CAMHS Flashcards
What are the differences between AMH and CAMHS?
AMH
- Individual focused
- Family history of mental health
CAMHS
- Young person as part of family system
- Family history of mental illness and life events
- Developmental stage essential in process of assessment and diagnosis
What is important to ask when speaking to a young person about their mental health?
Do they know why they’re there?
What would they like help with?
What is different between young children and adolescents in how you should speak to them?
Young children - speak to them via play
Adolescents - try to understand matters in their world
Why is development important?
16 and capacity - assume under don’t have capacity
ADHD only diagnosable over 6
How may depression present in a young child compared to an adolescent?
Young child
- Many not be able to describe depression and presents as irritable, temper tantrums, refusal to go to school and clingy to mum
- Rating scales helpful if child finds it difficult to explain
Adolescent
- Tearfulness, difficulty sleeping, feeling down, doesn’t want to go out with her friends, recently had suicidal thoughts
How do you gather a history using the family unit?
Interview family together to gain a better understanding of relationships/environment around the child
Speak to the young person on their own to get crucial information they may not volunteer with family present
What is good about the family unit?
Safety network around young person
What is a challenge with the family unit?
May feel vulnerable which can be expressed as anger and want you to sort out child
What is useful about school?
Good insight into how the young person manages socially and academically
Must obtain permission from young person and family before contacting the school
Most CAMHS services have link workers to schools who are very helpful
What is a challenge with schools?
Vary in their understanding of mental illness
What are the common neurodevelopmental disorders in young people?
ADD
ASD
Explain ADD
Triad of poor concentration, overactivity, inattention
Diagnosed over 6
Treated with parenting advices and stimulant medication
Explain ASD
Difficulties in social understanding, rituals, preoccupations, language difficulties
Multi-disciplinary assessment
Treatment support in schools and to parents
What are conduct disorders?
Description of young person with behavioural presentation eg tantrums, breaking things, disruptive in school, trouble with police
Controversial as medical diagnosis as breaking social norms
What are the common emotional disorders in CAMHS?
Eating disorders PTSD Self-harm Depression Anxiety disorders OCD Psychosis
How do anxiety disorders present?
Emotional - fear, worry
Physical - sweating, tremor, palpitations, nausea, breathlessness
Behavioural - avoidance of feared object, irritable, mood swings
How does OCD present?
Repetitive, intrusive thoughts that are ego dystonic
Feeling compelled to carry out certain acts
Both of above to stop something negative happening to self or others
Interferes with daily living
Symptoms same as adults but with shorter length of illness and illness often hidden
How does psychosis present?
Key symptoms same as in adults Specific diagnosis less clear Most common - hallucinations Delusions Ideas of reference Thought disorder unusual Most common onset late teens but can occur in childhood
What systems regulate mental health?
Limbic system - emotional regulation
Autonomic system - systemic arousal/energy conservation
Hippocampus/median temporal lobe and brain stem - memory
Temporal lobes and visual cortex - perception
Pituitary/endocrine - sleep/wake cycle
How does emotional dysregulation present?
Extreme emotional outbursts
Uncontrolled temper
Self-harm
Difficulty maintaining relationships
What can cause emotional dysregulation?
Disrupted attachment PTSD Temporary effect of trauma Life event Stress
What is attachment?
Attach to caregiver who feeds you
Functions to protect infants from external dangers
Emotional connection gives meaning/importance for functioning
Social animals
Essential for child development
Affects individuals throughout lifetime
Reaction to separation occurs quickly in babies
What does attachment involve?
Oxytoxin
Limbic system
Right hemisphere
What does separation involve?
Autonomic system regulation
How does separation present?
Increased pulse and decreased temperature
If prolonged and frequent can lead to changes in cortisol
Affects antibodies in response to stress eg increase in infection
What are the types of attachment?
Secure
Anxious
Ambivalent
Avoidant
How can you treat attachment issues?
DBT
Brain remains plastic into early 20s so can treat
What can affect attachment?
Primary caregiver emotionally unavailable eg depression
Drugs/alcohol (ambivalent)
Abuse/neglect (avoidant)
What is secure attachment?
Able to internally self-regulate the emotional neural systems and response to environment
Around around 5 and up
Develop reciprocal social bonds
What is anxious attachment?
Maintaining attachment with caregiver who is unpredictable
Clingy
What is ambivalent attachment?
Alternate clinging with excessive submissiveness to no trust
Role reversal - parent cared for by child
Dysregulation of fear and anger
What is avoidant attachment?
Child tries to minimise need for attachment to avoid rebuff
Remains in distant contact with caregiver
When severe can freeze when reunited with parent
What can happen with no attachment?
Clear delay in brain development, language, motor and socioemotional development
Often went to many different people to try and get care
