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Child Psychiatry

Sunday, April 15, 2012

When should my child see a child psychiatrist?  Why does my child need to see a child psychiatrist when he/she already has a therapist and pediatrician?
Child psychiatrists are medical doctors (M.D.s) who are best qualified to treat various developmental and psychological disorders with certain medications.  These disorders include autism, complicated Attention Deficit Disorders (ADD/ADHD), depression (and other mood disorders), anxiety, oppositional/conduct disorders.

Your child may also benefit from (or already be receiving) treatment by other professionals such as psychologists, occupational/speech/developmental therapists or social workers.  These therapists are an important part of your child’s treatment but they cannot prescribe medications.  As pediatricians, we have the ability to prescribe medications within our range of training.  We may have already prescribed psychiatric medications in the past for your child for uncomplicated ADD or other, milder, stable psychiatric/developmental disorders.  However, only specialists in Child Psychiatry have the training to diagnose and treat more complex disorders in the area (much the way only pediatric cardiologist would treat your child with heart medicines if they had a significant heart problem).

Unfortunately, there is a nationwide shortage of doctors who practice Child Psychiatry.  Also, many insurance plans have different benefits for these types of disorders and they are covered under a separate “Mental Health” aspect of the plan.  We understand it can be frustrating, and even scary, to work through the referral process to get your child the help he/she needs.  Don’t give up!  There are many effective treatments available that can truly improve your child’s life.  The following are some suggestions to help you get through the process:
  • Realize that even after you get that first appointment with a Child Psychiatrist, this is not a quick fix.  It may take time and several trials of different treatments to get the best results.
  • Become familiar with your insurance benefits for mental health.  Many plans require “self referral”.  This means that even though we can advise you your child should see a Child Psychiatrist, we cannot make the calls and set up the appointments for you like we may be able to for other types of problems.    Many large employers have “Employee Assistance Programs” or EAPs for mental health benefits.    Usually, you will have an appointment with an intake person who will assess your child’s needs, authorize treatment (such as a certain number of visits with a therapist) and direct you to another professional in network who will actually be your child’s regular doctor and/or therapist.  Similarly, other insurance plans have an intake person/therapist who will do an initial assessment.  Make sure this person knows that your pediatrician has specifically referred your child for a psychiatric/medication assessment.  However, do not be surprised if you are directed to see another type of therapist first.  Go ahead and do so.  This therapist cannot prescribe medication, but can likely see your child more quickly than a Psychiatrist can and begin non-medication therapies that can complement medication.  Also, he/she can confirm the recommendation to have a medication assessment and assist you further through the process of seeking a child psychiatry appointment.
  • If your child worsens during the wait for a psychiatry visit, there are some options.   A patient who is threatening harm to him/herself or others is considered “in crisis” and many times arrangements can be made to see him/her more quickly.  If your child is in this situation, see if your current therapist has instructions for crisis (often they will have a specific number for you to call in this situation).    Realize that you may have to make arrangements to have your child or adolescent well supervised during this time.  You may need to consider seeking help at an emergency department.
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Dr. Vicki Roe is  a Pediatrician at Northpoint Pediatrics. She received her  under graduate degree from Purdue, and her MD degree from IU School of Medicine. In her spare time she enjoys book collecting, genealogy, photography, Sc Fi and comic books.

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