I am a Consultant Child and Adolescent Psychiatrist. That means I am a trained as a medical doctor (not a clinical psychologist) who specialises in assessing and treating the mental health and wellbeing of children and teenagers. My Teaching Hospital Consultant Appointment is at the Maudsley Hospital, London; I am also Professor of Child Health and Behaviour at Institute of Psychiatry, King’s College London. The Maudsley Hospital and the Institute of Psychiatry are closely interlinked and combine to form perhaps the leading centre in Europe for the understanding and treatment of psychiatric and psychological problems. I have always been interested in both the physical and mental aspects of children and families. After a full degree in Psychology, I trained in medicine at the Royal London Hospital and Cambridge University, where I won a science prize and the psychiatry prize. I then worked as a Paediatrician for five years at a number of hospitals, including the Royal Brompton and Great Ormond Street Hospital for Children, including Paediatric Neurology. Having got a good understanding of children’s medical problems, I decided to widen my expertise by training in Child and Adolescent Psychiatry at the Maudsley Hospital, with four years as clinical lecturer with Professor Sir Michael Rutter FRS and Professor Eric Taylor. I am the author of the leading introductory textbook Child Psychiatry, (published by Blackwell, with Professor Robert Goodman, 3rd edition 2012) as well as being an editor and author of chapters of the large, authoritative text Rutter’s Child and Adolescent Psychiatry (6th edition, in press). I also publish scholarly articles on the findings of my research on how best to treat children. I lead a team of researchers investigating the best way to treat child and adolescent difficulties at the Institute of Psychiatry. I am Chair-elect of the leading professional body for training and research, the Association for Child and Adolescent Mental Health, and advise the government on mental health issues. In the 2014 New Year’s Honours list, I was made Commander of the British Empire (CBE) by the Queen, for services to families. The sort of problems I see: I see patients under the age of 18 with emotional, behavioural, communication or relationship difficulties. I see a wide range of general cases, and also have a special interest in (1) disruptive and difficult behaviour, which often overlaps with hyperactivity/ADHD (2) problems arising in the context of fostering and adoption (3) attachment problems (4) children who are proving difficult for their parents to handle (5) problems arising at school or with friends (6) complex cases with coexisting medical conditions. I do not specialise in psychoses, eating disorders, drug misuse or general learning disability (mental retardation) although do see cases with specific learning disabilities such as dyslexia or dyspraxia. The types of problem I see most often are: Problems with attention and/or overactivity, particularly when attention-deficit/hyperactivity disorder is suspected; this often affects school performance Defiant, angry or disruptive children or adolescents who are having difficulties at home in the family, at school, or both Depression and anxiety ; self-harm Obsessive-compulsive disorder Tic disorders and Tourette’s syndrome Difficulties with social interaction and making friends including autistic spectrum disorders Children who have received various assessments and diagnoses whose problems need clarifying; they may be complex and involve many agencies Children with coexisting medical conditions such as abdominal pain or other illnesses children who seem to have attachment difficulties in terms of being normally affectionate with their parents and others This isn’t by any means a complete list but is meant to give a general idea. What I do: Patients need to be referred to me in writing by another doctor, usually a general practitioner or a paediatrician. This is for various reasons: Health insurance companies usually require it I often need professional information about a child’s health and development I may need to ask the other doctor to carry out further treatments and they are not likely to do so if they did not request the referral In the UK healthcare system, the GP holds the overall view of a patient’s health and is the gatekeeper to specialist care. It is professionally proper to recognise this.
I see patients at The Child and Family Practice. I am happy to consider home visits in the London area. My first aim and main responsibility is to offer a senior, expert medical opinion as to what the diagnosis is and what should be done to treat it. In order to assess a clinical problem I have to ask a large number of questions in a fairly straightforward, conversational way. Some of these can only be answered by a parent, others only by the child or teenager. It helps me to see both parents, if possible. I usually start by seeing child and parents together because this enables me to get a list of problems from all concerned (there is often more than one problem or at least more than one aspect of it). It also enables me to observe the child or young person without embarrassing them. I don’t need to see brothers and sisters unless they are part of the problem in question. Parents are understandably wary of talking about their child’s problem in front of him or her. It doesn’t usually matter if the child is under five as they will not follow much adult conversation. I like to see parents separately from their child at some stage and similarly like to see all children over the age of five years on their own. This can usually be done within a single appointment. It is often the case that a school report is particularly illuminating but I will not contact your child’s school without your permission; if you have a recent report, it helps to bring it. I may need to carry out a physical examination on a child I see but can usually manage without having to take all their clothes off. I don’t often need to take blood for tests though I occasionally need to send a child for a brain scan which will need a separate arrangement. I will write a report about my assessment to you and to the referring doctor. If there needs to be a psychological treatment, then if you agree I may refer on to a clinical child psychologist or psychotherapist since they will be more skilled at these approaches than I am. If medicines are to be involved then I will manage these myself, often jointly with your GP or paediatrician. A first appointment lasts about an hour and a half. If I need to see you or your child again it will be for a shorter period. Sometimes I need to see parents rather than the child for a follow-up appointment. This is not because I think that parents are causing the problem – they usually are not – but because they are the people who have the power to change things. It is often the case that changing the way in which parents or teachers handle a child helps resolve the problem. It is unlikely that I can take phone calls myself as I spend my time seeing patients and families face-to-face and can’t be interrupted. I try to return calls within two working days. The phone number above gets to my personal assistant, Caroline Hesketh. Emails are easier for me to deal with. Nearly all treatment is carried out on an out-patient basis. It is very unusual indeed for me to admit a young person to hospital and I cannot do this without full parental agreement. Indeed I can do little in any case without your support and look forward to working with you.