Vlog of a psychiatrist

ANNE-LAURA VAN HARMELEN: It’s important to know that sometimes, you won’t be able to deal with things by yourself. In that case, you can talk to a school counsellor, or you can ring your GP, who will refer you to a coach, or a therapist, or a psychologist. In a next video, you will hear from a psychologist. And he will explain to you what it’s like when you go to him, and what you can expect from that, and why it’s important to do this.

PAUL WILKINSON: Hello, my name’s Paul Wilkinson. I’m a consultant child and adolescent psychiatrist from Cambridge. And I’m going to talk to you today about what happens when you come to a mental health clinic in the United Kingdom. It’s quite different to when you go to the doctor normally for a physical health problem. One of the differences you’ll notice is that the room which you’ll come into won’t be that clinical. There won’t be things like beds and desks there. What you’ll probably find is you’ll be sitting on comfy chairs. There might be toys there. There might be drawing equipment if there’s younger children. You’ll normally come along with your family to begin with.

In a few cases, if there’s problems with your family, you might come on your own. But it’s often good to come with your mum or dad, or both of them the first time. You’ll meet with a member of the mental health team. That might be a psychiatrist who’s a doctor trained in mental health, it might be a psychologist, a psychiatric nurse, a psychological therapist, or another member of the team. Sometimes, you’ll meet with two people the first time you come. We’ll ask you some questions really to find out about what’s been going on in your life, and try and work out what the main problems are.

We’ll also ask you quite a load of questions about your background and about other things that have been happening at school, at home, with friends, because that will help us to understand a lot better about why you’re having difficulties at the moment. We always give young people the chance to speak on their own. There might be things they don’t want to talk about in front of their parents for all sorts of reasons. Sometimes, it’s because they don’t want their parents knowing they’re doing certain things. But more often, it’s because young people don’t want to worry their parents too much. Another thing that’s important to say is that there are rules we have about what we can keep secret.

There might be some things that you don’t want us to share with your parents or anybody else. In a lot of cases with young people, we can’t keep those secrets. But there’s sometimes that we can’t, especially if we’re worried about young people’s safety or the safety of somebody else. We always let you know about that at the beginning because what we don’t want to happen is people tell us things, and then think we’ll keep it all secret, and we can’t, though. So we’ll give you a chance to speak on your own. Sometimes, that lasts a long time, sometimes, it doesn’t last long at all. But it’s important to give everyone that chance.

After we finish with the assessment, we’ll hopefully have a good idea about what the main problems are, and we’ll have a talk about that together. That might involve giving a diagnosis. It might not do. Sometimes it’s helpful, sometimes it’s not. What’s more important than that is having an agreement together about what we think the main problems are. And that’s a joint agreement between the mental health professional, young people, and their families. Then we’ll have a think together about the best ways that we can help you. And we often use a mixture of different things in that intervention. One of the things that’s always important is to think about what’s happening in young people’s lives, and how we can improve that.

For example, how we can make things go better with school, with friends, with family. We’ll often suggest talking therapies to help you talk about your problems. That might be for you on your own, it might be you with your parents, maybe your parents on their own. And often, talking therapy can really help people to think about things differently, to look at different ways of doing things that you’ll find more helpful. And sometimes, we suggest medication might be something that could help. It’s important to say we don’t force people to have medication. We don’t force people to have certain treatments.

What we do is we tell you about the kind of treatments that are on offer, and suggest you have a think about those, and think which would work best for you. Sometimes, you might just for one treatment to begin with. Sometimes, you might want a combination. Sometimes, you’ll try one thing, and if it doesn’t work, try something else. Often, we’d suggest you don’t make a decision that first day. But they make you go away for a week, and have a talk together, and think about what you want to do.

And we might give you some information sheets that tell you more about the problems that we think you might be having, about the diagnosis if there is one, and also about the treatments which we’ll offer, because sometimes when you’ve had a really difficult session and you’ve talked about difficult things, it can be quite hard to take in what professionals tell you. So if you have some of it written down, it can be much easier to remember that, and make up your mind.

Sometimes, when we have people come see us, we actually agree that it isn’t a big problem that we need to help with. And that’s always good for everyone, actually. Sometimes, just talking about things once can also suggest some simple solutions that families can put into place on their own, and they don’t need help with. Sometimes, it might be that the specialist child and adolescent mental health clinic isn’t the best place to get help. It may be better to get help from your school or local authorities services. And again, we’d always talk about that.

But what a lot of people say young people and their parents is that when they do come to our clinics, they’re quite friendly, they find us helpful, and they often find it much easier to speak to us than they thought beforehand. And often, we can be helpful. All right, thank you.