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Mental health and anxiety

My child is anxious about going to school. What should I do?

If you are a parent and are worried about how your child is getting on at school, start by talking to their class teacher or form tutor. They may share your worries and you can discuss how to help your child make progress, what extra help can be offered and whether some expert advice is needed. You can also ask to speak to the Special Educational Needs Co-ordinator (SENCO) – the teacher who has overall responsibility for special needs. Every mainstream school has a SENCO. Often it helps to ask for a meeting with the SENCO so you can explain your concerns and discuss what action the school will take.

In Nottinghamshire, schools have developed an Anxiety Related Non-Attendance (ARNA) strategy. The guide below contains information and advice for parents/carers where their child is anxious about going to school.

Finding it hard to get your child to school

Who can I talk to about my child's mental health? How are mental health disorders diagnosed in children and teenagers?

If you are concerned about your child’s emotional or mental health, you can get support from your child’s school, school nursing team or your GP.

They may ask for your consent and your child’s to organise a meeting with a primary mental health worker (PMHW) from CAMHS (Child and Adolescent Mental Health Services). The PMHW will have a discussion with the professional, where they will discuss their concerns about your child. They can then decide what is the best service to support you and your child.

CAMHS provide a service to children and young people, aged 0-18 years, who may be experiencing a range of severe and complex difficulties with their emotional and mental health. If you are aged between 12 and 18 years old and have a Nottinghamshire GP, you can self-refer to CAMHS. If you are the parent or carer for a young person aged 0 to 18 years old with a Nottinghamshire GP, you can refer on their behalf to CAMHS. Please click on this link for further information and contact details: CAMHS

Where can I find a list of mental health services who can support children and young people?

For further details of services who can support children and young people with emotional and mental health difficulties please click on the following link: Mental Health Support Services

I am a young person and I would like to know where I can find out more information about how I am feeling and also if there is anyone I can talk to?

A good starting point is the Health for Teens website, which offers lots of information and advice around feelings, emotions and mental health. This can also signpost you to services in your local area.

If you need to speak to someone, Kooth offer a free confidential online support chat service with trained Counsellors.

ChatHealth is a confidential text service, which is an easy way for young people to confidentially ask for help about a range of issues, or make an appointment with a health practitioner. Young people aged 11-19 can receive confidential advice on a wide range of issues such as bullying, emotional health and wellbeing, sexual health as well as illnesses. The ChatHealth number to text is 07507 329952 (The service will be available on Monday to Friday 9.00 am – 4.30 pm excluding bank holidays. During out–of–hours, anyone who texts the service will receive an automated message with advice on where to get help if their question is urgent).

Young Minds offer free 24/7 support for young people experiencing a mental health crisis. If you need urgent help text YM to 85258. Texts are free from EE, O2, Vodafone, 3, Virgin Mobile, BT Mobile, GiffGaff, Tesco Mobile and Telecom Plus.

What is CAMHS?

CAMHS stands for Child and Adolescent Mental Health Services. These are NHS services, which in Nottingham and Nottinghamshire are run by Nottinghamshire Healthcare.

They offer support and treatment for children aged 0 – 18 years who have emotional and/or mental health problems. The young people they work with may be experiencing severe or complex mental health problems and neuro-developmental disorders. These have a significant impact on the child’s development and cause distress to the child and their carers.

The Community CAMHS teams are made up of community psychiatric nurses, therapists, family support workers, specialist practitioners, peer support workers, psychologists, non-medical prescribers and psychiatrists. These professionals work together with children, young people and their families to try to overcome their difficulties using evidence-based treatments

How do I get a referral to CAMHS for my child?

If you are the parent or carer for a young person aged 0 to 18 years old with a Nottinghamshire GP, you can refer on their behalf to CAMHS. This means that you can directly approach the team to ask for help.  The telephone number is 0115 8542 299 and it is open from 8am to 5pm, Monday to Friday. You will speak to a specially trained professional who will ask you some questions and talk to you about how they can help. If you prefer, you can ask for help by completing an online referral form, which can be accessed by clicking on the following link: CAMHS Self-referral

If you prefer you can speak to your GP or school health nurse who can get in touch with CAMHS by calling or writing to them. Any other professional who works with your child/ young person like a social worker, counsellor or youth worker can also contact CAMHS to find out how we can help you.

I've heard there is a long waiting list for appointments and treatment sessions with CAMHS. Why is this?

