Behavioral & mental health · Teens
When a child needs a psychiatrist, and how we work with one
Most childhood anxiety, depression and ADHD is treated in our office. Some children need a child and adolescent psychiatrist. Here is how we decide, what the psychiatrist does, and how the two of us stay in step.
About one in five children has a diagnosable mental health condition at some point before 18, and most of them are cared for by their pediatrician, not a specialist. We screen for depression from age 12, for anxiety and attention problems whenever a parent or teacher raises a concern, and we treat mild to moderate cases here. This post is about the children who need more.
What a child and adolescent psychiatrist does
A child and adolescent psychiatrist is a physician who completed medical school, a general psychiatry residency and two further years of training in children and teenagers. They diagnose complicated or overlapping conditions, manage medication when the first or second choice has not worked, and treat conditions we do not manage in primary care, such as bipolar disorder, psychosis, severe obsessive-compulsive disorder and eating disorders that are medically unstable.
When we refer
- A child has not improved after a reasonable trial of treatment in our office
- Two or more conditions are tangled together, for example ADHD with anxiety and a tic disorder
- There are thoughts of self-harm, a suicide attempt, or a safety concern at home or school
- Symptoms suggest something outside primary care, such as hallucinations or mania
- A family asks for a second opinion, which is always a reasonable request
What the wait is like, and what we do about it
In north metro Atlanta the wait for a new child psychiatry appointment is often two to four months. We do not leave a family waiting with nothing. We start or continue treatment we can safely provide, arrange therapy, and use Georgia’s pediatric psychiatry consultation line, which lets us discuss a case with a child psychiatrist by phone within a day. For urgent situations, the Georgia Crisis and Access Line at 1-800-715-4225 and the 988 line are available around the clock.
How the referral works here
Every referral leaves this office with a summary of what we have tried, our screening scores and the questions we want answered. We track the appointment until it happens, ask for the psychiatrist’s note, and stay the prescriber for routine refills when the psychiatrist hands care back. Families should never have to carry information between the two offices themselves. This is what our closed-loop referral process means in practice.
What parents can do now
- Write down what you have noticed and when it started; patterns matter more than any single day
- Ask the school for their observations in writing
- Keep sleep, meals and movement steady; they are treatment, not extras
- Say plainly to your child that this is a health problem with treatments, not a character flaw
If you are worried about your child’s mood, behavior or attention, call us. The first step is a conversation, and it usually happens the same week.
