Confidentiality has long been considered a necessary provision of effective mental health treatment. State mandated breaches of confidentiality required of psychologists when a patient makes a credible threat to the life of another have, many argue, compromised the entire administration of mental health services. In this context, there are two possible effects through which these laws could affect mental health services. The first is an effect that directly changes how mental health professionals and patients interact spawning from a credible threat of reporting. The second is an indirect effect that could arise in the general delivery of mental health services. Using teen suicides as a measure of the direct effect, and adult suicides as the indirect effect, I estimate the impact of these laws on mental health services and find that states with these laws experience an increase in teen suicides of about 9% but that no such effect exists among adult suicides. © 2012 Elsevier Inc.