Child psychiatry is a speciality of mental health services that diagnoses, treats, and prevents the mental health problems of children and adolescents. Child psychiatry spans various issues, including ADHD, autism spectrum, depression, anxiety, behavioural issues, and more. Child psychiatrists and trainees see young people from infancy to adolescence, putting their specialist training to use to make sense of the complex interplay of biological, psychological, and social drivers that can affect a child’s mental health. Practitioners work closely with the parents and families in this field, offering therapy, support, and education that help children cope, regulate emotions, and engage in positive social behaviours.

As a child psychiatrist, one also serves as an intervener, working to address mental health issues before they get worse. Child psychiatry should also focus on identifying early warning signs, so that we might help children establish trajectories that are associated with optimal mental and emotional health, setting the stage for a healthier future.

Knowing when a child may benefit from a child psychiatrist as a parent can be challenging. But many red flags could be signs your child is struggling with emotional, behavioural, or developmental issues. Some of these include:

Behavioural concerns: Your child is persistently and increasingly aggressive, defiant, or irritable, beyond what you can manage using ordinary discipline.

Changes in emotional state: Rapid, drastic changes in mood, feelings that are so strong that they seem impossible to control, and feelings of extreme sadness, fear, or excessive worry.

Delays in development: Difficulty reaching developmental milestones or problems with speech, motor skills, or social skills.

School: Trouble concentrating, difficulty paying attention, or doing poorly in school, even though they’re trying.

Social problems: Withdrawal from friends or family, failure to make and keep friends, or extreme shyness.

Self or harm to others, suicide: Words self-harm, harm to others, or death, expressed or implied.

Excessive worrying is worrying all the time about something specific (for example, fear of going to school or fear of being separated from family).

If your child shows any of these signs, it may be time to schedule an evaluation with a child psychiatrist. Early intervention is critical to guard against the development of more serious mental health problems.

The initial visit with a child psychiatrist can be pretty intimidating for both parents and the child. But knowing what to expect can help alleviate some of the anxiety. Here’s a look at what typically goes down on the first visit:

History-taking: The psychiatrist will want to know about your child’s medical history, family history, and present behaviour. They will inquire about the child’s developmental progress, emotional health, and any specific concerns you may have.

Behavioural assessments: The psychiatrist watches your child and notes how they behave and interact with people or the surrounding environment to check for problems with emotions and behaviour. They may talk to your child to learn more about your child’s thoughts, feelings, and concerns.

Family dynamics: The psychiatrist may discuss family dynamics and how the child’s environment may be impacting their mental health. Parents/guardians are key to treatment, so expect the psychiatrist to provide some insights into your child’s home life.

Evaluating symptoms: The psychiatrist will assess your child’s symptoms using standardised tools or questionnaires that focus on behaviour patterns or emotional difficulties.

Discussion of your treatment plan: The psychiatrist will discuss your treatment options, including therapy, medication, or a combination thereof. They will let you know what is best for your child and answer any questions you may have.

Before the consultation, parents should gather any medical records that may be relevant, write down their impressions of any behaviours or symptoms they’ve witnessed, and be open to talking about family issues that could be influencing the skills or problems with their child’s mental health. This visit is instrumental in allowing the psychiatrist to ground their approach to treatment.

Yes, a child psychiatrist who prescribes is fully qualified to prescribe meds when needed. Medication is not, however, usually the first approach. The same goes for most child psychiatrists, who would want to start with therapy and consider non-medication approaches, like CBT and play therapy, especially for concerns like mild anxiety or depression.

Drugs should be considered if:

Symptoms are severe and/or persistent: If your child’s symptoms seriously interfere with her day-to-day life (her ability to do well in school, maintain relationships, or enjoy family life), medication may be necessary to help control her symptoms.

A precise diagnosis: If a child has been diagnosed with a specific mental health condition, such as ADHD, OCD, or bipolar disorder, medication can be used to help manage symptoms.

Other treatments have not worked: If therapy or changes to your child’s diet and daily routine have not worked well enough, medications may be prescribed and taken along with treatments your child is already receiving.

The child is in danger: Whether or not there are issues of self-harm or extreme anxiety, medications can be integrated into a holistic treatment approach to address the disorder that is meant to cause concern for the child or family.

Before deciding on medication, the psychiatrist will balance the benefits and risks using factors such as age, health history, and the severity of symptoms in the patient. They will also closely monitor your child for side effects and modify the treatment plan as necessary.

Most health insurance policies in India cover child psychiatry consultations. As a final note, coverage can vary, so check with your insurance provider to see if mental health services are included. In most instances, the answer will be yes. It’s also possible that other insurance companies have exclusions or other conditions under which they’ll cover mental health care.

If you plan to consult a psychiatrist at a hospital such as NIMHANS, Rainbow Hospitals, or Apollo 247, it’s better to ask about the insurance that such institutions accept. Psychiatric consults, therapy, and medication can often be reimbursed by health insurance, particularly when treating diagnosed conditions like ADHD or depression.

If your child exhibits self-harm, thoughts of suicide, or violence to others, prompt psychiatric care is necessary. These are not things you can leave sitting around – that demands serious attention. This is equally true if your kid’s behaviour radically changes quickly or if s/he starts to engage in potentially dangerous behaviour (for example, excessive withdrawal, aggression, or risky behaviour). It is essential to see a psychiatrist as soon as possible.

Besides these severe symptoms, if your child’s emotional or behavioural problems are interfering with their daily functioning (such as in school, in their relationships with peers and family), professional help should be contacted to avoid continued deterioration.

The timeline to notice an improvement in a child’s mental health varies depending on the specific disorder, type of treatment, and how often the child attends therapy. For particular issues, like ADHD, anxiety, or depression, it can take weeks to notice any improvement.

As for medication, you have to try to find the right dosage and type of medication, which can take time. If your child is in treatment, expect weekly or twice-weekly sessions over several months to make a difference. What’s most important is to be patient and stay in regular communication with the child psychiatrist, note your child’s progress, and make any necessary changes to the treatment plan.