Under fire for keeping abortions secret from parents, school counsellors say confidentiality has to come first.
Last week's Sunday Star-Times story about parents being in the dark over their children's abortions led to widespread criticism, but the head of the country's counsellor group says without secrecy, many students would never get the help they need.
Association of Counsellors head Chris Hooker said confidentiality "has to be absolutely protected".
"We would rather work with parents. It's more comfortable and productive when we can, but I come back to that basic thing – if it's not confidential, kids won't get the help they need."
He said there were cases where parents had not been told their children were prescribed Prozac or other drugs, had attempted suicide, or were contemplating a sex change. Students were promised confidentiality and the service was bound by the Health Privacy Code.
"We have kids seriously contemplating suicide, if they didn't come... it doesn't bear thinking about."
But when it came to telling parents, Hooker said the law and the health professionals' code of ethics stipulated it must involve a serious and imminent risk of harm.
"Obviously, we would want to tell the parents of any significant event. But where it can't happen, it can't happen."
The Star-Times suggested some situations:
A counsellor takes a student to a doctor who prescribes Prozac. "Once the student has seen the doctor, the responsibility for that decision is the doctor's. Counsellors don't administer medication." It was common for students to get medication after a counsellor arranged a visit to a doctor.
A student has suicidal thoughts. "Our job is to make a risk assessment. If our assessment is the kid really is at risk then there's no choice – the parent must be told. When kids are genuinely at risk, there's no fight in them, and they actually want someone to take responsibility for their safety."
A student is self-harming. "It depends on the level. If it is part of a significant risk of suicide – yes. If it's relatively minor, no."
A student considers a sex change. "If there is no indication of serious imminent harm, then there's no choice; we can't tell."
Hooker said he had seen students with all those issues. "We do walk a tightrope – it's not comfortable."
Christchurch lawyer Kathryn Dalziel said the Education Act required a school to report anything affecting the student's progress or harming their relationships.
But a counsellor was not the school, just a health service within it.
"As a separate agency, the counsellor must comply with their professional code of ethics," she said.
"Teachers say, `If only you had told me that they were suicidal, or that their parents were breaking up'. But the counsellor can only do that with the young person's consent."
- Sunday Star Times
Should fluoride in water be the responsibility of central government?