CAMHS aim to offer initial assessment within 8 weeks and treatment within 12 weeks of a referral being received. As with any specialist health service, there are lots of families that need the support and this means that at times, there is a delay for this.

CAMHS have increased their evidence based group offer within community teams and also offer telephone assessments which is reducing waits within the service.

My child needs to be seen urgently as they are in distress. What should I do?

The Child and Adolescent Mental Health Services (CAMHS) Crisis Resolution Home Treatment Team offer a service for young people experiencing a mental health crisis. This includes young people who are:

  • are at risk of immediate and significant self-harm
  • are an immediate and significant risk to others due to their mental health
  • are being considered for admission to a mental health inpatient unit
  • are in acute psychological or emotional distress that is causing them to not be able to go about their daily activities, such as going to school and looking after themselves

To access further information on the team and contact details please click on the following link: CAMHS

You can also find out further information on dealing with a mental health crisis or emergency by clicking on the following link: NHS

Young Minds offer free 24/7 support for young people experiencing a mental health crisis. If you need urgent help text YM to 85258. Texts are free from EE, O2, Vodafone, 3, Virgin Mobile, BT Mobile, GiffGaff, Tesco Mobile and Telecom Plus.

Are there any inpatient facilities in Nottinghamshire for children with mental health problems?

Yes. Hopewood, Nottinghamshire Healthcare's, state of the art, £21m mental health services hub for children, young people and families, was opened to patients on Monday 4 June 2018. 

The 40 bed site on Mansfield Road in Nottingham offers specialist inpatient care and support for adolescents and perinatal women experiencing acute mental health difficulties that can no longer be managed in the community. It is also the base for the Trust’s community Child and Adolescent Mental Health Services (CAMHS) and perinatal services.

Hopewood includes The Lookout Adolescent Unit, a 32 bed inpatient facility, which provides 20 more CAMHS beds than previously available. This includes a 12 bed specialist eating disorders ward and an 8 bed Psychiatric Intensive Care Unit (PICU), the first of their kind for young people in the East Midlands. Also on site is The Lookout Education Centre, provided by Nottingham City Council, which supports young people to continue their education whilst admitted to the unit.

 

CAMHS have discharged my child for not engaging with them but I know they desperately need help and support. What other services can help?

When Children and Young People (CYP) are discharged from CAMHS, a discussion would be held with the Child/young person and also families regarding other available support – there are many other agencies and this will vary depending on the needs of the individual.

If CYP do not wish to engage, different approaches are used. If CYP do not wish to engage, it is sometimes recognised that they may need to be re-referred to the service when they feel motivated and ready.

 

When my child has identified mental health issues, should they have a named key worker within health and education?

Not always, this will depend on the nature of your child's needs and what support or intervention would be most appropriate. Speak to your child's school or any services involved in identifying your child's mental health issues to find out what support would be most appropriate.  

CAMHS Involvement

When working within community CAMHS, children and young people will have a care co-coordinator (CCO). The CCO may be the practitioner working directly with the young person or it may be another practitioner offering an intervention that has been identified whilst having the CCO co-ordinating their care.

What happens when my child turns 18? Will they have to be put on the waiting list for an appointment with adult mental health services?

Not all children and young people requiring a CAMHS service will require ongoing work and adult mental health services.

If they do, CAMHS work on transitions and would be preparing for this and making any appropriate referrals to adult service teams before the young person turns 18.

CAMHS have been working on improving this transition process into adult services.

How can I improve my child's mental health?

It can be helpful to understand mental health as being made up of two key elements i.e. feeling good and functioning well.

1. Feeling good means experiencing positive emotions like happiness, contentment and enjoyment. It also includes feelings of things like curiosity, engagement and safety.

2. Functioning well is about how a person is able to function in the world. This includes having positive relationships and social connections, as well as feeling in control of your life and having a sense of purpose.

What is Resilience?

Resilience is the process of bouncing back or coping with adversity/challenge.

Resilience is the balance between risk and protective factors present for each child in terms of their individual needs, their family and their community (including school). Resilience is a key part of children’s mental health. When thinking about a child’s mental health, we should always consider the full picture of risk and protective factors. No single risk factor or protective factor alone will determine outcomes for your child, it is always about the combination and overall balance of risk versus protective factors. As a parent, a helpful approach is to work on developing strong protective factors for your child across a range of situations. Some examples of protective factors are listed below:

Protective Family Factors

  • At least one good parent-child relationship
  • Affection
  • Clear, firm and consistent discipline
  • Support for education
  • Supportive long-term relationship/absence of discord

Protective Community Factors

  • Support outside family e.g. friendship, neighbours, extended family
  • Good housing
  • High standards of living
  • Range of positive sport leisure activities

Schools that have positive ethos, high morale, support academic and non-academic achievement with positive policies for behaviour, attitudes and anti-bullying.

