Staff Sparkler 1.1 – Adolescent Champion Focus Areas
Focus Area #1 - Accurately
discusses and applies confidentiality/consent laws with
all adolescent patients.
Excerpts from: Testimonials from The Adolescent Champion Teen Advisory Council (TAC TAC), 2014
“So my primary healthcare provider knows my mom really well. We come in and
they talk for a few minutes, and I’m like, ‘Yo, I need birth control.’ It ends up
being this really weird atmosphere where I’m not sure if she’s going to tell my
mother something I told her because they’re friends.” – C.J., age 16
The primary causes of illness and death in
adolescents are from high risk behaviors
including substance use, sexual activity,
dating violence, and depression/suicide.
One study showed that 58% of high school
students have health concerns they want to
keep private from their parents.
The most common reason adolescent girls identify for missing a necessary health service is
that they do not want their parents to know.
Adolescent patients say that confidentiality is one of the most important factors in their
healthcare.
Studies have shown that a lack of confidential care does not delay or discourage adolescents
from engaging in high risk behavior. In fact, adolescents who don’t receive health care due to
confidentiality concerns are more likely to engage in risky behaviors and report psychological
stress.
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Blum RW, Beuhring T, Wunderlich M, Resnick MD. Don’t ask, they won’t tell: the quality of adolescent health screening in five practice settings. Am J Public
Health. 1996; 86:1767-1772.
Klein JD, Wilson KM. Delivering Quality Care: Adolescents’ discussion of health risks with their
providers. J Adolesc Health 2002; 30:190-195.
Ford CA, Bearman PS, Moody J. Foregone health care among adolescents. JAMA 1999;
282(23):2227-2234.
Cheng TL, Savageau JA, Sattler AL, DeWitt TG. Confidentiality in healthcare. A survey of knowledge,
perceptions, and attitudes among highschool students. JAMA 1993; 269(11):1404-1407.
Healthcare providers “have
to explain that nothing bad is
going to happen if you’re
honest.” – D.C., age 17
Staff Sparkler 1.1 – Adolescent Champion Focus Areas
Michigan Confidentiality/Minor Consent Laws
Parent/Guardian Consent Exceptions
A parent or legal guardian must provide consent on behalf of a minor (under age 18) before health care services are
provided, with several important exceptions.
o Emergency care
o Care for emancipated minors
o Minors can be emancipated by: court order, marriage, military active duty.
o Specific healthcare services related to:
o Sexual health
o Mental health
o Substance use treatment
Patients ages 12 and up have the right to the following WITHOUT parental/guardian consent or knowledge:
o
o
o
o
Pregnancy testing and prenatal care
Birth control information and contraceptives
Testing and treatment for sexually transmitted infections (STI's)
Substance abuse treatment
Patients ages 14 and up can access mental health counseling WITHOUT parental/guardian
consent/knowledge
o
Up to 12 visits, or 4 months
Minors need a parent/guardian’s permission for:
o
o
o
o
Vaccines (including HPV)
Mental health medications
Inpatient mental health treatment
An abortion (unless a court-approved waiver is obtained)
Healthcare providers must breach the minor’s confidentiality and report if:
o
o
o
o
There is suspicion of abuse by an adult
The minor is a risk to themselves or someone else
The minor is under age 12 and has been sexually active
The provider may choose (but is not obligated) to tell the parents about any care provided to the minor patient
UMHS Abuse Consultation Team
Mission: The Abuse Consultation Team (ACT) provides consultation to Health System personnel regarding assessing,
reporting and intervening in suspected cases of child abuse, sexual assault, elder/vulnerable adult abuse and domestic
violence (both past and present) of our patients.
It is the policy of the Health System to facilitate the notification of legal authorities when appropriate or required. ACT
will provide consultation about legal or confidentiality issues related to abuse, neglect or domestic violence.
For help in assessing and referring cases of suspected abuse, neglect or exploitation, please call the Abuse
Consultation Team: 734-763-0215.
Staff Sparkler 1.2 – Adolescent Champion Focus Areas
helps adolescents navigate referrals and any other
systems that may be challenging.
Focus Area #7 - Patiently
Excerpt from: Testimonials from The Adolescent Champion Teen Advisory Council (TAC TAC), 2014
“My story is about when I was, like, 20, and I had the not-so-good insurance.
