DC Minor Self-Consent for Mental Health and Substance Abuse Treatment

DC Lets Minors Consent to Certain Care on Their Own

District of Columbia law gives minors of any age the legal capacity to consent to specific health services without a parent's or caregiver's involvement. For relative caregivers raising a teenager, this is essential to understand — not because it undermines your authority, but because it gives the young person a direct path to care when they need it most.

What Minors Can Consent to at Any Age

Under 22-B DCMR § 600.7, a minor in DC can consent to requested health services for:

• Sexually transmitted infection testing and treatment — any age
• Pregnancy care or lawful termination — any age
• Substance abuse assessment and counseling — any age
• Mental or emotional health conditions — any age

The regulation excludes sterilization, such as tubal ligation or vasectomy, from self-consent.

Outpatient Mental Health — The 90-Day Rule

D.C. Code § 7-1231.14 adds a specific pathway for outpatient mental health counseling. A minor of any age can receive non-medication outpatient mental health services without parental consent if the provider determines the minor is seeking care knowingly and voluntarily, and the services are clinically indicated.

This authorization is limited to 90 days. At that point, the provider must either make a new determination that the minor is voluntarily seeking care and it remains clinically indicated, terminate services, or—with the minor's consent—notify the parent or guardian to obtain consent for further treatment. This provision covers outpatient services other than medication. Inpatient admission generally requires parent or guardian consent, except for emergency or court-ordered admissions. A minor age 16 or older may consent to psychotropic medication only under the conditions in § 7-1231.14(c)(2).

D.C. Law 25-145 — Expanded Rights for Teens 16 and Older

For teenagers 16 and older who are enrolled in DC Medicaid or the DC Healthcare Alliance, D.C. Law 25-145 expanded self-consent to include:

• Routine primary care visits
• Dental cleanings and exams
• Vision care
• Requesting their own medical records

The teen must be able to understand the need for, nature of, and significant risks of the health services — the law's informed consent standard. Vaccinations, specialist care, surgery, and emergency care are excluded from this pathway.

What This Means for Relative Caregivers

If you're raising a teenager and they're struggling with mental health, substance use, or a sensitive health issue, they have a legal right to seek care independently. You may not be notified, and the provider generally can't disclose treatment details to you without the teen's consent.

That said, there's no barrier to the teen voluntarily involving you. Most therapists encourage family support. The law protects the teen's option to seek help privately — it doesn't require secrecy.

The one exception: mandatory child abuse reporting. If a provider has reasonable cause to believe a child has been abused or neglected, the provider must report to CFSA or the Metropolitan Police Department. CFSA's 24-hour hotline is 202-671-SAFE (7233).

For a complete breakdown of which health services require caregiver consent and which don't, the DC School and Medical Consent Guide maps every consent pathway by the child's age and insurance status.

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