In school - Talk to your child’s teacher/SENCO. Evidence shows that effective communication between home and school can support children’s mental health. If your child is doing well at home or at school but not in other settings, it can be helpful to ask what is working well at home/school and try to build on/celebrate these strengths and protective factors.

The school may also have an ELSA. ELSAs are Emotional Literacy Support Assistants working in schools.

  • ELSAs help children to recognise, understand and manage emotions to increase success.
  • ELSAs plan and deliver individual (and small group) support programmes.
  • ELSAs receive training and supervision from educational psychologists.

For more information about ELSAs, visit https://www.elsanetwork.org/

Nottinghamshire schools can access support from their link Educational Psychologist. Information about working with an EP is found in this guidance document:

ed psyc

Further information and advice

Young minds

YoungMinds Parent Helpline:

0808 802 5544

(Mon-Fri 9.30am-4pm)

 

Are ASD and ADHD mental health issues?

ASD (Autistic Spectrum Disorder and ADHD (Attention Deficit hyperactivity disorder) are neurodevelopmental disorders and do not always lead to mental health difficulties. Children who have medical diagnoses such as ASD or ADHD can develop mental health disorders if they have risk factors present in their lives. However, they can also develop positive mental health if they have a good range of protective factors to balance out risk factors.

Children with ASD are more prone to stress and anxiety because…

  • They have difficulties in terms of language and communication skills, regarding what they understand as well as what they are able to express.
  • They have difficulties with social skills which make it hard to initiate and maintain friendships due to issues with social empathy and the perceived unpredictability of other people.
  • They have a rigidity of thought processes which makes it challenging to cope with change or accommodate the needs of other people.

They have a difference in processing sensory information which can lead to sensory sensitivities. 

 

Promoting Emotional
Well-being in Pupils on
the Autism Spectrum –
A Guide for Schools.

My toddler's temper tantrums are getting out of control. How do I know the difference between normal behaviour and possible warning signs of a mental health issue?

Helpful things to consider are:

  • Temper tantrums, including extreme tantrums are usually a normal part of children’s development, particularly before the age of 5.
  • Adults should try to remain calm, provide clear and firm boundaries and reassure the child that they are safe and loved.
  • Consider the extent to which the child is overwhelmed and unable to cope with situations. The level and duration of emotional distress are also important.
  • Consider how much the distress impacts on the child’s day to day life i.e. are they still able to take part in daily activities?

If you have concerns, speak to your child’s nursery or pre-school who can help you to access information, reassurance and support. or you can speak to your Health Visitor who will be part of your local Healthy Family Team. To contact your local team please click on the following link: Healthy Family Teams

My child has suffered a bereavement or other trauma. Will they develop mental health issues?

Not necessarily, grief is a normal human reaction to loss and bereavement and will not necessarily lead to mental health difficulties. Some useful points to consider:

  • Most young people do not need grief counselling but need support from trusted people around them within their family, school and friendship group. Good support leads to healthy grieving. Knowledge about loss and bereavement is empowering to those giving support.
  • Young people are active in constructing their recovery from loss and often come up with their own ideas on how they would like to commemorate the loss.
  • Experience of loss is unique so the young person’s perspective must be considered.

One way to support your child is to read stories together to start a discussion about bereavement. Click on the link for some helpful books and resources to use:

Educational Psychology Service Suggested books and resources for bereavement

Bereavement Support Services

The Children’s Bereavement Centre is run by a committed team of friendly, supportive and professional people who are qualified to help with the grieving process brought on by the death or terminal illness diagnosis of someone close. The Centre is open to children aged 3 to 18 and offers a welcoming and safe environment for them and their families to receive the help and guidance they need. It’s really easy to refer to their services, click here for more information about how to access their support.

Cruse Nottinghamshire can offer support and help to those who are grieving, following the death of someone close: Telephone: 0115 9244404
Email: nottinghamshire@cruse.org.uk

My child has a life limiting condition. What mental health support is available?

