Singapore Proposes Mental Health Consent Guidelines to Help Young People Seek Care

Proposed rules would let some teenagers receive therapy without parental consent

Singapore is proposing guidelines that would allow young people aged 13 and above to receive certain mental health services without parental consent when a professional judges that they understand the care and that receiving it is in their best interest. The Ministry of Health (MOH) will seek public feedback from 10am on November 11 to 6pm on December 8, 2026.

The proposal addresses a gap between young people experiencing distress and getting help. MOH says about one in three people aged 10 to 18 reported symptoms such as depression and anxiety. A different national study found that 70% of young people with mental health symptoms had not sought professional support.

Under the proposed approach, consent requirements would depend on the service. Emotional support and helplines could be provided without parental consent. Screening for children below 13 would generally require it. For psychotherapy, professionals should first seek parental consent, with a route to care for some teenagers when consent cannot be obtained.

MOH sets out the consultation dates and policy goals in its public consultation announcement. The guidelines remain proposals, and the announcement gives no date for their final release or implementation.

Why parental consent has become a barrier

Singapore legally considers a person an adult at 21, when they gain full legal rights to make decisions without parental consent. MOH says there is currently no minimum age for independently consenting to mental health services. Providers have consequently developed different practices.

A teenager may therefore encounter different requirements at a school, a charity or a private psychology practice. National mindline 1771 callers can remain anonymous, while schools are more likely than community providers to require parental consent because of their close working relationships with families.

MOH has received feedback that needing parental permission makes some young people hesitate to ask for help. The difficulty becomes more serious when parents dismiss a child's distress, refuse care or contribute to an unsafe home environment.

A 17-year-old identified by the pseudonym Alice, who described experiencing an eating disorder and anxiety, said a requirement to involve her parents made seeking support harder. She described her reaction to being told that her parents would need to be informed:

Someone is already so vulnerable and you're telling them, 'I need to inform your parents about this'. Then it makes the youth feel like, why did I even ask for help in the first place?

Alice's experience illustrates the practical problem the proposed guidelines seek to address: a young person can be willing to receive help while being unwilling or unable to obtain permission at home.

How the proposed consent levels would work

MOH's proposed approach separates services by their nature and intensity. A conversation offering emotional support, an assessment and a course of therapy would have different consent requirements.

• Emotional support and helplines: basic support could be provided without parental consent.
• Screening and assessments that do not result in a diagnosis: parental consent should be obtained for children below 13.
• Psychotherapeutic services: parental consent should first be sought. Examples include cognitive behavioural therapy and school counselling.
• Psychotherapy when parental consent cannot be obtained: care could proceed for a person aged at least 13 if a professional considers it in their best interest, assesses them as mature enough to understand the risks and benefits, and obtains their own consent.
• Medical diagnosis and medical services: providers would continue to refer to the Singapore Medical Council's Ethical Code and Ethical Guidelines.

Screening is an initial check for possible mental health difficulties. An assessment explores a person's experiences and needs in greater detail. Cognitive behavioural therapy helps people recognise and change patterns in their thinking and behaviour that contribute to distress.

For a teenager seeking therapy, age would be one part of the decision. A professional would also need to consider whether the young person understands the proposed service and whether proceeding would support their welfare. The teenager would need to agree to the care themselves.

What happens when a parent or teenager says no

Care professionals would be encouraged to explore the reasons behind a refusal, whether a parent declines consent or a young person objects to approaching their parents. That conversation would help the professional understand the family situation and decide how to respond.

MOH recognises that parental consent is important when a young person lacks the maturity to make an informed decision. Informed consent means understanding what care involves, including its likely benefits and risks, and making a decision on that basis.

Parents may also be unable or unwilling to give permission, and delays can expose a young person to further harm. The proposed exception for suitable teenagers would give professionals a way to respond to those circumstances while assessing each person's needs.

Ooi Sze Jin, founder and psychologist at A Kind Place, described why an inflexible requirement can prevent care:

If we require parental consent in every situation, we might end up preventing the very children who need help from accessing it.

MOH's stated aim combines access, welfare, privacy and family participation. Parents would remain part of the approach, with their involvement shaped around helping the young person recover.

Providers already use different approaches

Existing practices show how much a young person's route to care can depend on the organisation they approach. ImPossible Psychological Services requires parental consent for all clients under 18. Mental health charity Limitless requires it for children under 14 and first seeks it for those aged 14 to 17.

