Children and Young People

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Serious mental illness is rare in young people, however it is not uncommon to experience emotional and behavioural problems which affect their daily lives and relationships. These are often a response to difficulties in the family or school, or a stressful event, such as bereavement, bullying, or parental separation. They may also be associated with physical illness or developmental disabilities, including learning difficulties, ADHD or Autistic Spectrum Disorder.

Assessment of a child or young person’s mental health therefore involves looking at their medical and developmental history, family history, school functioning and relationships at home and school, and getting the perspectives of the child themselves, their parents and other relevant adults such as teachers. A range of treatments may be offered, including 1-to-1 sessions with the child, family work, liaison with other professionals and medication.

Our Team

Our experienced CAMHS team consists of  

Dr Su Sukumaran, Child and Adolescent Psychiatrist
Dr Naomi Coleman, Chartered Clinical Psychologist
Ms Lucille Balcombe, Child Mental Health Nurse

We provide multidisciplinary assessment and treatment for a wide range of child mental health problems for children up to 18 years of age.  Each of us has particular areas of expertise and we work together to provide a comprehensive service in line with the scientific evidence and good-practice guidance. When appropriate, we often work with other professionals such as GPs, schools, and Paediatricians.

Some Problems that We Could Help With

ADHD

Anxiety
Anxiety is an experience which we all have at some point in our lives to varying degrees. Sometimes it can usefully motivate us to do things that we may not want to do, such as studying for an exam or attending an interview. However, when anxiety becomes overwhelming and we avoid or are prevented from doing our best in tasks it can become very stressful.

Severe anxiety may be triggered by a stressful event, such as bereavement or bullying.

Symptoms can include somatic symptoms such as headaches or tummy aches, chest pains, palpitations, cold hands and feet, blurred vision, dizziness and nausea, which can seriously affect our everyday functioning, although there is no actual physical illness.

Autistic Spectrum Disorders (ASD)
These include Asperger syndrome and produce difficulties in 3 areas:

  • Social interaction – including lack of understanding and awareness of other people’s emotions and feelings.
  • Language and communication skills – including delayed language development and an inability to start conversations or take part in them properly.
  • Unusual patterns of thought and behaviour – including making repetitive movements, such as hand tapping or twisting , or set routines of behaviour which, if broken, the child finds upsetting.

Although there is no cure for ASD, difficulties can be managed with specialist education, behaviour management support, and social skills training. Every child with ASD is different, and a detailed assessment to identify the extent of the problems and educating the young person, family and others in the child’s life (such as teachers), is important.

Obsessive Compulsive Disorder
OCD is another way in which anxiety can be expressed. People with OCD have unwanted and distressing thoughts that may include the fear of harm coming to them or other people if they do not carry out specific behaviours. Although sufferers are aware that these thoughts do not always make sense, the fear of what might happen if the behaviour is not carried out far outweighs the belief that the fear does not make sense.

Compulsive behaviours that people carry out can include excessively washing, cleaning, checking, or counting, or repeating phrases. The compulsive behaviours can take up a huge part of the day and often prevent people from getting on with other important parts of their lives, including going to school or family and social activities

Depression
This can can involve a variety of distressing symptoms, including low mood, not being able to sleep or sleeping too much; a significant loss of or increase in appetite; reduction in motivation and concentration; withdrawal from usual activities; sometimes the feeling that life is not worth living.
People who suffer from depression can find themselves being frequently tearful and not wanting to do activities that they used to enjoy. Depression can often be a reaction to a particularly difficult life event, but in some cases, it just seems to appear as if out of nowhere.

Self-harming behaviour
Self-harm is a technique used by some young people (and adults) who feel overwhelmed by their difficult emotions and/or experiences and are unable to manage them. The sufferer deliberately causes harm to him or herself in order to feel physical pain rather than emotional pain.

Treatments Available
  • Advice on managing distressing feelings and unwanted behaviour
  • Family appointments to think about ways to resolve problems together
  • Individual therapy for your child to help them understand their feelings and learn new ways of coping
  • Medication prescribed by a child and adolescent psychiatrist
  • Support to other professionals about how best they can help you and your child

Cognitive Behavioural Therapy
A model that focuses on the relationship between thoughts, feelings and behaviours and explores practical and meaningful ways of working through current difficulties.

Systemic Therapy
The young person is understood as part of an organic and evolving system, for example the family. Change in one part of the system affects the system as a whole.

Parent Training (Behavioural Therapy)
The therapist coaches parents in applying such strategies as rewarding positive behaviour, and responding to negative behaviour with clear consequences and time out .

Medication
There is increasing evidence that medication can be a helpful addition to other treatments in some conditions e.g. severe depression, OCD, ADHD

Liaison with Other Agencies
It is often important to share information about the child with professionals e.g. teachers, Paediatricians or school nurses, so that everyone is working together.

When a Child is Referred to Us
  • All referrals are discussed by the team before a first appointment is offered. An initial appointment may be with any of the team, depending on the problem being referred.
  • We would usually see the parents and child together as well as separately, as appropriate.
  • After this, further sessions with the same clinician may be offered if appropriate, or a more detailed assessment organised with other members of the team.
  • At the end of an assessment or piece of treatment, we would usually produce a report for the family, which can be shared with others e.g. GPs, with the family’s consent
Further Information
Who’s Who in CAMHS

Child And Adolescent Psychiatrists – they are medical doctors who specialise in young people’s mental health, including the use of psychological and pharmaco- therapies. They have knowledge of child development, the links between physical and mental health, and how biological, psychological and social factors combine to produce mental health problems.

Clinical Psychologists – they have a comprehensive doctoral training in mental health and emotional wellbeing, and have detailed knowledge of patterns of thinking, feeling, relating and behaviour. They can do assessments of psychological functioning, including psychometric assessments of intellectual ability (IQ) and other cognitive functions that may affect learning (e.g. memory, attention). They may specialise in particular therapies e.g. family therapy or cognitive behavioural therapy.

Child And Adolescent Mental Health Nurses – they are qualified mental health nurses who specialise in working with young people with mental health problems and their families. They often have additional training in in specific therapies e.g. family therapy, cognitive behavioural therapy, parent training, or psychodynamic approaches to treatment. They usually work in multidisciplinary teams, liaising closely with GPs, schools, social workers, etc.

Useful Web Resources

The Royal College of Psychiatrists (UK)
The British Psychological Society
Young Minds (UK)
Mindfull (information and support for 11-17 year olds)
The National Institute for Mental Health (USA)