You can access support support and information from Together for Short Lives. Their family support hub offers emotional and practical advice. If you have questions, need support or just want someone to talk to you can contact the Together for Families Helpline free on 0808 8088 100 or email: info@togetherforshortlives.org.uk

The Butterfly Project provides comprehensive practical and emotional support to children & young people with life limiting illnesses and their families, from diagnosis to bereavement. The project is funded by the local health authority and can provide a service in the following areas:- City of Nottingham, Gedling, Rushcliffe & Broxtowe. The contact details are tel: 0115 9255565 (office hours Monday to Friday 9:00am to 5:00pm) or email: kerry.lawson@barnados.org.uk

I have found evidence of self-harming. What should I do?

The guide below contains very useful information on coping with self-harm and includes sources of help for both parents/carers and young people:

Coping with
self-harm
A Guide for
Parents and
Carers

Is there anywhere I can access counselling for my child? Can my child receive counselling at school?

Speak to your school’s Head Teacher, Head of Year or SENCO to find out what counselling support is available. Some schools employ school counsellors or ELSAs. Some forms of emotional support can be provided at school within whole-class or group activities and school staff may be able to tell you what support is available at the school.

ELSAs are Emotional Literacy Support Assistants working in schools.

  • ELSAs help children recognise, understand and manage emotions to increase success.
  • ELSAs plan and deliver individual (and small group) support programmes.

ELSAs receive training and supervision from educational psychologists.

 

Other sources of support

CAMHS provide a service to children and young people, aged 0-18 years, who may be experiencing a range of severe and complex difficulties with their emotional and mental health. If you are aged between 12 and 18 years old and have a Nottinghamshire GP, you can self-refer to CAMHS. If you are the parent or carer for a young person aged 0 to 18 years old with a Nottinghamshire GP, you can refer on their behalf to CAMHS. Please click on this link for further information and contact details: CAMHS

If you have a young person who needs to speak to someone, Kooth offer a free confidential online support chat service with trained Counsellors.

 

Which mental health disorders are often seen in children and teens? How do I know if my child's mental health problems are serious?

These are some of the mental health problems that can affect children and young people:

  • Depression affects more children and young people today than in the last few decades, but it is still more common in adults. Teenagers are more likely to experience depression than young children.
  • Self-Harm is a very common problem among young people. Some people find it helps them manage intense emotional pain if they harm themselves, through cutting or burning, for example. They may not wish to take their own life.
  • Generalised anxiety disorder (GAD) can cause young people to become extremely worried. Very young children or children starting or moving school may have separation anxiety.
  • Post Traumatic Stress Disorder (PTSD) can follow physical or sexual abuse, witnessing something extremely frightening of traumatising, being the victim of violence or severe bullying or surviving a disaster.
  • Eating Disorders usually start in the teenage years and are more common in girls than boys. The number of young people who develop an eating disorder is small, but eating disorders such as Anorexia Nervosa and Bulimia Nervosa can have serious consequences for their physical health and development.

If you do have any concerns at all for your child's mental health then you should discuss this with your GP who can make an assessment of your child's mental health and make a referral to appropriate services if required.

School are saying they are concerned about my child’s mental health yet my child is fine at home. What should I do?

It can be helpful to understand mental health as being made up of two key elements i.e. feeling good and functioning well.

1. Feeling good means experiencing positive emotions like happiness, contentment and enjoyment. It also includes feelings of things like curiosity, engagement and safety.

2. Functioning well is about how a person is able to function in the world. This includes having positive relationships and social connections, as well as feeling in control of your life and having a sense of purpose.

What is Resilience?

Resilience is the process of bouncing back or coping with adversity/challenge.

Resilience is the balance between risk and protective factors present for each child in terms of their individual needs, their family and their community (including school). Resilience is a key part of children’s mental health. When thinking about a child’s mental health, we should always consider the full picture of risk and protective factors. No single risk factor or protective factor alone will determine outcomes for your child, it is always about the combination and overall balance of risk versus protective factors. As a parent, a helpful approach is to work on developing strong protective factors for your child across a range of situations. Some examples of protective factors are listed below:

Protective Family Factors

  • At least one good parent-child relationship
  • Affection
  • Clear, firm and consistent discipline
  • Support for education
  • Supportive long-term relationship/absence of discord

Protective Community Factors

  • Support outside family e.g. friendship, neighbours, extended family
  • Good housing
  • High standards of living
  • Range of positive sport leisure activities

Schools that have positive ethos, high morale, support academic and non-academic achievement with positive policies for behaviour, attitudes and anti-bullying.

