Since 18-year-olds were given the right to vote in Federal elections in 1971, most States have awarded adult status to people over 18. However, the transfer of adult rights and privileges on a chronological rather than individual basis may not fit the best interests and unique circumstances of the particular person involved. Parental consent is traditionally required because children are considered to be incapable of understanding the nature of the condition being treated, treatment alternatives, the risks of treatment, and the probability of the treatment's success. The four major exceptions to the requirements of parental consent for psychiatric treatment of minors relate to emergency care; emancipated minors; statutory laws granting special rights to teenagers for confidential treatment of certain conditions; and the judicial doctrine of the mature minor, who is an emotionally mature adolescent age 15 and over who is receiving conservative treatment for a non-life-threatening emergency. Confidentiality issues relate to the youth's right to privacy, requirements to inform parents once treatment has begun, the desirability of building an alliance with parents, and information given to schools or other third parties. Two final issues are financial barriers that adolescents face and the need for psychiatrists to help parents recognize their adolescents' rights to achieve identities of their own making with a minimum of intrusion and a maximum of respect. 26 references.