Seeking advice on psychiatric assessment and support for a struggling teenager

[littlebabycheeses99]

Hello

Am wondering whether to go down the route of an assessment for our teen DS.

Suspect he is ASD but he refuses a formal assessment. He's been very low for a number of years but is now having issues with OCD, intrusive thoughts, feeling 'out of his body' and is now having issues with diet and not eating properly (so has lost weight recently).

Have tried the GP on numerous occasions and they won't help but have referred to CAMHS. Then received a call to say that given his age (17) it wasn't worth putting him on the waiting list as he would be moving into adult mental health services. So it seemed like they were signing him off!

He does see a Clinical Psychologist - he finds her useful, but we haven't seen any marked differences, in fact he is on more of a downward trajectory.

He wants medication - GP initially did prescribe it but then then it wasn't 'signed off' and ultimately he got refused because of his age.

So we are hoping that a psychiatrist might help with giving him some form of diagnosis and perhaps some anti Ds.

Does anybody have any experience with this - and perhaps could recommend anybody in the Yorkshire area? Thanks

What does the clin psych say?

Feeling out of his body could be depersonalisation/derealisation.

a private psychiatrist would be able to prescribe if necessary and will also be able to diagnose,

what you describe does not sound like standard Asd.

oh sorry I wasn't clear, there are lots of other things that we suspect make him ASD - lots of difficulties socially, sensory issues, black and white thinking, obsessive.

doesn't really say much to be honest but she did talk about anti depressants with him (although said she can't prescribe). She won't talk much about what she's doing with him or how he's responding etc as a lot of it is 'confidential'. She has talked a bit about how fixed he is with his ideas and how he has difficulty 'buying into the process' because his patterns of thinking have become so familiar.

I guess I could ask her about whether she thinks a psychiatric assessment would be useful?

The clinical psychologist should have already done an assessment and diagnosed him. Because if he is showing signs of ASD in her psych assessment, she would have referred him for an ASD specialist to do the full ASD assessment (which you say he has refused).

The information is private so that’s why you don’t know the results or her diagnosis or diagnoses. Your DS would have to tell you or give permission for her to tell you.

A psychiatrist is also needed if medication is required. I would ask DS if she has suggested he see a psychiatrist for medication? She would know who to refer him to based on her assessment of him.

It isn’t advisable to see a psychiatrist and not coordinate that with the psychologist. The two need to be able exchange information and have multi-functional team meetings to provide individualised care to your DS. Your DS should ask the clinical psychologist for a referral to a psychiatrist to look at medication options.

Has he been referred by CAMHS to adult mental health?

I can't remember exactly, but she did do an assessment and there wasn't really a diagnosis. She does ASD assessments herself, but said she couldn't say if he was or wasn't ASD without doing the full assessment. She said she didn't think it was a personality disorder or bipolar or anything like that. I wish I could remember exactly what she said now. I know she talked about his low mood and low self esteem etc and she felt he would benefit from CBT.

I have talked to him separately about an ASD assessment and he just maintains that he isn't ASD.

Since then I feel like there has been more issues - ie the not eating, the intrusive thoughts etc.

I don't think he was referred to adult mental health no, I didn't get that impression. It was more like 'oh the waiting list is so long it's not worth putting him on it' and then I didn't think to ask if he'd been referred to adult mental health. I will need to chase that up.

I feel like my head has been swimming for so long and now I can't think straight.