Private diagnosis for schizophrenia?

[YouAreMyRain]

It's me again.
I have posted a similar thread in children's MH on here but there's not much traffic.
I thought some people on this area may (unfortunately) be able to help.

I have two adopted DD. DD1 is 8yo, under Camhs, lots of MH issues. We have had a horrendous few days with her trying to drown her sister (6yo) in the bath and saying that she wasn't angry, she just had a "feeling" that she "had to hold her head under the water until she stopped breathing".
I have spoken to Camhs and PAS, who were considering removing her as a risk to the other children (I have a one yr old DS who she has previously threatened) but have changed their mind.

Anyway, the main reason for this thread is that I am concerned that she is showing early signs of schizophrenia or a personality disorder.

Camhs in our area have said that they would not diagnose either of these until late teens or early twenties as the personality is still fluid until then.

I would be happy to pay privately as she may need meds and specialist treatment etc but I don't know how to find a private child psychiatrist who would do so. Any thoughts?

Who gave you the "good moral compass " speech ? Children with RAD have no difficulty telling right from wrong . They just don't have uncomfortable feelings when they do things that are "wrong " .

I think before you aim for diagnosis you need to really look at the whole child, what the child has witnessed, experienced and even horror movies that they may have been exposed to. Nobody on MN can give you warnings or advice based on a couple of sentences in an anonymous thread.

Having a 'feeling' as an 8 year old can mean absolutely anything. It doesn't mean she's a psychopath or anything else. You sound sensible and very reasonable and I would have thought you would agree that therapy has to be the way to go. A therapist will be able to reveal the truth about your child, aiming for a diagnosis and medications won't. The child needs to heal from whatever problems she has had in the past - you simply have to try that first.

Poor child, and your poor 6 year old. How is she?

I am a senior psychiatric nurse - I have worked in and out of CAMHS- there is NO psychiatrist within the NHS or privately that would diagnose a child for very good reasons - with schizophrenia or a personality disorder before the age of 18.

The personality is not fully formed and would you want your child stigmatising at such a young age?

Another experienced and senior MH nurse. Agree with Blessed 100%. I would be horrified to hear of any Psychiatrist diagnosing an 8 year old with either a PD or schizophrenia and it would not happen in the UK NHS.

I am not sure you fully understand the symptoms of schizophrenia or personality disorders and how they would manifest in any case. That's not a criticism either, many many people do not and assume they must be the cause of violent or disturbed behaviour.

Speak to CAMHS, social services, adoption agency/support - anyone who is involved already or should be.

You must feel frightened and alone and should be getting more help but please, please do not seek to label this behaviour as either schizophrenia or PD - it is not the answer.

In fairness to the OP, I think she is just desperately trying to get some help for her child and that she is hoping that a diagnosis will help achieve that .

There is quite a back story here that posters who are new to this board won't be aware of .

I know of two 8yr olds who have been diagnosed with schizophrenia, in different areas of the country, I was wondering if it was just in my area that they were reluctant to diagnose.

I'm not concerned about stigma, I just need appropriate help for my child. She doesn't fit any mould, not RAD, not ASD (still undergoing assessment but so far her results are contradictory)

She is very confused, she can't distinguish reality from fantasy, she has false memories, she has attacked me, made various false allegation, made threats to kill various people, earlier today she got upset about something and screamed that she wanted to smash the babies head.

She went straight from the hospital to foster care, has not seen any horror films etc (she likes CBeebies and is terrified by cbbc, especially horrible histories because it confuses her)

Both Camhs and pas have said to bathe them separately. Camhs said that many children have homicidal thoughts about their siblings and that she has a good moral compass etc.

Pas have said very little and are clueless.

Sorry my responses are a bit jumbled, I was trying to remember all the points I wanted to cover.

So when did her problems start - in foster care or after you adopted her?

I'm speechless at the lack of support you and your family are receiving. The only suggestion I can add (if you're not already doing it) is to record every conversation you have with PAS or CAMHS by emailing the person you spoke to and outlining the conversation as you understand it. Copy their manager in if possible. Then you have a paper trail. I think it also sometimes pushes people into action when they see the reality of the situation and their utter lack of response there in black and white.

I'm sure there is a huge back story here and the OP is desperate, frightened and distressed but for anyone involved in safeguarding whether through working in MH or CYPS etc then we are trained that the needs and support of the child are ALWAYS prioritised over the adults involved.

