Keeping it confidential: Many teens lack access to contraceptive services and mental health care


Kristin Makin, 25, wanted to get medical care without her parents finding out when she was a sexually active minor. She needed access to birth control in a confidential and teen-friendly setting.

“It was very important that I could have a relationship with doctors and nurses without my parents knowing,” she said.

Kristin settled on West Suburban Teen Clinic, a clinic in Excelsior that provides confidential health care to teens. The clinic operates on a sliding scale, which means teens only pay what they can afford. For seven years, the clinic treated Kristen. She also saw a mental-health counselor there for a year and a half.

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Many Minnesota teens don’t get the care they need. When West Side Community Health Services, which operates community and school-based clinics throughout St. Paul, surveyed teens, 25 to 60 percent said they lacked some of the care they needed.

“We know that there are certain categories of care kids are more likely to miss,” said Gloria Ferguson, the program director of West Side Community Health Services, which serves 3,500 teens a year.

Half of kids who reported not getting needed care said they lacked access to birth control and other help with reproductive health and 57 percent lacked mental health care.

About 37 percent of those teens were worried about having a sexually transmitted disease. “That is a real public health issue because STDs that aren’t treated can lead to infertility for both boys and girls and they can infect other people, so that is a major concern,” Ferguson said.

Some of the biggest barriers for teens are the need for confidentiality and the fear of getting in trouble, according to Ferguson.

“They’re coming to an age where reproductive health is a big part of their health care needs and it’s very awkward to be a teenager and to be needing reproductive care and to tell your parents about that,” Ferguson said. “Which is why we work really, really hard to protect confidentiality.”

Dr. Michele Van Vranken, a physician at Teen Age Medical Service in Minneapolis, said teens are trying to find their own place in the world. “You have to make decisions, you have to make mistakes.”

Teens often lack the money to pay for medical but don’t want to use their parent’s insurance because a bill might get sent home.

One remedy is the Minnesota Family Planning Program, which spends more than $11 million in government money each year to pay for reproductive health care for Minnesotans ages 15 to 50 who don’t have other insurance. The program covers contraceptives, STD testing and family planning services for people who meet certain income limits. A single person earning less than $1,805 a month qualifies.

Many clinics also operate on a sliding scale, charging teens only what they can pay, and, frequently, nothing at all.

The Minnesota Minors’ Consent Law, passed in 1971, helps TAMS and other teen clinics around the Twin Cities provide confidential care to teens. This law ensures that teens younger than 18 can still receive services such as birth control, STD testing, and pregnancy testing without their parents’ knowledge.

TAMS sees about 2,000 patients a year, mostly for reproductive health services like birth control and pregnancy testing. The clinic also has a counselor and a psychologist.

“We’re really good at protecting people’s privacy,” Van Vranken said. “We’re kind of experts at it.”

TAMS protects teens’ privacy by not calling at home or sending bills to parents when teens request it. They only bill for general services, never reproductive care.

Teens sometimes don’t know where to go for health care, which is why West Side Community Health Services offer care in many St. Paul schools. “We are where adolescents are. They don’t have to find us,” Ferguson said.

West Suburban Teen Clinic did a lot for Kristen. It helped her get testing for attention deficit disorder and counseling for suicidal thinking, depression, and anxiety.

“There’s so many parts about West Suburban Teen clinic I absolutely love,” she said.