Teenager mental health crisis

[watchingplanesicantafford]

I need urgent advice please. My 17 yr old has messaged to say he is having a panic attack. He has a long standing diagnosis of anxiety but has so far been uncooperative and discharged years ago from cahms. He's begging me to get him help this morning as he feels so out of control. Is this a&e? I don't know where best to take him. Could go to the dr but it feels more serious than that. He appears manic to me. Please don't judge me for not knowing what to do.

You could go to a&e, but the experience will probably be stressful and negative. Long hours of waiting in an unpleasant environment, after which they may just tell him to wait for another service to contact him.

I'd suggest not going to a&e unless you have a pressing safety concern.

In the first instance it might be better to ring your GP surgery and see if you can arrange an urgent appointment there.

Talk to your son first to assess whether there is an emergency safety concern. Since he has initiated contact with you, I'm thinking that he may well feel that things are a little more in hand now that you are working on the problem together.

You could call 111 and see if they have any options available?

If he's a danger to himself or others than yes A&E now.

But if not, it wouldn't be my suggestion. If he's anxious, the experience of waiting in A&E will probably be awful

Phone your CAMHS clinic. They have a crisis team, were you given the number? Do you have old paperwork from them?

Short term right now, will anything distract or sooth him? A bath? A walk? Playing a video game? Watching a favourite film? Music?

Get him an apt at the gp to discuss a new mental health referral. He's going to be at that tricky stage between children and adults services. Get the ball rolling on it.

It should be different in an and e now. They should have a mental health liaison team who will meet you and your son and hopefully make a referral to the Cahms crisis team who don’t have a waiting list and will see you within a week. Worth googling mental health liaison team an and e with your county to see if there is one.

111 has a mental health option. At 17 in A&E they'll probably call CAMHS and he'll have an assessment for safety. Not sure if it's national but in my area they have to be seen within 4 hours. CAMHS will arrange a follow up and may then offer further intervention if they think it's needed. It may be worth engaging with CAMHS as due to his age they will involve the transition team and can refer him to Adult MH when he turns 18.

I've just noticed that cahms have a self referral form. I'll do that

Phone 111 press option 2

CAMHS will not respond fast. First aid:

• Are you with him? Can you be with him?
• Ask the GP for an urgent same day appointment
• Do some grounding - 5 things he can see, 5 things he can feel, 5 things he can hear - it just helps the brain to remain in 'reality'.
• Square breathing. In through the nose, out through the mouth. Slow. Breathe in as he traces up the left side of the square, out as he goes along the top, in as he goes down the right hand side, and out as he goes along the bottom.
• Don't ask what he's panicking about. He can't rationalise. That part of his brain is closed for business.

Great advice.
My three are now in their 20s but all had their share of minor but scary MH problems. Limited Cahms involvement, quickly discharged and a couple of 🙄 self medicating events.
My advice: touch grass. Get him, go for a walk in the countryside or to the beach. Get take away food en route. Let him talk if he wants. Reassure him it’ll pass.Try and tire him out. Then let him sleep but be rigorous about good MH hygiene. Fresh air, good food, limited screen time, definitely not overnight. Up and out of bed tomorrow.
💐

Panic attacks are terrifying but physically harmless. It might reassure you if not DS.
focus on his breathing, small sips of water, walking might help or might not. The power of controlled breathing can not be underestimated.

A&E only if you feel it’s heightening not reducing, he’s a risk to himself or otherwise unsafe.

GP apt to discuss options re counselling/CBT and medication.

Its great he called you.

One thing to note is that the physical symptoms of a panic attack promote panic. So the elevated heart rate, the palpitations, the feeling dizzy. It's all part of the panic attack, but they make you feel very panicky. That's why the breathing is important. It will stop the hyperventilation that causes his CO2 levels to drop and brings on dizziness and the fizzy fingers. It will lower his heart rate. It will reduce the nausea. Then he will start to physically feel better, so he'll panic less about how he's feeling, which will give space for his brain to start processing whatever has caused the panic attack.

Honestly I don't think an and e will do much. When I had a suicidal child and rang 111 they asked if they were actively trying to kill themselves and had a plan. As the answer was no they just told me to lock sharp things out the way and wait for our CAMHS appt to come through. Welcome to nhs MH support in 2025.

Thank you for all the messages. To answer some questions - yes I'm with him and can stay with him. He is safe. He's calmer than he was, although he has underlying issues which has meant that his mental health has always been difficult. I have contacted the dr and waiting to hear back from them and will take it from there.

Thank you everyone for your advice while I was in a panic this morning. Things are ok for now.