It's not a criticism of the OP. My Dad and Step - Mum are experienced foster carers so I understand the limitations of help that is often offered.

I've also worked with service users (over 14 years of age when I met them) who were adopted and exhibited the most disturbing and violent behaviour from a young age and the families were offered zero help after adoption.

I know there must be great follow up happening somewhere but my views are coloured by lovely people (like the OP probably) who wanted to offer a happy and stable home and found social services just disappeared once the adoption was formalised and they were left with extremely damaged and distressed children with no help whatsoever.

It is one of the failings of the system that enrages me. Not wanting the OP to label a child of 8 with a severe mental illness does not mean I don't sympathise deeply with the situation she is in.

It fucking sucks IMHO but no Psychiatrist in the NHS will give either of those diagnoses to an 8 year old and absolutely should not because they would not be valid.

OP - as I said before, speak to anyone already involved or who should be. You may have to press the point repeatedly but this situation will break down if you are not given help - tell them that.

Good luck

She doesn't have a psychiatrist, just the psychotherapist.

She is having psychodynamic psychotherapy, not sure if that is to do with transferring attachment, her psychotherapist says it's about getting her to understand herself better.

X - posted with OP. I am horrified that you know of 8 year olds diagnosed with schizophrenia.

I have worked in MH for nearly 20 years. I did a placement in a CAMHS ward and worked in early intervention for psychosis for several years.

NONE of the many Psychiatrists I have worked with over the years would diagnose an 8 year old with schizophrenia. None.

There was extensive drug use by her birth mum during the pregnancy (mainly crack), and violence during the pregnancy.

There is suspicion of neglect in the foster placement.

We adopted a "normal" 2.5yr old apparently.

Birth mum has adhd.

Camhs have DD has attachment issues and that they will mask or distort a lot of things eg ASD.

I just want some answers.

How do I get more support if pas want to just carry on with Camhs and won't pay?

I don't even know what support I need or what would be helpful.

I am a psychiatrist although not a CAMH one.

Schizophrenia is vanishingly rare in young children. Almost unheard of before teenage years. Do you know her family history? If she has 1st degree relatives with the diagnosis it might make it more possible but really it is almost never diagnosed in children. I would actually feel quite suspicious of a psychiatrist who was happy to diagnose this illness at that age. It is really hard to tell with a child what is a description of a psychotic experience from fantasy that is normal in childhood.

Personality disorder also is not diagnosed before adolescence because part of the definition is that it has to be a longstanding pattern of behaviour. Conduct disorder is sort of a pre- personality disorder type diagnosis that can be given in adolescence. Even that she is a bit young for I think.

I have lurked a bit on this board because of my own experiences and I have read your story before. I can understand how desperate you must be to get help for DD1 but I don't think a private psych diagnosis will be able to help you much at all. Even if she did have either of those diagnoses it does not really open up any other avenue of treatment. Medication would not be likely to be of much use and can cause severe side effects. It would hardly ever be used for a child

It certainly isn't my expert area but I do know that attachment disorder can cause very severe behavioural issues and can look very much like autism for instance. I would think that her behaviour could be explained by the diagnosis she already has without postulating anything else.

What you need much, much more than another diagnosis is some proper treatment and support for DD1 and your whole family. I am shocked at what little support you seem to have received for what are clearly very serious and long term issues. I guess that if she can't be safe at home another option not mentioned so far would be an inpatient CAMH admission. I know that such units are rare but certainly they do exist. I am not expert enough to know if this would make the attachment issues worse but clearly priority no 1 is safety.

Can you ask to see the psychiatrist in your current CAMH service to clarify diagnosis and ask particularly for an assessment of her risk to others and to herself? I would request this in writing and state in writing that you are very concerned about risk to your other children. They will surely be obliged to respond to that. If you are not getting much joy from social services then I would channel your efforts into CAMH.

I am afraid that complaints do get action certainly in the NHS. If you don't feel you are getting good care for your daughter and the response to your letter is still inadequate then contact PALS and make a formal complaint.

Schizophrenia or PD is not the answer in an 8 year old.

I hate that adoptive parents are just being left to deal with this without any support.

IF you feel that this situation may lead to the adoption breaking down (despite all your feelings of love for your child) then I think you need to be very clear in your dealings with anyone that that may happen.

