
Quoting
Abrams v. Jones, 43 Tex. Sup. J. 1064, 35 S.W.3d 620 (2000)
We agree with the dissent in the court of appeals that, unfortunately, parents cannot always be deemed to be acting on the child's behalf. See Abrams, 983 S.W.2d at 382 (Edelman, J., dissenting). An obvious example is when a parent has sexually molested a child and later demands access to the child's mental health treatment records. A court would not presume that the parent is acting on the child's behalf in such circumstances. Similarly, parents embroiled in a divorce or other suit affecting the parent/child relationship may have motives of their own for seeking the mental health records of the child and may not be acting "on the patient's [child's] behalf." Tex. Health & Safety Code § 611.0045(f). We therefore conclude that a mental health professional is not required to provide access to a child's confidential records if a parent who requests them is not acting "on behalf of" the child.
* * *
When a parent is acting on behalf of his or her child, the question that then arises is whether, under section 611.0045(b), a professional may nevertheless deny access to a portion of a child's records if their release would be harmful to the patient's physical, mental, or emotional health.
* * *
This Court has recently recognized that, through Chapter 611, "the Legislature has chosen to closely guard a patient's communications with a mental-health professional." Thapar v. Zezulka, 994 S.W.2d 635, 638 (Tex. 1999). One purpose of confidentiality is to ensure that individuals receive therapy when they need it. See R.K. v. Ramirez, 887 S.W.2d 836, 840 (Tex. 1994) (describing the purposes of the physician-patient privilege under the Texas Rules of Evidence). Although a parent's responsibilities with respect to his or her child necessitate access to information about the child, if the absence of confidentiality prevents communications between a therapist and the patient because the patient fears that such communications may be revealed to their detriment, neither the purposes of confidentiality nor the needs of the parent are served.
If a professional does deny a parent access to part of a child's records, the parent has recourse under section 611.0045(e). Tex. Health & Safety Code § 611.0045(e). First, the professional denying access must allow examination and copying of the record by another professional selected by the parent acting on behalf of the patient to treat the patient for the same or a related condition. Id. Second, a parent denied access to a child's records has judicial recourse. See id. § 611.005(a). We therefore conclude that the court of appeals erred in construing sections 611.0045(b) and (f) of the Health and Safety Code as giving a parent totally unfettered access to a child's mental health records irrespective of the child's circumstances or the parent's motivation.