I know that it can be daunting to think about meeting a new person and talking about things you find difficult. But by thinking about what is particularly troublesome, how you’re feeling and what’s been happening we can make a plan for understanding and making things easier.
I do ask a lot of questions. This is important for making sure I understand what’s going on for you as best as possible. I’ll ask about your family, home and school / college / work. I’ll ask about what you like doing, how you’ve been feeling and things that are easy for you and what is harder. I also ask some background questions and other specific questions that I need to ask all young people. These sometimes seem a bit trickier, for example I’ll ask if you’ve ever been in trouble, or used alcohol or other substances (depending on your age). I’ll also need to know about friendships and boy/girlfriends. None of these questions are to judge you or to get you into trouble. The information is for me to understand what you’ve been facing, your situation and how you’ve been managing only.
I’ll ask your parent or carer about when you were little, what you were like as a baby and how you developed. I’ll also ask about how things are now. Sometimes young people and their parents / carers see things differently and I am used to this.
Young people will always be offered time alone from their parent / carer and this is important.
I will always respect your confidentiality. This means I keep the information you give me private. I won’t discuss it with anyone else and I keep your data and documents secure – files are locked away or encrypted on a computer. I take this very seriously. However, sometimes I might need to break this confidentiality. This would be if you told me something that meant I thought you or somebody else was in danger. I don’t break confidentiality lightly and would usually discuss it with you first but must prioritise your safety.
At the end of the assessment I’ll tell you what I think, and we’ll make a plan together. There are generally three outcomes.
It might be that I can reassure you I don’t think you’re suffering from a mental health problem. This isn’t to say things aren’t very difficult or distressing but there might be other explanations, and understanding those are what’s required to make things better.
I may be able to make a diagnosis from what you and your parent / carer have told me, for example of depression or anxiety. I would recommend what I think would help best. Often people come expecting medication (or hoping for anything but!) and can be disappointed if I don’t prescribe straight away. But in depression and anxiety there are lots of things that can affect our mood and wellbeing and it’s important to consider these. Formal psychological therapy should also often be thought of first.
Alternatively, I may agree that what you’re telling me is suggestive of a mental health problem and need to make further assessments. For example, I won’t be able to make a diagnosis of Autism Spectrum Disorder (ASD) or Attention Deficit Hyperactivity Disorder (ADHD) the first time we meet. This is for important reasons:
Young people often present differently (not look like their usual selves) in new and unusual situations – someone who bounces around the room and fidgets constantly may look like they have ADHD but in fact be very anxious and agitated.
These diagnoses require information about a young person and how they manage in different environments and throughout the day – for example at home and at school – this is something I would collect as part of the complete assessment.
ASD and ADHD are frequently complicated diagnoses and affect each young person differently. Given the potential consequences of diagnosis they should not be made lightly. Good practice dictates that multi-disciplinary (professionals from different backgrounds) agree to make the diagnosis of ASD.
Much of the benefit from a diagnosis relates to the ongoing understanding of a young person’s difficulties and appropriate adjustments that can be made. The diagnosis must be respected as correct for these to be most available.
In these cases I would discuss with you what I would suggest and you could then decide to continue the assessment with me or take the information we’ve gathered and my report and advice back to your GP or other services for further support.