In 2016, Florida law changed to mandate, in parenting plans designating shared parental responsibility, that either parent retains consent to their child’s mental health treatment. See Section 61.13(2)(b)3., Florida Statutes, amended by Laws of Florida 2016-241. Analysis of the final version is available here.
Each parent’s reserved right to consent to a child’s mental health treatment, with no prior obligation to confer with the other parent, invites confusion and disputes and presents practical challenges. Parents, courts, and collaborative practitioners may explore workable solutions that will forestall later costly modification or enforcement actions.
History of Retained Consent to Mental Health Treatment in Florida
How did this change in Florida parenting plan law come about? The Florida Legislature intended the amended language would help parents sharing responsibility for decision making after divorce or separation.
Mental health professionals identified challenges in providing mental health treatment or counseling to children after divorce or separation. The Florida House Civil Justice Subcommittee drew guidance from a University of North Carolina, School of Social Work study. See Souders, T., Strom-Gottfried, K., & DeVito, D., Theimann Advisory: FAQ on Services to Minors of Divorced Parents, available here.
North Carolina Mental Health Provider Study
The 2009 North Carolina study asked mental health providers:
- If a parent brings a minor in for counseling, must the clinician/agency inquire about another parent? Must they ask if the other parent has consented to treatment? Does this change if payment/insurance is in the name of another adult?
- Must the clinician/agency secure documentation that verifies custody? How frequently should the clinician/agency request documentation? What documentation is sufficient?
- How is informed consent executed with the other parent?
- What difference does it make if the parents have joint custody or one has sole custody?
- When both parents have custody, one parent consents to treatment, but one refuses, what are the clinician’s/agency’s responsibilities?
- What if the parent presenting the child for service explicitly requests the other parent not be contacted? What if the parent states a compelling reason (a history of explosive anger, abuse, instability, or paranoia)?
- Must the clinician/agency share information with the other parent about the child’s care? Does this obligation differ if the parent requesting information does not have majority time sharing?
- If a grandparent (or other nonparent relative) brings a minor in for counseling, must the clinician/agency inquire about the parent? What if the parent is incarcerated, resides in another state, is hospitalized, or is otherwise unavailable?
- When can the clinician/agency treat minors without parental consent?
Parents Exploiting Consent to Child’s Mental Health Treatment in Family Disputes
The Florida House Civil Justice Subcommittee described parents using consent to a child’s mental health treatment as leverage:
Obtaining the consent of both parents often involves navigating emotionally-charged and history-laden territory. This can create a tug-of-war between divorced or separated parents who are, in effect, using their child as leverage in their interpersonal dispute. This seems to arise most often when children need in-patient or full-day treatment for psychiatric issues related to depression, often caused by the family discord.
Quoting Ann Bittinger, Legal Hurdles to Leap to Get Medical Treatment for Children, THE FLORIDA BAR JOURNAL (January 2006), p. 24, available here.
Florida Circuit Judge R. Thomas Corbin lamented about shared parenting and decisions about a child’s mental health:
In cases in which a settlement agreement or a judgment said the parents will “share parenting”, family judges are frequently asked in post judgment motions to decide if a child should take medication for ADHD, depression, a bipolar condition, etc.,… because the parents cannot “confer with each other” and “share” these parenting decisions and neither one has any authority to make the decision alone because the order in their case requires them to “share parenting decisions.”
However, there is no authority that a judge in a Chapter 61 case has the power to make such parenting decisions. A Chapter 61 judge has no authority to become a “super parent.”
See The Honorable R. Thomas Corbin, A Parenting Plan Must Include a Parental Responsibility Order and a Time-Sharing Schedule, The Florida Bar Family Law Section: Commentator (Fall 2010), p. 18, available here.
On each parent’s retained consent to mental health treatment, the Florida Senate Committee on Rules, discussing companion Senate Bill S/CS/SB 794, said: “The scope of what is meant by mental health treatment, however, is not defined.” See Analysis found here.
The Opportunity to Avoid Future Disputes About Mental Health Treatment Consent to Which Each Parent Retains
In shared parenting, each parent retains consent to the child’s mental health treatment. That can lead to problems when the parents disagree, however.
As parents and collaborative practitioners work through the issue, rather than leave to future judicial or legislative interpretation, they may benefit by precisely stating in the parenting plan what they mean by “mental health treatment.”
Stating Intent Precisely: Child-Counselor Communications: Bentrim v. Bentrim, Case No 4D21-1303 (Fla. 4th DCA March 9, 2022)
As discussed, precision in drafting agreements regarding a child’s mental health treatment is beneficial. A related issue is ambiguity about access a parent has to records of the child’s mental health treatment.
For example, consider the March 2022 Bentrim case. For 11 years after they divorced, the Bentrim parents fought in court. The court ordered them to agree on a counselor for their daughter. The order directed that all communications between the child and her therapist would remain confidential, “as section 90.503, Florida Statutes provides.”
Mom gave dad three potential counselors to consider. He told her he preferred a social worker the child had been seeing. Yet she took the child to another counselor, a psychologist, without dad’s prior knowledge or consent. Dad found out and was unhappy.
The social worker testified mom emailed her and said she didn’t want the daughter to keep seeing her, and asked for notes of the counseling sessions. The counselor, who knew nothing of the court order about confidentiality, sent her session notes to both parents.
At dad’s request, the court held mom in contempt for requesting and getting the child’s confidential records. But the appeals court reversed, because the order didn’t explicitly bar either mom’s or dad’s ability to request their child’s counseling notes.
The Fourth DCA discussed each parent’s rights to request records and interplay with the child’s psychotherapist-patient privilege, which each parent may assert. Section 90.503, Florida Statutes. Because the trial judge could have, but hadn’t, “clearly and precisely” banned mom from requesting the social worker’s records, the court reversed the contempt order. Bentrim v. Bentrim, Case No. 4D21-1303 (Fla. 4th DCA Mar 9, 2022).