In a rapidly changing world, mental health teams are on the frontline for children, adolescents, young people and their families in crisis. How do you find a psychiatrist that will make a difference to your child’s treatment? What should you look for in a child/adolescent psychiatrist?
What Does It Take To Be An Excellent Psychiatrist?
Psychiatrists are medical doctors who specialize in mental health. Psychiatry requires a superb skill set that combines medical, scientific and interpersonal skills to benefit patients – covering inpatient, outpatient and acute or intensive care settings.
1. Outstanding Communication Skills
Communication skills are important in all branches of medicine and crucial in great psychiatric practice.
Psychiatrists spend a lot of time listening. Active listening is a very different skill from the routine day-to-day listening that we all practise. Active listening requires psychiatrists to listen to the content of the conversation and the ‘process’ or the backstory. Psychiatrists listen in a non-judgmental manner as children, young people, and their families describe their thoughts, feelings and emotions. Young adults with complex mental health issues will often describe internal worlds that can be quite different from normal processing. A great psychiatrist will be listening out and able to step in when needed.
Communicating is all about building the foundations for great therapeutic and professional relationships. A great psychiatrist will explain their diagnosis and treatment plan in a way that is clear and concise, using language that the young person and their family can easily understand.
2. Flexible And Understanding
A really good psychiatrist will listen to the needs of young people and their families in treatment. That doesn’t mean that they will always agree. It does mean that they will work with the young person to explain their thoughts in therapy and use a patient-centred approach to finding solutions that work for everyone.
Flexible and adaptable. An excellent psychiatrist will reflect, move forwards and not be afraid to change direction when treatment does not go according to plan.
Every child, adolescent and family are different. Whilst a diagnosis may be the same or similar, the intricacies of each young person’s experience can vary greatly. People respond in different ways to treatments, and a creative approach is necessary.
Psychiatry is full of investigations and active enquiry, and a great psychiatrist will be genuinely interested in their patients’ experiences, thoughts, feelings and concerns.
3. Look Through Psychological And Social Lenses
Mental illness in teenagers and young adults has many dimensions. While genetics play an important role, and the biological aspects of mental illness are incredibly important, a really good psychiatrist will also consider the impact of life experiences – environmental, sociocultural, and trauma – which all play a significant role in a young person’s development.
4. Have A Mixed Bag Of Tools
Psychiatrists are prescribing physicians, but that’s not all!
Psychiatry is often described as ‘an art, not a science’. Whilst that is not entirely true, really great psychiatrists will have many tools in their toolbox. Treatments are numerous and varied. Treatments that work well for one young person may have absolutely no positive effect on the next.
Medications play a significant role in the management of many types of mental illness and helping young people and families to understand the benefits, effects and side effects are all crucial aspects of a great psychiatrist’s practice.
Psychological, social and holistic aspects of care are equally important. A superb psychiatrist will have a multidisciplinary team supporting them and access to the latest evidence-based treatments for all, from specialist dietitians and MBT therapists to trauma-informed yoga practitioners and case managers.
5. Can Read Between The Lines
It is often not the things that a young person or family tell you that help you feel and hear them but rather the things that are not said.
Superb psychiatrists will notice the subtle moments shared and the dynamics within families. Somatic experiencing – watching the non-verbal, body-focused messages and connections – is an additional skill that psychiatrists who have finely-tuned interpersonal skills will notice and reflect on.
‘Reading between the lines’ is also something that applies to case presentations and academic literature. Dr Rasyid Suliaman (Consultant Psychiatrist and Medical Director at The Wave Programs for Young Adults) offers practical advice to early years’ psychiatrists, who he mentors in Malaysia. He requires his young psychiatrists to develop a keen eye for details.
‘Often young people who arrive for assessment and consultation will not present in a textbook fashion.’ He advises that a skilful psychiatrist will understand that clinical practice guidelines and clinical practice are two very different things.
A great psychiatrist will help young people understand what they think may be happening to them and why. They will also take the time to explore a little ‘off grid’ and look at the other options. Remember that nobody is a textbook case, one family member may not tick all the boxes, and a great psychiatrist will help them see other possibilities.
