situations change that:

1. Treatment the minor consented to under § 37-7-8. Where the minor lawfully consented and no parental consent was required, HIPAA treats the minor as the person who controls the protected health information for that care (45 CFR 164.502(g)(3)), although the Georgia statute leaves the physician discretion to inform the parent.
2. Psychotherapy notes kept separately have their own protection under HIPAA regardless of who consented.

Outside those situations, Georgia does not give adolescents a right to confidentiality from parents. Agree on confidentiality expectations with the family at the first visit: what will be shared, what stays between clinician and adolescent, and the safety situations in which the parent will always be involved.

Divorced or separated parents

Every Georgia custody decree incorporates a parenting plan under O.C.G.A. § 19-9-1. The plan allocates decision-making authority in four areas, education, health, extracurricular activities, and religious upbringing, and where authority is shared it names which parent has final decision-making authority in each area. Three practical rules follow:

• Ask for the parenting plan. It tells you which parent decides health matters when the parents disagree. Final decision-making authority is not a license to act without consulting the other parent, but it settles a dispute. If the plan gives one parent sole legal custody, that parent's consent is the one that counts.
• Records access usually follows the plan. Most Georgia parenting plans give both parents access to the child's medical records and the right to consult providers regardless of physical custody, and Georgia's education records statute guarantees the non-custodial parent access to school records unless a court order removes it (§ 20-2-720). Read the plan before withholding records from either parent.
• When the plan is silent and the parents disagree, pause non-urgent treatment, document what each parent was told, and leave the dispute to the parents and the court.

When the minor is at risk

Duty to warn. Georgia has no duty-to-warn statute, and its case law is thin. In Bradley Center v. Wessner (Ga. 1982), the Supreme Court held that a facility with control over an inpatient who it knew or should have known was likely to harm others owed a duty to exercise that control with reasonable care; the patient killed on a weekend pass. Georgia courts have not clearly extended that duty to outpatient treatment, and commentators describe the outpatient question as unsettled. HIPAA permits disclosure to prevent a serious and imminent threat (45 CFR 164.512(j)). The safe course is the professional standard: when a patient makes a credible threat against an identifiable person, take reasonable steps, which may include hospitalization, warning the person, and notifying police, and document the reasoning.

Mandated reporting. Under O.C.G.A. § 19-7-5, physicians, psychologists, licensed counselors and therapists, social workers, nurses, school personnel, and the other listed reporters who have reasonable cause to believe that a child has been abused must report it immediately, and in no case later than twenty-four hours, to the Division of Family and Children Services at 1-855-422-4453 (1-855-GACHILD) or through the online portal, or to law enforcement. A reporter in an institution may notify the person in charge, who then reports, but the duty remains the reporter's. Knowing and willful failure to report is a misdemeanor; good-faith reporters are immune.

Hospitalization. See the inpatient section above.

School records

A school's records about a student, including records from a school counselor or school-based clinician employed by the district, are governed by FERPA rather than HIPAA, and parents have rights of access under FERPA until the student turns eighteen. Records a school receives from an outside clinician become part of the education record once filed. Send the school what it needs to act, not the full evaluation.