While teenagers fundamentally have many of the same rights as adults, the manner in which those rights are exercised, in nearly all cases, is entirely dependent upon how a given child's parents or legal guardians permit the child to do the same. By way of example: minors may be permitted to wed in Pennsylvania or enter federal military service before turning 18. The caveat in either instance is that a parent or guardian must first give consent. The obvious question asks: when may a minor make decisions about his or her affairs without further consent of parents or guardians?

What many parents and minors in the Commonwealth of Pennsylvania fail to realize is that in certain instances, such as mental health treatment, minors have certain rights of their own. Under Act 147 (the Mental Health Procedures Act), which took effect on January 22, 2005, a minor who is 14 years of age or older may consent to his or her own outpatient mental health treatment independent of whether his or her parents consent to such treatment. Interestingly, in the event the parent or guardian consents to the mental health treatment of a minor 14 years or older, the minor may not abrogate that consent any more than a parent may abrogate the child's right to consent to his or her own treatment.

Interestingly, the effect of Act 147 for minor children ages 14 through 18 is that it may be used as a sword, but not as a shield. Effectively, the act empowers minors 14 years or older to make their own decision regarding outpatient mental health treatment, while simultaneously failing to provide a vehicle by which that same minor's parents or guardians may be prevented from making decisions about the minor's mental health treatment in the absence of consent by the minor.

The law regarding inpatient mental health treatment is effectively the same, but for the requirement that parental consent must be preceded by the recommendation of a physician who has examined the minor child. Otherwise, the rights and inabilities to abrogate those rights are identical to the laws on outpatient mental health treatment.

While in many respects Act 147 is empowering to young men and women who wish to control their mental health treatment plans, it invariably conflicts with the abilities of parents and guardians to independently decide what is best for their children. If a 14 year-old exercises his or her rights to outpatient treatment and his or her parents object, it is unquestioned that the child's rights trump the parents' wishes. Act 147, however, imposes no duties on a parent in that situation to provide the minor with transportation to therapy, coverage for the therapy, funds to support the therapy or any assistance whatsoever. So, in a situation where a parent does not agree with the minor's decision for mental health treatment, who really wins? Act 147 provides sufficient ammunition for a minor to win the initial battle, but it's likely a war that's ultimately won by the parents.