Limitless may assess a teenager's ability to consent independently when there are valid reasons for not involving parents, such as abuse or a greater risk of harm. It uses the Gillick competence test, an assessment of whether a child has sufficient understanding and maturity to make a particular treatment decision.

The test considers the decision itself, including the complexity and risks of the proposed care. A professional assesses whether the young person can understand what is being offered and make an informed choice.

Impart, a charity working with young people facing adversity, explains confidentiality and its limits before care proceeds. Its practitioners may offer initial support without immediately involving parents, work towards parental consent when risks are minimal, or seek support from another trusted adult when parental involvement could threaten safety.

Dr Raksha Kartik, a clinical psychologist at Impart, described how uncertainty about privacy affects the first conversation:

For some of our youths, the question 'Will you inform my parents?' comes even before 'Can someone help me?' If that first question isn't answered clearly and honestly, youths tend to shy away from continuing the conversation with the triage workers.

A clearer shared framework would help providers explain the next steps to young people before they disclose sensitive information. It would also guide staff who currently have to navigate different organisational policies.

Why parents still have a role in recovery

Parents can help sustain progress beyond a counselling session. They may support appointments, respond to a child's needs at home and change family interactions that contribute to distress.

Muhammad Haikal Jamil, founder and senior clinical psychologist at ImPossible Psychological Services, said progress during therapy can be difficult to maintain when a child's home environment stays the same. His practice typically brings parents in at the end of the first session, while parents of older children may receive updates after every five sessions.

Other practitioners describe situations where bringing parents in too early could make a young person less safe or less willing to continue care. Project Green Ribbon provides initial support to young people in crisis without making parental consent a prerequisite, while working with social service agencies to involve families where appropriate.

Health Minister Ong Ye Kung called on October 10 for a balanced approach that allows young people to seek help first and involves families appropriately as care progresses. The proposal follows that approach by retaining parental consent as the starting point for psychotherapy while allowing professionals to consider exceptions.

What the mental health figures show

MOH attributes the finding that about one in three people aged 10 to 18 reported mental health symptoms to the Singapore Youth Epidemiology and Resilience study, identified in its announcement as the 2023 study. It attributes the 70% figure on not seeking professional support to the National Youth Mental Health Study, identified as the 2024 study.

Expressed simply, 70 out of every 100 young people with symptoms in the latter study had not sought professional help, while about 30 had. The figures describe a substantial gap between experiencing difficulties and receiving support.

Parental consent is one reason for hesitation identified through feedback to MOH. The ministry's announcement does not quantify how much of the gap is linked to consent requirements.

MOH also says most mental health conditions emerge between childhood and early adulthood, with about one in three people who develop such conditions experiencing their onset before age 14. That makes access during the school years an immediate concern.

The Ministry of Health explained the risks of missed support in its consultation announcement:

Failure to identify and support young persons with mental health needs increases the risk of long-term consequences, such as poor educational attainment, unemployment, chronic physical conditions and substance misuse.

For a young person, timely support can address distress while they are managing school, friendships and family life. The proposed guidelines focus on making the route into that support more consistent across settings.

What happens during the consultation

MOH convened an expert group drawing on several agencies to develop the guidelines. Young people, parents and service providers have already contributed their experiences and concerns. The public consultation is intended to bring in a wider range of views before the proposals are refined.

The main dates are:

• October 10, 2026: Ong announced the development of parental consent guidelines on World Mental Health Day.
• November 11, 2026, at 10am: the public consultation opens.
• December 8, 2026, at 6pm: the deadline for public feedback.

Ong also said the Singapore Medical Council was revising its ethical guidelines to give doctors clearer guidance on parental consent. MOH's proposed framework addresses access across different service providers, while medical diagnosis and treatment continue to be guided by the council's ethical rules.

For families and providers, the central practical decisions concern when to seek permission, how to assess a teenager's understanding, and how to involve parents without delaying necessary help. Public feedback will contribute to the final guidance on those decisions.

Key Points

• Singapore's consultation runs from November 11 to December 8, 2026.
• Basic emotional support and helplines could be available without parental consent.
• Parental consent should be obtained for screening and assessments without diagnosis for children below 13.
• Professionals should first seek parental consent for psychotherapy.
• Some teenagers aged 13 and above could receive therapy without parental consent after an assessment of their understanding and best interest, and with their own agreement.
• MOH aims to improve access while protecting privacy and involving parents in ways that support recovery.