Dealing with mental health issues on your own can be a major challenge. Getting help is an important part of most people’s recovery. But when you’re under 18, it can be hard to know where to turn—especially if you don’t want your family to know.
There are lots of reasons why you may want to get help without your family knowing. You may be afraid they’ll react badly. You might feel ashamed that you need help. Maybe your family is dysfunctional or abusive, and they’re part of the reason why you’re struggling in the first place!
Let’s take a look at why getting help in this situation can be tricky, and then go over what you can do about it.
What roadblocks should I be aware of?
The first treatments for mental illness that most people think of are therapy and medication. These are medical treatments that require working with a professional. They can be hard to access because:
- You may not be old enough to consent to treatment. In order to be treated by a mental health professional, you need to provide informed consent. In many states, minors cannot provide consent to treatment on their own—a parent or legal guardian must do this on your behalf. Some states make exceptions for sensitive things like mental health. Google the name of your state along with “mental health consent minor” to find out if you can provide informed consent in your state.
- In the United States, mental health treatment costs money. Most people who see a doctor or a therapist pay for their treatment by using their health insurance. If your parents have health insurance, that’s a good start. But even if the treatment is covered, there is usually a copay—a small portion of the bill that you pay each time you receive treatment. That can add up really quickly if you’re picking up medications every month or seeing a therapist every week.
- If you use your parents’ health insurance, they may know you received treatment. By default, insurance companies notify the policyholder each time the insurance is used. Your parents will get an explanation of benefits (EOB)—a document that states what kind of treatment was received, when, and how much it cost. It may be sent in the mail, or it may be made available online. The EOB may or may not include details about what kind of treatment you received. (It might say “mental health treatment” or just something like “office visit.” It also may or may not include the name of any medications you picked up.) You can try calling your insurance provider and requesting that they send the EOBs to you instead of your parents. But this depends on the insurance company and the laws in your state.
- Confidentiality can be tricky. Often with minors, your doctor might assume that whatever they tell you, they can tell your parents. In states where you’re old enough to provide informed consent, you should also be able to receive confidential treatment—meaning whatever you tell your doctor stays between you and them. Therapists are usually very good at respecting your privacy. But there some exceptions: doctors and therapists are mandated reporters, which means they are required by law to tell someone if you talk about child abuse or plans to commit suicide or harm someone else. Depending on the situation, that might mean telling child protective services, your parents, or some other authority. Mandated reporting laws also apply to teachers and school counselors. In some states, they apply to all adults.
What options are available to me?
The obstacles we’ve been talking about apply to getting professional help. But that’s not the only type of help you can get!
- You can start by learning more about mental health. There are lots of ways to do this. You can look for information online—this website is a great place to start! (Use a private browsing window if you’re worried your parents might see your browsing history.) Just make sure the websites you’re looking at are reliable sources. There are also anonymous sources offline—you can read about mental health in a library, or call a warm line and ask questions.
- Find support. There are online and offline support groups, where people with similar experiences get together and offer advice and support. Check out our “Connect” page to find some ways to connect with other people online. You can also check to see if your school or community have any clubs that might be helpful—for example, if your family isn’t accepting of your gender or sexual identity, you may find support in a group for LGBTQ youth. Many communities also have LGBTQ centers. Mental health is a common topic in these spaces.
- Look for alternatives to professional therapy. You can make an appointment with your school counselor. Or talk to any adult you trust, like a teacher, school nurse, or coach. Just remember that if you tell these people that you are being abused or that you are making plans to commit suicide, they may be required by law to pass that information on to authorities.
- Try some self-care. There are lots of things you can do on your own to improve your mental health. Simple things like writing in a journal or spending more time outside can help you feel better. Do things that make you feel good about yourself. Spend time with friends and other people you trust. Learn to pay attention to your thoughts—try to reframe your negative thoughts and learn to see yourself more positively. It’s easier said than done, but even just making the attempt can help you start to feel better.
Addressing your resistance to family involvement
It’s totally understandable to not want your family to know about your treatment. But there are also advantages to having family support:
- As you can probably tell by know, getting treatment is going to be a lot easier if your family is on board. They can help pay for treatment, get you to and from appointments, and find resources you didn’t know about.
- Your family may be supportive than you know. Any time you open up to another person about your mental health, there’s a risk involved. But people can’t support you if they don’t know you need support. Even if your family reacts poorly at first, they may eventually come around.
- It feels good to be open about what you’re experiencing. Hiding something this important from the people closest to you can be draining.
When you do talk to a professional, one of the first things they will probably talk to you about is how to get your family involved. Hopefully they won’t pressure you to do that right away. But it’s a good idea to plan on working towards being able to open up to your family, at least enough to allow them to help you get the treatment you need.
- Andrews, Michelle. (2016). States Offer Privacy Protection for Young Adults on Parents' Health Plan. Kaiser Health News. Retrieved from https://www.npr.org/sections/health-shots/2016/06/28/483836497/states-offer-privacy-protection-for-young-adults-on-parents-health-plan
- Barnhorst, Wintemute, & Betz. (2018). How Should Physicians Make Decisions about Mandatory Reporting When a Patient Might Become Violent? AMA Journal of Ethics. Retrieved from https://journalofethics.ama-assn.org/article/how-should-physicians-make-decisions-about-mandatory-reporting-when-patient-might-become-violent/2018-01
- Child Welfare Information Gateway. (2019). Mandatory Reporters of Child Abuse and Neglect. Retrieved from https://www.childwelfare.gov/topics/systemwide/laws-policies/statutes/manda/
- McNary, Ann. (2014). Consent to Treatment of Minors. Innovations in Clinical Neuroscience, 11(3-4), pp. 43-45. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008301/