Help us to help you
Lots of people have to see all sorts of specialist doctors at some points in their lives. The big problem with seeing a specialist in mental health is that people can be very judgemental – especially young people. So one good thing about seeing a psychiatrist online is that it is all completely private.
If you are being asked by your parent or guardian to see a psychiatrist they are obviously really worried about you. Perhaps you share those worries, or perhaps you think they are being over concerned and that everything is OK. Another good thing about agreeing to let us be involved is that we will give you a chance to explore the issues with someone other than them.
It’s not a blame game
Though we are called child and adolescent psychiatrists, we do not usually see ourselves as concerned only with you as the child or adolescent. We tend to see ourselves as family psychiatrists.
We can promise you that we will be listening and talking to you as well as to them and that we have a lot of experience of what being in a family where you are being seen as having the problem can be like. We hope that you will agree to let us try to help you – and them.
What to expect during the appointment
The first appointment that you will have with a psychiatrist will usually be split into three bits. There will be a bit with your parents/guardian and you, a bit with you on your own, and then a bit for them without you.
There will usually be a lot of questions so the whole thing may take as much as 90 minutes.. This long appointment gives the psychiatrist time to listen to you and hear your whole story.
We might then also want to speak with other health and education professionals who know you, or other members of your family such as your brothers and sisters if you have them – but the doctor will discuss that with you.
Your psychiatrist will:
- listen to you/your parents/carers talk about your/their concerns and symptoms;
- ask questions about your general health and early development;
- ask a bit about your family history;
- ask you (and them) about any tablets you’re taking, and whether you are smoking anything, drinking alcohol or have tried any other drugs (but normally that bit is when they aren’t in the room);
- ask about your education and your hopes for the future.
You may well need to complete some questionnaires before your appointment.
Your psychiatrist may also order some more tests to help us to understand what is going on.
Getting a diagnosis and making a plan
It might take a couple of appointments for your psychiatrist to make a full diagnosis/formulation of your needs. Then the next step is to work out a treatment plan with you.
This is normally going to consist of a combination of therapies that suit your health needs, personal preferences, family situation and age, with perhaps some medication if the doctor thinks that might help you.
You and your psychiatrist will work together to develop a treatment plan that’s right for you. The psychiatrist might provide some of the treatment themselves e.g. medication, or they might recommend you see another health professional – for example a psychologist.
After your appointment
Your psychiatrist will write you and your parents/guardian a report detailing what has been discussed and what your next steps should be. It will also be copied to your GP. Any other copies to be sent out will have to be agreed with you and your parents/guardian, for example, to your school.
Your report may involve any/all of the following:
- Referring you to your local Child and Adolescent Mental Health Service for further treatment. Even if you have tried to get help with your issues from local services already, doing so with the help of a report and diagnosis from us will almost always make it easier to get what you need. They should be able to provide you with the medication, therapy, supportive counselling you need, as well as arranging local multi agency meetings with educational and social support services.
- Requesting your school apply for an Educational Health and Care Plan (EHCP) An EHCP is a legal document that describes a child or young person’s special educational, health and social care needs. It explains the extra help that needs to be given to meet those needs and how that help will support the child or young person to achieve what they want to in their life.
- Signposting you to helplines/websites specific to your needs. There are some amazing resources available on the internet to help people with mental health issues and many of the best ones have been developed with children and adolescents in mind. We are often asked for our opinions and to give recommendations as to what works or can be judged as just being a waste of time or money.
- Referring you to online or local (voluntary) agencies for support specific to your needs. As well as some online facilities with whom we work, we can help you to find suitable. early help hubs, parent partnership groups or support groups in your local area.
- Offering you some basic strategies for self support. For example, there are some very simple techniques to try with distraction for self-harm, or for management of anger, and we can often help you to improve your mood/self esteem, just by giving you a professional medical perspective on the issues you face.
- Requesting your school/education authority to give additional time/support for upcoming exams. Having us support you with your representations to your school and local authorities will always add weight to your case.
- Making requests to school/college around specific needs for your education. Schools have to listen to a consultant psychiatrist!
- Recommending specific reading materials based on your presentation. If you want to know more about your condition or are seeking to have a more nuanced understanding of what can help you, we love to give some guidance as to where you might find such information.
Though we will try to help you get local help from the NHS, you may decide you would like to remain under the care of your PUK psychiatrist. This is also possible, so don’t worry about getting to have a relationship with someone and then having to start again. We will work it out with you.