Two versions of this question come up constantly, from opposite directions.
A parent asks whether they can make a resistant sixteen-year-old attend. A fourteen-year-old asks whether she can talk to someone without her parents finding out what she says.
Nevada law answers both, and the answer surprises most people.
What Nevada law provides
In Nevada, a minor twelve years of age or older may consent to their own mental health care. The same provision covers treatment for substance use, communicable disease, pregnancy, and sexual assault.
A minor may also consent to health care regardless of age if they are married or have been married, are a parent, are living apart from their parents or guardian, or would face a serious health hazard without care.
Nevada is not unusual in this. Many states have similar provisions, and they exist because the alternative — adolescents in crisis unable to access care because a parent will not consent or must not be told — produces worse outcomes.
What it means practically for a teenager
If you are twelve or older in Nevada, you can seek mental health care on your own. Where you have legally consented and requested confidentiality, that confidentiality is generally maintained.
Two practical caveats worth being honest about.
Payment. Legal consent and paying for it are different problems. If a parent's insurance is billed, an explanation of benefits typically goes to the policyholder, which may reveal that a service occurred. Self-pay avoids this, and some clinicians can discuss reduced rates. It is worth raising directly at first contact rather than discovering it later.
Practice policies vary. Some clinicians will see minors without parental involvement; others prefer or require it as a clinical matter even where law permits otherwise. Ask when you call.
What stays confidential, and what does not
This should be spelled out explicitly at the start of any adolescent therapy, and often is not.
Generally confidential: what you talk about, your feelings, your relationships, ordinary adolescent life.
Not confidential, in any therapy, at any age:
- A serious risk of harming yourself
- A serious risk of harming someone else
- Abuse or neglect of a child or a vulnerable adult
- A valid court order
Those exceptions are narrow and they are not discretionary. A therapist who suspects a young person is in danger has to act.
Where the arrangement is set: in situations where parents are involved and consenting, most clinicians negotiate an explicit agreement at the outset — typically that the therapist will share general progress and themes with parents but not session content, and that anything involving safety will be shared. Having this stated openly, with the teenager present, prevents a great deal of later conflict.
For parents: why less access can produce better outcomes
Many parents find this uncomfortable, and it is worth explaining the reasoning.
Adolescents will not use therapy honestly if they believe it is a reporting channel to their parents. A teenager who suspects everything gets relayed will produce a performance rather than a disclosure, and the therapy will accomplish nothing.
Giving them a genuinely private space is what makes the treatment work. In practice, therapists working with adolescents almost always want parental involvement — just not surveillance. You will typically be included in goal-setting, in periodic progress conversations, in family sessions where useful, and immediately in anything involving safety.
You will not be told what your daughter said about her friend, and that is the point.
The resistant teenager
The other common situation: you can see something is wrong and they refuse.
Some things that help.
Do not make it a punishment or a verdict. "You need to see someone" heard as "there is something wrong with you" produces refusal.
Offer control over the details. Which therapist, in person or video, what time. Autonomy is the currency at this age.
Try a defined trial. "Three sessions, then we'll talk about whether to continue" is far easier to accept than an open-ended commitment.
Let them go alone. Many adolescents agree much more readily when they understand that you will not be in the room and will not be told everything.
Consider telehealth. A substantial number of teenagers strongly prefer video sessions from their own room to sitting in a waiting room.
Go yourself. Parent-focused sessions genuinely help even when the teenager refuses. You will learn how to respond differently, and household change frequently follows.
How we handle it
We work with children from age three and adolescents through high school, including anxiety, depression, emotional regulation, school stress, grief, identity development, trauma, self-harm and suicidal ideation, substance use, and affirming care for LGBTQ+ youth.
At the first session we set out explicitly — with both the teenager and the parents present — what will be shared and what will not, so that everyone knows the terms from the beginning.
Sessions are available at our east valley office on E Russell Road, our northwest office on N Durango Drive, and by secure video anywhere in Nevada. We are in network with most major insurance plans, and Nevada Medicaid covers adolescent behavioral health.
For a teenager reading this
If things have been bad and you do not know who to tell: you can ask for help. In this state you can consent to your own mental health care at twelve. If your parents are supportive, ask them. If they are not, you can still call a practice yourself and ask what the options are.
988 is answered any hour by call or text, free, and you do not need a parent's permission. If you are LGBTQ+ and want someone who specifically understands that, the Trevor Project is at 1-866-488-7386.
The earlier the better
Adolescent anxiety, depression, and trauma respond well to treatment, and considerably faster when they are addressed early rather than after two years of decline.
If your household is stuck on this question in either direction, book an appointment and we will help you sort out the arrangement that will actually work.