In school - Talk to your child’s teacher/SENCO. Evidence shows that effective communication between home and school can support children’s mental health. If your child is doing well at home or at school but not in other settings, it can be helpful to ask what is working well at home/school and try to build on/celebrate these strengths and protective factors.

The school may also have an ELSA. ELSAs are Emotional Literacy Support Assistants working in schools.

  • ELSAs help children to recognise, understand and manage emotions to increase success.
  • ELSAs plan and deliver individual (and small group) support programmes.
  • ELSAs receive training and supervision from educational psychologists.

For more information about ELSAs, visit https://www.elsanetwork.org/

Nottinghamshire schools can access support from their link Educational Psychologist. Information about working with an EP is found in this guidance document:

ed psyc

Further information and advice

Young minds

YoungMinds Parent Helpline:

0808 802 5544

(Mon-Fri 9.30am-4pm)

 

 

 

My child masks their mental health problems in school. How can I get support for them when the school are saying there are no problems?

If you are concerned about your child’s emotional or mental health, you can get support from your school nursing team or your GP. School nurses are part of Healthy Family Teams and you can find the contact detail for your local area team by clicking on the following link: Healthy Family Teams

CAMHS provide a service to children and young people, aged 0-18 years, who may be experiencing a range of severe and complex difficulties with their emotional and mental health. If you are aged between 12 and 18 years old and have a Nottinghamshire GP, you can self-refer to CAMHS. If you are the parent or carer for a young person aged 0 to 18 years old with a Nottinghamshire GP, you can refer on their behalf to CAMHS. Please click on this link for further information and contact details: CAMHS

I told my GP about my concerns about my child’s behaviour but they suggested I was worrying unduly. I have been worried for some time and my concerns seem to be discounted. What should I do next?

It can be helpful to understand mental health as being made up of two key elements i.e. feeling good and functioning well.

1. Feeling good means experiencing positive emotions like happiness, contentment and enjoyment. It also includes feelings of things like curiosity, engagement and safety.

2. Functioning well is about how a person is able to function in the world. This includes having positive relationships and social connections, as well as feeling in control of your life and having a sense of purpose.

What is Resilience?

Resilience is the process of bouncing back or coping with adversity/challenge.

Resilience is the balance between risk and protective factors present for each child in terms of their individual needs, their family and their community (including school). Resilience is a key part of children’s mental health. When thinking about a child’s mental health, we should always consider the full picture of risk and protective factors. No single risk factor or protective factor alone will determine outcomes for your child, it is always about the combination and overall balance of risk versus protective factors. As a parent, a helpful approach is to work on developing strong protective factors for your child across a range of situations. Some examples of protective factors are listed below:

Protective Family Factors

  • At least one good parent-child relationship
  • Affection
  • Clear, firm and consistent discipline
  • Support for education
  • Supportive long-term relationship/absence of discord

Protective Community Factors

  • Support outside family e.g. friendship, neighbours, extended family
  • Good housing
  • High standards of living
  • Range of positive sport leisure activities

Schools that have positive ethos, high morale, support academic and non-academic achievement with positive policies for behaviour, attitudes and anti-bullying.

In school - Talk to your child’s teacher/SENCO. Evidence shows that effective communication between home and school can support children’s mental health. If your child is doing well at home or at school but not in other settings, it can be helpful to ask what is working well at home/school and try to build on/celebrate these strengths and protective factors.

The school may also have an ELSA. ELSAs are Emotional Literacy Support Assistants working in schools.

  • ELSAs help children to recognise, understand and manage emotions to increase success.
  • ELSAs plan and deliver individual (and small group) support programmes.
  • ELSAs receive training and supervision from educational psychologists.

For more information about ELSAs, visit https://www.elsanetwork.org/

Nottinghamshire schools can access support from their link Educational Psychologist. Information about working with an EP is found in this guidance document:

ed psyc

Further information and advice

Young Minds

YoungMinds Parent Helpline:

0808 802 5544

(Mon-Fri 9.30am-4pm)

CAMHS (Child and Adolescent Mental Health Services)

My child’s mental health problems are affecting everyone in our house. Who can other family members talk to?

There are organisations who can offer advice, guidance and support for carers and family members of someone who is experiencing mental health problems. Just click on the links below:

Rethink Carers Hub

Young Minds - For Parents

Mind

 

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