Getting help for depression and anxiety in children and young people can be very difficult. Depression and anxiety in children and young people can present with quite different symptoms as compared to adults.
As a parent or carer of a young person, you need to know what to look for and also how to manage to get help. Rule number one is, if you are concerned, talk to a professional – or several, until you feel that your concerns have been addressed, stop trying to tick symptoms off a self-help list from this site or any other before talking to someone. Remember also, your neighbour, the child’s teacher, a mum at school, your GP, they don’t know your child – you do.
Intervention level one: be concerned, connect and find information
Being able to discuss your concerns and have someone help you put concerns in a perspective, validate your feelings and maybe help with practical concerns can be a good start regardless of what your concerns are. The following are suggestions where to start getting help for depression and anxiety.
Getting help for depression and anxiety in children: Find more information
- Contact school counselors. These people are trained, they know your school and your local community and more importantly, they know the services available in your locality.
- Find and enroll with community counseling places like Headspace that are specially set up for children and young people.
Make practical arrangements. Contact teachers and year coordinators if you feel your child is academically slipping behind or he or she feels unable to cope socially. However, unfortunately, you may experience that they will be reluctant to make big adjustments until they have more information from other health professionals.
Getting help for depression and anxiety in children: Contact your GP
Contact your GP. Be aware they are extremely unlikely to prescribe any medication for young people, however, they are not legally precluded from doing so. They can order blood tests so as to rule out genetic and nutritional causes for symptoms and they can provide a referral to other professionals, including:
- GP Referral to a private psychologist. This is called a mental health plan and will entitle you to ten medicare refunded sessions and the rate of refund is about $85 and you pay the difference.
- GP Referral to a private psychiatrist. You don’t have to specify a name or if you do specify a name and can’t get in, use the same referral for someone else where you can get in.
- GP Referral to the local community health team. You have to apply to get accepted and they are usually extremely stretched services and it is hard to get a place.
- GP Referral to a pediatrician, especially if the patient is young. A private pediatrician is expensive, don’t expect to pay less than $350. If you are willing to wait longer, you may get access to one in outpatient services in a hospital.
Is your young person uncritically following lifestyle gurus and picking up strange information from YouTube or other internet sources? Read Critical thinking in the age of Facebook and YouTube.
Intervention level two: get professional ongoing support
Getting help for depression and anxiety in children: Finding a psychologist.
If you find a private psychologist, be aware that this can dis-entitle you from enrolling with the community health team if you later find you need further support. Governance rules can stipulate that they are the only care provider.
Most likely a psychologist will familiarise you with cognitive-behavioural therapy. If the patient is a young person, he or she should see a psychologist specialising in young people, it can make a very big difference to how they can make a meaningful evaluation of the behaviour presented. The carer of the young person should also consider therapy as especially teenagers are a handful even at the best of times and good parenting is not some natural state of grace. When domestic situations get difficult, analysing and rationalising can be very useful. A psychologist can:
- Provide therapy, including coping strategies.
- Write letters to psychiatrists. This is not a referral, but professional evaluation and patient history that can assist the psychiatrist.
- Write letters to the hospital to assist with background information when presenting to the emergency room.
- Help you find a psychiatrist.
Getting help for depression and anxiety in children: Find a psychiatrist
A psychiatrist is trained to evaluate whether the patient will benefit from medication.
Search the Royal Australian and New Zealand College of Psychiatrists RANZCP website.
Child and adolescent psychiatrists are rarer than hen’s teeth and do not expect to wait any less than three months to see one. I have not come across any charging less than $750 for initial consultations so don’t forget to ask how much they will charge. However, watch out for visiting psychiatrists at large medical centers, some kind individuals do a “public duty” day of bulk billing.
Child and adolescent psychiatrists can be accessed through the community health centers as well.
Intervention level three: be prepared and seek help
Calling an ambulance
Self-harm is common in teenagers. The important matter to remember about self-harm is that things can turn critical very quickly even if the young person does not intend to bring the self-harm to the level of suicide. Standard advice is to call an ambulance when a young person self-harms. This is what to expect when you call an ambulance for a young person.
