Autistic Teen with MH issues refusing to engage with psychiatrist

[bosstick]

Hello

I couldn't find the SEN board but hope I get some help here.

So my autistic teen has been on medication for anxiety for some time now and it is working on some level but the dosage needs to be reviewed and in (our) opinion, increased.

However after a few month without a follow up session, suddenly and out of the blue (which is a person autistic's worst nightmare) we were given an appt with a completely new doctor and the news that her former doctor left.

Somehow I managed to convince Dear Teen to attend an online session but DT took an instant dislike to the doctor and towards the end of the call even became slightly rude (I'm not been precious but DT has always been praised for manners despite the difficulties interacting with people).

The doctor did not do anything wrong per se, but it was clear that although he understood autism and DT's MH on a rational and professional level, he couldn't get through to DT.

DT's feedback is that the doctor did not ask the right questions, did not listen properly, interrupted and was pushy.

We had this problem before with a number of different professionals and it is so frustrating tbh. When DT clicks with a professional, they do amazing work together but when DT don't click, they shut down and refuses help.

Problem is - with NHS on their knees etc how realistic it is that we can get a new doctor and what are the steps?

The doctor said he will not review the medication unless DT attends another session in person and DT refuses point black and would rather have nothing at all.

I sympathise. I have a teen exactly like this. Is going private an option? That way, hopefully, you'd be able to find someone who your DS gels with.

Sorry, your DD.

However after a few month without a follow up session, suddenly and out of the blue (which is a person autistic's worst nightmare)

Eh? I'm autistic and this is far from my worst nightmare. If you think that this is an autistic person's worst nightmare you know nothing about being autistic.

gatorpickle I disagree. I have two kids with autism. One really hates change and wouldn’t like it if a trusted adult stopped helping them. Both are quite distrusting of adults anyway.

How old is your teen? To be honest my older child could do with help but found one Psychiatrist so unhelpful, and felt he accused her of being a pathological liar. She now refuses to be seen by the other psychiatrist at the local provision. She would never agree to online or telephone consults.
I would start by talking and listening to your teen.
Be guided by them.
And seek alternative provision.
Is the medication helping? It's not for everyone.

You have two children with autism - you do not have autism. Your attitude is incredibly ableist, ignorant and arrogant.

(1) You do not know what it is like to have autism, I do. I am autistic. (2) Just like neurotypicals, what is a true for one autistic person may not be true for another autistic person.

My post was in response to @stealthninjamum .

gatorpickle I’m not sure I’m ablist, ignorant and arrogant when I am describing things from my kids perspectives in a non judgemental way. One would react very, very badly to losing a trusted adult. The other wouldn’t. I recognise that they are individuals and different, which is what I said!

Why the aggression? My autistic DC would both react very badly to a trusted adult being changed for someone else. Not all autistic people would, obviously, but my teens both would. That's why I pay for them to go private and hopefully see the same person all the time.

Well shoot me too, I can relate as well. You have to go back to the Dr and say that dd is refusing to engage for the reasons stated and ask what he thinks your options are to enable your daughter to engage with help.

Hi op. Same happened to my dd. Just as she had got comfortable with her doctor they left quite suddenly and my dd just immediately took a dislike to the replacement. I didn't feel like they took enough time to engage with my dd before heading straight into her therapy too. I spoke to the doctor and he agreed they would see if another doctor could take over and before that first session I asked to chat with them about my dd so they could get a good handle on how to approach her. This worked a treat. Best of luck

Thank you.
It is somehow a relief to know it is not a DT thing

Unfortunately private is out of cards although I dont even know how much it costs

Sorry if this offended you

Should have said my child’s worst nightmare as she doesn’t like sudden changes and surprises

Yes, I know little about autism as I am not autistic myself and all I understand is how it manufests in my daughter

The medication is helping as she started eating again and stopped self harming. She nearly died of starvation and dehidration and used to cut often

@Gatorpickle give over eh? She’s worried about her child, and isn’t out to get you, or people with autism, or anything. Ok?

Im not a teen now but I get this being autistic and mh problems. It took me mum years of fighting to see the right people and quite honestly maybe I was rude but some just did not get it and that for me was enough to not engage. Luckily we got there and I've been on the right meds for 5 years now and I have to say it's been the best years since a youngster for me

I don’t think it’s ethical to force someone to go to therapy. If she says she doesn’t want to go, I think you should respect that, autistic or not.

Can you ask to see a different member of staff? Most services would be able to accommodate this.

It’s not therapy, it’s a doctors appointment to review meds!

Surely they can't just refuse to review medication if it's needed?

I’m not forcing her to go to therapy and psychatrists do not do therapy anyway.

As I said is about managing the medication dosage which I need a psychiatrist to prescribe - in order to make assessements about dosage, the psychiatrist needs to talk to the patient and ask questions.

The doctor said that he needs to be able to properly talk to her in order to review the medication - and he wants this to be in person at the hospital even though he knew that she does not leave the house at all (agoraphobia) and sometimes not even her bedroom.
She couldn’t even be in front of the camera for the virtual appt.

Anyway, I sent an email to the team as I don’t have direct access to him.