Child and adolescent psychiatry: what the specialty covers, conditions treated and what to expect

Child and adolescent psychiatry deals with emotional, behavioural and neurodevelopmental difficulties from early childhood through the teenage years. The Royal College of Psychiatrists describes CAMHS as services that help children, young people and families with a wide range of mental health conditions, neurodevelopmental conditions and behavioural problems.

A child and adolescent psychiatrist is a medically qualified doctor who has gone on to specialist training in working with young people and their families. Because they are doctors, they can consider the biological, psychological and social factors that may be contributing to a young person's difficulties, and they can prescribe medication when it is appropriate. The same college points out that seeing a psychiatrist does not automatically mean a problem is severe or that medication will be prescribed.

The psychiatrist is rarely the only professional involved. Clinical psychologists, psychological therapists, specialist nurses, occupational therapists and family therapists commonly work in the same team, and the mix varies between services.

The range is wide, and many young people have more than one difficulty at the same time. These are the groups of problems most families meet.

• Anxiety and related problems, including separation anxiety, social anxiety, panic and school avoidance. See our guides to anxiety in children and to school refusal.

• Low mood and depression in teenagers, which can look like irritability or withdrawal rather than obvious sadness.

• Obsessive-compulsive disorder, where unwanted thoughts drive repetitive routines; exposure and response prevention is the usual talking therapy.

• Eating disorders, including anorexia nervosa, bulimia nervosa and binge eating disorder, which in young people are usually treated with the family closely involved.

• ADHD, which the NHS says usually starts to show before the age of 12 and involves inattention, hyperactivity and impulsivity in varying combinations.

• Autism, assessed through a team that looks at communication, play, development and behaviour across settings.

• Self-harm and thoughts of suicide, which need a prompt and non-judgemental response.

• Tics and Tourette syndrome, mood disorders such as bipolar disorder (uncommon in childhood), and psychosis, where early specialist input matters.

The Royal College of Psychiatrists lists several kinds of service that can sit under the CAMHS umbrella, noting that names and availability vary by area. Understanding them helps a family make sense of letters and referrals.

The NHS describes children and young people's mental health services as a range of support that is usually delivered or funded by the NHS and differs depending on where you live. They may include mental health support teams in schools and colleges, services run by local charities that the NHS funds, and what many people call CAMHS.

A professional such as a GP, teacher, school nurse or social worker can put a family in touch with these services, and the NHS notes you can refer yourself to some of them. The Royal College of Psychiatrists adds that referral criteria are agreed locally, and that in general a young person is referred when other support has not worked or is not available, when there is a risk to themselves or others, or when other factors such as a neurodevelopmental condition make coping harder.

For ADHD and autism, the NHS suggests starting with the school's special educational needs co-ordinator or a GP. In England the Right to Choose scheme lets a family ask for an NHS-funded assessment at any provider that offers the service to the NHS, which can shorten the wait; the NHS acknowledges that waits for ADHD assessment can run to many months or years in some areas. The NHS constitution standard for most consultant-led referrals is 18 weeks from referral to treatment, but waits for neurodevelopmental assessment differ widely by area, so ask the service for its current expected wait.

Private assessment is available for most of the conditions above, and families usually arrive either by GP letter or by approaching a clinic directly. Private health insurance policies differ in how they treat mental health and neurodevelopmental assessment: some exclude ADHD and autism assessment altogether, and many require pre-authorisation, so check the policy wording before the first appointment.

What drives the cost is mostly the structure of the assessment: whether it is a single consultation or a series, whether psychological testing, school observation or reports from teachers are included, and whether follow-up and medication monitoring are bundled. Ask for an itemised estimate that separates assessment from ongoing care. If a diagnosis is made, ask how medication would be prescribed and monitored, and whether the GP can take over under a shared care agreement; the NHS notes this is only possible if such an agreement exists between the GP and the specialist.

The Royal College of Psychiatrists describes a CAMHS assessment as a meeting, or series of meetings, between the young person and one or more professionals, sometimes with parents or carers present. It suggests preparing by noting down your concerns and any changes you have seen in behaviour.

Expect questions about mood, sleep, appetite, friendships, school, family life and development, plus how long each difficulty has lasted and how much it interferes with daily life. For ADHD, the NHS says the specialist will usually speak to a teacher or SENCO and may use a computer-based test. For autism the assessment team may observe play, speak to people who know the child well and, in some cases, visit the school.

Young people aged 16 to 18 are presumed under the Mental Capacity Act 2005 to be able to make their own decisions about treatment, including consent, and the college notes that parents' decisions cannot override those of a competent 16 or 17-year-old.

• Bring school reports, any previous assessments and a short timeline of when difficulties began.

• List current medicines and any past reactions.

• Write down what you most want to understand by the end of the appointment.

• Ask what will happen next, who will write the report, and who will be responsible for follow-up.

The NHS lists self-help advice, talking therapies such as cognitive behavioural therapy, counselling and family therapy, medicines offered alongside talking therapies, support in hospital where needed, and referral on to social care, education services and charities. It adds that some young people need only one or two sessions, while others need longer-term specialist support.

For ADHD, the NHS says medicines must be started and monitored by an ADHD specialist and that not every child needs or wants to take medicine; practical changes at school and at home, such as breaking tasks into short slots and giving clear instructions one at a time, are part of the picture. Transition planning matters too: the Royal College of Psychiatrists notes that waiting lists can delay a young person's move to adult services, so planning should begin well before 18.

If a young person has seriously harmed themselves, has taken an overdose or is in immediate danger, call 999 or go to A&E. If you are worried about their safety but it is not an emergency, NHS 111 can advise on urgent mental health support. Do not wait for a routine appointment if a young person talks about wanting to die or is hearing or seeing things that are not there.