If the situation is not critical to life on arrival, the paramedics will get some background information from a responsible person in the household. The paramedics will assess the situation, patch up the injuries and probably have a private conversation with the young person. They can then decide whether they would like to take the young person back to the hospital for further treatment and/or a psychiatric evaluation.
If they want to take the young person to hospital, there are two scenarios: the young person agrees to come and no further paperwork is done; however, if the young person does not want to come, paramedics can section him/her and then it is no longer up to you as the carer or the young person. They will call the police if they think they need to.
Arriving at the hospital there are two scenarios. If the young person is calm and not considered a risk to self or others or flight risk, he/she will be given a bed. If the young person is a flight risk or considered a danger to self or others, all ERs got a cell that can be locked;
A full battery of questions will be asked of carers.
A psychiatric consult with a psychiatric nurse or a psychiatrist will be made available. The thing to know about the ER psychiatrist is that this person can make an assessment and give recommendations but cannot prescribe anti-depressants or other medication as he will not be available to follow up. Over weekends they can arrange for the acute care team to follow up with your family by telephone but after that, the acute care teams are designed to follow up only adults and they will not be able to offer any further support to children and young people.
The ER psychiatrist cannot get you an appointment with either a community health psychiatrist or a private psychiatrist.
You will probably be sent home after assessment with an information sheet for mostly adult, indigenous and housing specific services and a note with the Royal Australian and New Zealand College of Psychiatrists website.
Costs: if you have a private medical cover, the costs should be covered in full. If you don’t have a cover, expect to pay about $300 – $1000. Check your state if this is important for you.
You may either find that the police arrive with the ambulance or you may decide to call the police if you are concerned that your young person is affected by illicit drugs, are a threat to others in the family or if they have run away or is missing.
Police are experts at finding hidden items like drugs, blades, ropes etc. They have a record of finding in moments what a suspicious parent or carer has not found on several searches. They are not afraid to rattle your young person a bit if they think reminding that actions have consequences is warranted.
Police cannot, however, section a young person, that is to forcibly take them to a hospital. They can arrest them if there has been a criminal offence but otherwise, they will need the ambulance personnel to bring a young person to a hospital.
Intervention level four: When treatment in the community is not appropriate
The pathway beyond community care has two main options.
Hospital admission for assessment
The psychiatrist may decide the young person needs monitoring and a comprehensive assessment and can try to make a referral to hospital. The youth wing in a hospital is not a secure unit and this is only suited for a calm person who needs monitoring but not if they will seek to escape because the hospital will not keep the young person forcibly. This is a monitor and assesses option. Getting in is not so much a matter of need as a matter of luck. Youth services are oversubscribed and admission may not be possible simply because it is already so full.
Youth mental health facility
These places work in two modes: day admissions and full-time admission that can be either voluntary or on a forced and securely closed basis.
Full-time admission will ideally be and short-term of max a week for assessment.
Youth mental health dedicated facilities are few and far between. For this reason, some adult facilities will take in emergency admissions of young people where the young person will be separate from the adult population.
Finishing comments: getting help for depression and anxiety to support children and young people
Most teenagers have to work hard to get through those difficult years from about twelve to sixteen/seventeen and with positive parenting and support from friends and family, most get through it. Having a hard time is not the same as depression and having a heightened level of anxiety is typical of teenagers. Those around them will usually have to make a judgment when support has to progress to higher levels of intervention.
Go with your gut instinct and not for convenience or perfection. There actually is a thin red line where mental health concerns pass into a diseased state and where the reduced ability to cope becomes clinical depression and anxiety, often as co-existing conditions. This is when no manner of talk and skills will improve the mental state and coping ability.
The mental health support system can be very difficult to navigate and having concerns taken seriously can be very hard since teenagers are supposed to be moody and difficult. Going with your gut instinct on mental health can save lives.
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