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Suicide is the second leading cause of death among children ages ten to 14, per the CDC. Experts have been concerned about the mental health of young children and teens for years. The National Institute for Health Care Management reports that three-quarters of all mental illnesses develop by age 24, that nearly one-third of teenagers have an anxiety disorder, that major depression is actually more prevalent in children aged 12 to 25 than it is in adults over the age of 26, and that suicide rates among children increased from 2000 to 2017.

Not surprisingly, the COVID-19 pandemic has had significant effects on children’s mental health. According to the CDC, the pandemic has resulted in a number of new stressors for children, including changes in routine, education, and health care, housing and food insecurity, fear of physical illness, and missed significant life events, like vacations and graduations. These stressors can affect even infants.

According to a Kaiser Family Foundation publication from May 2021, by October 2020, 31% of parents said that their child’s mental or emotional health was better pre-pandemic. Some issues reported included increased irritability, clinginess, issues with sleep, anxiety, and issues with appetite.

Over a quarter of high school students surveyed reported worse mental health during the pandemic. The article mentions that even prior to the pandemic, children and their parents often struggled to find appropriate mental health care, and that this problem has worsened since the pandemic began. Many children also essentially lost access to mental health services offered at school, such as school counselors, due to school closures and virtual learning.

The CDC states it is important to notice of a child displays excessive worry, changes in eating or sleeping habits, and new difficulty with concentration. The CDC also recommends that adults who are struggling with stress that may interfere with caretaking of young children seek mental health services as well. They also recommend that parents recognize and address any signs of stress, be a good role model in things like handwashing, mask-wearing, and social distancing, attempt to keep their children physically healthy, and attempt to keep children connected to family and friends through whatever medium is safe.

What are parents to do when they are separated from the other parent and there is a significant disagreement pertaining to their child’s health? Typically, if you have joint legal custody of a child, health care providers must be chosen jointly. This is because the Nevada case law discussing legal custody – Rivero v. Rivero, a Nevada Supreme Court case from 2009 – defines it as having “basic legal responsibility for a child and making major decisions regarding the child, including the child’s health, education, and religious upbringing.”

Unfortunately, the Nevada Supreme Court has not addressed the issue of a child’s therapy when one parent believes a child needs therapy and one parent does not want a child to go to therapy. Generally, it comes down to the discretion of the Family Court Judge assigned to a case and what they determine is in the child’s best interests.

Other states’ appellate courts have addressed the issue. In Georgette S.B. v. Scott B., a case from 2018 out of Alaska, a father took a mother to court after their divorce because the mother was not allowing the children to participate in therapy, among other issues. The district court ordered her to take the children to therapy and then, ultimately, gave the father sole legal custody of the children’s mental health needs. The appellate court affirmed the decision, finding that the district court did not abuse its discretion in weighing the children’s best interests and their need for therapy.

In a New York case from 2002, Gonya v. Gonya, a family court judge awarded sole custody of the children with the father. The appellate court affirmed, noting that the father had been actively involved in obtaining services to address the children’s developmental delays, while the mother had interfered in speech therapy and resistant to other services.

In 2017, in McRoberts v. Ferguson, the Court of Appeals of Michigan upheld a district court order granting a father sole legal and physical custody was proper and in a child’s best interests in part due to the father’s involvement in counseling and speech therapy

While not exactly on point, a case from earlier this year out of New York – Michael P. v. Joyce Q. – involved a child’s father attempting to modify a custody arrangement under which the child’s great aunt had custody of a child who had autism. In affirming the district court’s decision setting the father’s visitation, the court noted the father’s lack of involvement in the child’s medical and therapy sessions, as well as the aunt’s involvement in the same. The appellate court also noted that the father did not understand the scope of the child’s diagnosis and sensory challenges.

It is clear, therefore, that courts are paying attention to issues pertaining to mental health care for children. In Nevada, custody determinations are made by the court, taking into consideration the best interests of the child. There are a number of factors the court considers when determining a child’s best interests, which are contained in NRS 125C.0035(4). Notably, the “ability of the parents to cooperate to mee the needs of the child” and the “physical, developmental and emotional needs of the child” are two important factors considered by the court. If a child needs mental health care and one parent refuses to consent to obtaining mental health care for the child, the court can certainly take it into consideration when determining custody.

If a parent believes that their child needs mental health care, to which the other parent will not consent, it is advisable for that parent to seek permission from the Court to enroll the child into the needed health care. An attorney experienced in child custody disputes can assist a parent in bringing an argument for mental health care before the court.

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