So pretty much, I’m very talkative, and I try to be personable with people. I went to a doctor’s
appointment, I’m talking to the staff, the nurses – I’m cold, they’re cold, we’re laughing, and
they get to the ‘Oh, do you still have your old insurance coverage?’ and I’m like ‘No, not
anymore, my mom lost her job.’ And they were like ‘OH.’ So the entire energy shifted, and it
was just like well, okay, we’re still going to take you back [to see the doctor], and I went
because I was lethargic and feeling weak, and I needed to be tested for Lupus, and the doctor
comes and the same thing happened. At first, it was really conversational and nice, because I
did my research, so I think it was refreshing for her to have a patient
that knew so much. But when it came time to get referred to a
specialist, and she was like ‘Oh, you’re not with that insurance company
anymore. Oh.’ And then the entire energy and the tone changed.
I think the frustrating part was that no one gave me options, and no
one said, ‘Hey, there’s a clinic or there’s a program, or hospitals have grants or funding where
they can help you pay for this,’ none of that came up… So I still made the appointment with
the rheumatologist, and though I was in pain then, they were like ‘Well, you can’t get in for
like 5 or 6 months,’ and I was like, ‘Well, what do I do until then?’ and it really pushed me to
advocate for myself and other young people. But, I guess, you leave with the feeling of like
‘Oh, I don’t matter,’ you know.
So, the interesting thing was, later I had an experience at another clinic, and when
I explained to the nurse practitioner that I didn’t have insurance, she was like, ‘Oh,
there’s this program, and there’s this resource, you can get help here, or you can
go this route,’ and it was just like Wow, no one ever told me that. Otherwise, I felt
doomed, and she kind of gave me hope. I’ve gone to other physicians at really
nice clinics, and same thing, they were just positive about it, like ‘That’s no big
deal, we can work with that, and there’s options.’ Whenever I was given
options and I didn’t feel hopeless, it was a good experience.” – Rae, age 23
Staff Sparkler 1.3 – Adolescent Champion Focus Areas
Focus Area #9 - Uses
sensitivity and maintains neutral language and body language with
adolescents, withholding judgment related to sensitive subjects, such as
sexual health, substance use, interpersonal violence, gender and personal
expression, and mental health.
Excerpts from: Testimonials from The Adolescent Champion Teen Advisory Council (TAC TAC), 2014
“If a teenager has sex, don’t brand
them. I mean they aren’t a bad
person after that, so why not give
them access to safer ways to have
sex? It [sex] is going to be
happening anyway.”
“It would be a priority of my life to find
someone that can answer my questions
about my health, and if you can’t answer
my questions, find somebody that can
and relay that back to me. And I have to
be able to trust that you are giving me
correct information and I won’t be
judged for the things that I say or the
things that I tell you.”
“At an appointment, the
doctor came in right when
my mom called to tell me
where my family had
decided to put my
grandfather’s ashes. When
I tried to answer the
phone, the doctor was like
‘No, put your phone away.’
I was like, ‘Excuse me?’
And my phone rang again.
And I was like ‘this is my
mom on the phone.’ And
she was like ‘I don’t care,
put away your phone.’ And
I was like, ‘I don’t like her,
never again.’”
Staff Sparkler 1.3 – Adolescent Champion Focus Areas
Focus Area #9 - Uses
sensitivity and maintains neutral language and body language with
adolescents, withholding judgment related to sensitive subjects, such as
sexual health, substance use, interpersonal violence, gender and personal
expression, and mental health.
I feel like adults dehumanize teens.
I feel like once a teenager hits
puberty is when the thoughts of
sex come into your mind. Adults
had the same thoughts when they
were 16 – why can’t we have those
thoughts?
“If you see a train coming, you don’t stand
there and wait for it to hit you. And if teen
pregnancy has been happening since time
began, and you know it is going to happen still,
then why not do something to derail that
train? We just stand there and go ‘No no no
morals morals stop stop.’ It is not going to stop
this way.”
“I am gender non-conforming, and I got referred to this doctor when I was
like, 13, because I wanted to talk about it, so, I went to this doctor who was
supposedly an expert in his field, of kids who don’t conform to gender norms,
like, particularly adolescents. And I go to him, and I’m like ‘Here’s what’s
going on, don’t really feel like a girl, not sure what’s up,’ and he tells me I have
gender identity disorder, which is an obsolete term, it’s not used anymore, it’s
not respectful, it’s really not what you say to a scared kid who comes in for
some help. Then, my mother’s like ‘How can we help, how can we support our
kid, like, what can we do?’ And he’s like ‘She’ll grow out of it. This is when
kids change their minds about this.’ You know, I was just blown away by his
lack of sensitivity, and I did not feel like telling him anything that was
important to me.”