{"data":{"id":"us-gu/17-gca-6702","jurisdiction":"us-gu","citation":"17 GCA § 6702","heading":"Contents of Informed Consent Form.","body":"The consent form must include the following information:\nTO: (parent or guardian)\nFROM: (school or organization)\n[Particulars regarding name of screening program, where and when it will take place]\nFULL INFORMED CONSENT FOR MENTAL HEALTH OR\nPSYCHOLOGICAL SCREENING\nMental health or psychological screening methods for children and adolescents vary from state to\nstate, but may involve a self-administered computer interview or survey to determine how a\nstudent feels emotionally (anxious or worried, sad or depressed) or to judge his or her behavior\nat the present time or in the past. These questions can cover thoughts or feelings your child has\nhad or thoughts and feelings your child thinks you may have had or currently have about him or\nher.\nAn outcome could be you are asked to take your child for a follow-up interview or evaluation to\ndetermine if he or she has a mental disorder or syndrome. Based on an evaluation of your child’s\nanswers, he or she may be diagnosed with a “mental” or “psychiatric disorder”. These diagnoses\nhave to be made by a psychologist, psychiatrist or medical doctor, but the subjectivity of this\ndiagnostic process makes it a risk.\nQuestionnaires or tests are frequently based on symptoms outlined in the Diagnostic and\nStatistical Manual of Mental Disorders (DSM) or the mental disorders section of the International\nClassification of Diseases (ICD). The psychologist, psychiatrist and medical doctor often depend\nupon these diagnoses in order to bill private or government insurance.\nThe attitudes, beliefs, actions, inactions, or behaviors of a child or adolescent and whether or not\nthese constitute a mental disorder are based on the opinion only of the person making the\ndiagnosis. Unlike methods to determine physical diseases like cancer, diabetes or tuberculosis, a\ndiagnosis of “mental disorder” or “syndrome” cannot be determined by any physical, medical\ntest, such as a brain scan, a “chemical imbalance” test, X-ray or blood test.\nMental health screening could be presented to you as a means of preventing suicide. However,\nthere is no scientific evidence to substantiate this at this time. The U.S. Preventive Services Task\nForce (USPSTF) studied this and recommended against screening for suicide in 2004, saying that\nit “found no evidence that screening for suicide risk reduces suicide attempts or mortality”.\nCommonly psychiatric drugs prescribed to treat mental disorders can have very serious effects on\nsome children. In 2005, the European Committee for Medicinal Products for Human Use\n(CHMP), which includes members from 25 European Member States determined that\nantidepressants should not be prescribed to those under 18 years old because they can produce\nsuicidal behavior, including suicide attempts and thinking about suicide and/or related behavior\nlike self-harm, hostility or mood changes.\nThe U.S. Food and Drug Administration ordered that a “black box”, its highest level of drug\nwarning, be placed on antidepressant packaging advising that the drugs can induce suicide in\nchildren and teens. The FDA also has issued concerns that stimulant drugs prescribed to children\nmay cause “psychiatric events,” described as “visual hallucinations, suicidal ideation, psychotic\nbehavior, as well as aggression or violent behavior”.\nBefore consenting to any such screening or survey, the educational facility must provide a manual\nand other published information which fully describes:\n(a) The nature and purpose of the screening/test or questionnaire.\n(b) The development of the screening/test or questionnaire, its scientific validity as\nreplicated in scientific studies, the rationale for the screening/test/questionnaire and reliability.\n(c) Scientific journal citations demonstrating that the proposed screening/test or\nquestionnaire has been proven to be reliable and valid by replicated scientific studies.\n(d) A guarantee that no screening/test or questionnaire is based or related to any “mental\ndisorder” as covered in the Diagnostic and Statistical Manual of Mental Disorders.\n(e) The intended use of the results or outcomes of the child or adolescent completing such\nscreening/test or questionnaire.\n(f) The right to rescind consent at any time before, during or after the screening/test or\nquestionnaire being proposed.\nINFORMED CONSENT FOR MENTAL HEALTH SCREENING\nI acknowledge that I have read and understood the above information to the best of my ability\nand have read (NAME OF MANUAL), and based on my understanding, I am choosing one (1)\nof the following:\nI give my consent for my child to undergo an evaluation for emotional, behavior, mental, specific\nlearning disabilities, or other health impairments (mental health screening), and require that I be\nprovided, in writing, any findings determined.\nConsent means that I do/do not (strike which is inappropriate) give permission for the information\nobtained from such survey or testing to become part of my child’s school or other record or to be\ntransmitted to any other agency outside of the [name of school].\n________________________ ____________\n(Signature of Parent) Date\nI do not give my consent for my child to undergo an evaluation for emotional, behavior, mental,\nspecific learning disabilities, or other health impairments (mental health screening).\n________________________ ____________\n(Signature of Parent) Date\nTHIS FORM MUST BE RECEIVED BY THE PARENT AT LEAST 45 DAYS BEFORE THE\nPLANNED SCREENING. PLEASE ENSURE THIS FORM IS RETURNED BEFORE THE\nSCREENING DATE. YOU HAVE THE RIGHT TO REVOKE YOUR CONSENT AT ANY\nTIME.","path":["Title 17: Education","Division 2 - Department of Education","Chapter 6: Pupils","ARTICLE 7: MENTAL HEALTH SCREENING, CHILD PROTECTION AND INFORMED CONSENT ACT"],"source_url":"https://col.guamcourts.gov/sites/default/files/17gc006.pdf","current_through":"P.L. 38-133 (June 4, 2026)","vintage":"","retrieved_at":"2026-09-27T03:43:48Z","sha256":"92f2417e992bb6e13307ea62dc104e84b70a0f82a8954b98c826605bc424cf2e","source_id":"us-gu","stale":false,"prev":"us-gu/17-gca-6701","next":"us-gu/17-gca-6703"},"notice":"GroundRules: Original legal text. Not legal advice."}