I really feel for you OP. You are in an awful situation and should be given much more intervention and support.

Oh I see from you latest message not RAD

Definitely does need 2nd opinion then but you can request it on the NHS

Cottage- she was seen as very spirited and boisterous in fc. She has repeatedly rocked/head banged from 8 months of age and still does now. When she came to us she was very anxious, angry and defiant from the start. She has always been very quirky/eccentric.

She has always worried a lot. She has been obsessed with death since not long after she came to us and the snowman we had built melted and she said he had died.

She couldn't accept love from day one, she would scream when I told her I loved her and so I made it into a song which she accepted better.

She has always been very controlling.

In year one, so at 5yo she started worrying about being too fat, I discussed it with her teacher and was going to speak to the gp but she settled down again, then at 6yo she had "angry hands that want to hurt people" and would beg me to help her. She wanted to cut herself into pieces, she didn't want to be real. She would scream that I wasn't the real YouAreMyRain and would beg me to go and get the "real" one from the garden. She accused me of leaving her in the house alone. She tried to kill herself by jumping out of a window (I grabbed her) because people in her head were telling her that she was stupid and ugly.

I am a very dedicated therapeutic parent. I always get great feedback that I am doing everything "brilliantly". I don't react when she says or does extreme things so I am not feeding into any need for attention etc but it's not enough. I am constantly trying to help and support her but it's like trying to fill a sieve with water. It's not enough. Everything I do is not enough. Even maintaining the status quo is totally fucking exhausting and the status quo is shit.

According to Camhs, if I bathe them separately then the risk is removed and if I feel like I can supervise them enough then that's ok. I have told everyone that I cannot supervise three children 24/7. It's impossible. DD1 and DD2 share a room. I have to decide if I can supervise them enough.

It feels like it's all up to me.

Yesterday PAS were asking me if I wanted to make a safeguarding referral!!?!
I pointed out that I have no experience of this situation and that I hoped they could draw upon their professional judgement as SWs to make that decision. They said "well you have had two recent referrals" (due to DDs allegations) it sounded like they were trying to dissuade me from making it a safeguarding issue.i asked why that was relevant and if something got triggered after three referrals but no. They just "know how stressed I have been with the previous referrals" even though they were for different circumstances entirely.

I appreciate that it must be extremely hard for you. Of course you are doing everything you possibly can and your daughter needs help urgently, I hear you.

Thnking about the headbanging specifically, what was ruled out - autism, glue ear, migraine etc? A child can normalise pain when very young and headbanging can be a symptom of that.

Please do what mamadoc suggests re contacting CAMHS and speaking to a psychiatrist . She needs a proper risk assessment From a medical practitioner , not a psychologist , especially given her history of attempted suicide and now the attacks on her sister and verbalising violent thoughts towards the baby

These are all safeguarding issues .

Have they ruled out RAD and FASD? I'm not sure how they can if she's not seen a psychiatrist .

Ive seen no evidence that psychodynamic psychotherapy is effective in children like your DD.

Please contact FF and /or PAC tomorrow by phone .

Hi op, I have PM'd you.

What I'm saying is rather than looking at her mental health, get a full review of her neurodevelopment. Has she ever been referred to a neurologist? Also autism can be hard to diagnose in girls and perhaps that was missed early on?

Also was her BM taking any meds while pregnant?

Initially she was reported to be a restless baby by the fc who told us that a medic had put the rocking/head banging down to drug use in utero. This is not documented. It is documented that she was rocking at 8 months.

At 2.5 it was a full body roll, side to side with one arm extended, off and on (with sleep cycles presumably) all night. Her arm would bang on the wall/headboard thump, thump thump all night.
She would rock her whole upper body backwards and forwards almost constantly when sitting, thumping back on the sofa/chair or even onto a wall. This is when she is calm and regulated and is more of a compulsion than a self soothing thing.

At night she has reduced her movements to a head rubbing on the pillow which is normally accompanied with banging her head constantly on the wall or head board. Still thump thump thump all night long. (We get strange looks on the campsite during caravan holidays)

If you YouTube autistic rocking, that is what it looks like. She is currently being assessed for ASD and has scored positively for it in the assessment but contradicted that in other areas of the assessment.

They are assessing her again next week to get a full cognitive profile.