They Turned 18 and Nobody Will Tell You Anything

What actually changes, what does not, and what you can still do.

The phone call

You ring the GP, or the university, or the mental health team, because you are worried. And somebody polite explains that they cannot discuss it with you.

Most parents I meet describe this moment in much the same way: not simply frustrating, but disorienting. You have been the person who booked the appointments, sat in the waiting room, chased the referral. And then, apparently overnight, you are outside the room.

It rarely arrives with any warning. Nobody writes to tell you it is coming. So, it is worth understanding what has actually happened, because the reality is both stricter and more flexible than most parents assume.

It starts earlier than you think

The first surprise is that the significant shift is not at 18 at all.

In England and Wales, young people aged 16 and 17 are presumed in law, in the same way as adults, to have the capacity to consent to their own medical treatment. So, by 16, in most healthcare settings, your child is already making their own decisions and holding their own confidentiality.

Below 16 it depends on understanding rather than age. Gillick competence, which comes from a 1985 House of Lords ruling, allows a child under 16 to consent to their own treatment where they have sufficient understanding to grasp what is involved: the purpose, the likely effects and risks, the chances of success, and what the alternatives are. It is assessed case by case and decision by decision, so a 14-year-old might be competent to make one decision and not another.

Confidentiality reaches further down still. Under-16s are entitled to the same confidentiality as any other patient, including having information withheld from their parents, other than in exceptional circumstances where there is serious risk.

Records go earlier again. In data protection terms, children are generally recognised from around 12 as able to make decisions about their own information. This is often why a parent finds that access to their child's online GP record quietly stopped working somewhere in early secondary school.

So, by the time the eighteenth birthday arrives, much of this has already happened. What 18 does is remove the remaining ambiguity.

What actually changes at 18

In law, the eighteenth birthday is the line between childhood and adulthood, and in healthcare an 18-year-old has as much autonomy as any other adult. In practice:

• Parental responsibility ends.
• No service is obliged to tell you anything, and most will not.
• Your young person decides who is told what, including nobody at all.
• Child and adolescent mental health services hand over to adult services, which work differently and generally expect the young person to manage their own engagement.
• At university, your child is an adult student. Attendance, results and welfare concerns are not automatically shared with you.
• And a particular sting: student finance is still assessed on household income, so parents are expected to contribute financially while receiving no information whatsoever.

What does not change

This is the part that tends to get lost, and it is the part that matters most.

Your legal standing changes. Your significance does not.

Attachment does not expire at 18. The people we are closest to remain our primary source of security throughout life, and particularly under stress. A 20-year-old in difficulty is still oriented towards their parents, even while refusing to talk, even while appearing to want the opposite. Especially then.

What changes is that your influence is now entirely relational. You have lost the formal levers, but the informal one, being someone they can come back to, was always the stronger of the two.

The conversation worth having before you need it

There is one practical thing worth doing early, ideally while nothing is wrong.

Following work by Universities UK with the suicide prevention charity PAPYRUS, universities are advised to hold a trusted contact for every student and to involve that person where there are serious concerns about their safety or mental health. The guidance suggests asking for a trusted contact at registration, being explicit that it does not have to be a parent, reviewing it at the start of each academic year, and making it straightforward to change.

Some universities run this as an opt-in. Bristol, which introduced its scheme following a number of student deaths, has reported take-up of around 94%.

Two things follow. First, find out whether your young person's university runs such a scheme, and whether they have completed it. Second, and more delicately: let it genuinely be their choice who they name. Research into why students decline to opt in found that the objections were rarely about the principle. Students worried about what would actually happen and whether it would be handled well. That same research found that where risk was highest, involving family was generally seen as reasonable.

The same logic applies outside university. A young adult can tell their GP in advance that they consent to a named person being contacted in specified circumstances. It is a five-minute conversation, and it changes what is possible later.

Ask for it as a favour to them, not as a condition of your support. Framed as a demand, it becomes something to resist. Framed as a plan they control, most young people agree.

What still works when the formal routes close

You can always give information, even where none can be given to you. If you are worried, you can tell the GP, the university wellbeing team or the mental health service what you are seeing. They may not respond, and they may not confirm anything at all. That does not mean it has not been recorded or acted upon. Parents routinely stop short here, assuming confidentiality is a wall in both directions. It is not.

Be specific rather than general. "He seems depressed" is much harder to act on than "he has not left his room in nine days, has stopped eating with us, and told me last week that he did not see the point."

Keep contact unconditional. The most common pattern I see is contact that has become contingent on progress: calls that always come round to the job application, the deferred year, the appointment that was missed. It is entirely understandable. It also teaches a young person that contact with you means being assessed. Some of your contact needs to cost them nothing.

Stay available while being refused. Being turned down is not the same as being unwanted, and a message that expects no reply still registers.

Look after your own regulation. A frightened parent is a less useful parent, and young adults are quick to detect panic and to manage you accordingly, usually by telling you less.

When it is a crisis

The rules bend, and they are designed to.

Confidentiality has never been absolute. Where there is a serious risk to someone's life or safety, professionals can share information without consent and are expected to use their judgement about involving family. If you believe your young person is in immediate danger, say so plainly and directly, or use the emergency services. Do not wait to establish whether you are entitled to be told anything.

Where someone is detained under mental health legislation, family have a formal role. At present in England and Wales this is the nearest relative, identified from a statutory list. A new Mental Health Act passed in December 2025 will replace this with a nominated person chosen by the patient, though it is being phased in over the coming years and is not yet in force.

Where the line is

This is not a guide to managing a crisis at home, and there are situations that need more than a parent can reasonably provide.

Seek help now, rather than waiting, if your young person talks about ending their life, is hurting themselves, has stopped eating or is eating in a way that frightens you, seems to be losing touch with reality, or if your own instinct is telling you that something is badly wrong. Your GP is a reasonable first call. In an emergency, contact 999 or go to A&E. Samaritans can be reached at any hour on 116 123.

Asking for help early is not an overreaction, and it is not a failure of parenting. It is the thing that keeps the door open.

Alexander Lajer is a BACP-Registered Psychotherapist working with children and young people, based at Golders Hill Health Centre in North London. He works with children, adolescents and young adults aged 6 to 24.

This article describes the position in England and Wales; arrangements differ in Scotland and Northern Ireland. It is general information, not legal advice, and not clinical advice about any individual young person.