6. The Ability To Hold Big Feelings
A highly skilled psychiatrist will hear, see and ‘hold a space’ for young people and their families, whatever a treatment session brings up. Empathy, care and understanding, together with curiosity and well-tuned observational skills, create an environment where families and young people can openly share and explore.
Young people in distress can often be aggressive, hostile, defensive, agitated and sometimes exhibit rage in the consulting room. A great psychiatrist will understand that this is not personal. Young people who have experienced adverse life experiences can often find trusting others incredibly difficult. They may have core wounds and fears that prevent them from forming a relationship with professionals or become incredibly sensitive to perceived rejection or abandonment. Young people who are experiencing a first episode of psychosis, or the parents of a young person in intensive care following a planned overdose, may be frightened, angry and anxious.
Good therapeutic relationships often have bumps and bruises. A great psychiatrist will invest in repairing relationships because they will understand that in the fracture and repair process, they are able to see the vulnerability and reality of a young patient’s internal world. This is a gift that not only informs diagnosis and treatment plans but can also be instrumental in rebuilding the interpersonal skills needed for life.
7. Superb Ethics: Cultural Competence And Diversity Driven
A great psychiatrist is always sensitive to gender, ethnicity and culture.
They hold a space that contains a vast amount of personal and family history together with thoughts, feelings and medical information. Great psychiatrists have superb clinical skills that are matched by their strong and nurturing boundaries. A skilful psychiatrist will wish for the best possible outcome whilst remaining in a professional capacity. Friendship, business relationships, social media contacts or dual relationships of any sort are not OK.
A great psychiatrist will demonstrate cultural awareness and where they are not sure they will be OK with asking. Whether using a young person’s preferred pronouns or discussing culturally sensitive subjects, top psychiatrists will take the time to understand the importance to their patients.
A great psychiatrist respects confidentiality and is mindful of any disclosures.
8. An Educator And A Leader
A highly skilled psychiatrist will take the time to make sure that teenagers, young adults and appropriate family members understand both the diagnosis and any recommended treatments.
Educating young patients and their families is an essential aspect of the treatment plan and empowers young people in their pursuit of wellness.
A great psychiatrist will take the time to educate families in areas that may impact the well-being and healing within the family system, offering strategies, tools, and techniques for problem-solving. They will also refer to specialist family therapists where necessary.
9. Not Afraid To Say Goodbye: Onward Referrals
A great psychiatrist will be confident in referring young people and their families on when necessary.
Like other branches of medicine, psychiatry has specialists who may have more or less experience with particular types of mental health problems. We call these sub-specialities. Eating disorder treatment is an example of a sub-speciality. Psychiatrists treating eating disorders need to have extensive experience and be committed to gaining further knowledge and expertise in eating disorder treatment and management.
Onward referrals are a sign of an excellent psychiatrist working within their area of expertise and having the best outcomes for the young person at the heart of everything they do.
10. Humility And Collaboration
Great psychiatrists will show enthusiasm in collaborating with families and young people and in developing treatment options. They will also demonstrate knowledge and experience with reliability and leadership and be calm in a crisis.
They will ensure that young people and their families have an out-of-hours plan and availability to them in the event of an emergency or mental health crisis.
A great psychiatrist can work within the realms of uncertainty, is humble and kind and has just a sprinkle of humour.
Teen And Adolescent Psychiatry In Malaysia & Singapore: Mental Health Matters
Mental health issues continue to rise across all age groups in Malaysia, Singapore and Hong Kong. The dramatic rise in adolescent mental health concerns and behavioural issues continues the upward trend that has been evident for the past two decades.
Addiction, eating disorders and severe mental health concerns continue to rise in the tween, teen and young adult populations. Depression continues to be one of the leading causes of referral to psychiatrists and mental health teams. Self-harm and suicidal thoughts are estimated to affect four in every ten children in the region.
The Wave Programs continue to be the leader in mental health treatment for teens and young people in Asia and beyond. Young people travel to The Wave Clinic from Asia, Europe and the Middle East, with smaller numbers from the USA and Canada.
The Wave Clinic is uniquely positioned in the Asia region to provide residential care and telehealth services for young people age 13 and over, together with young adult programs for the 23–30 age group.
Mental health treatment is changing in Asia. There are more opportunities to reach out for exceptional mental health care in the community, local and private sectors. We can work together to reduce stigma and increase accessibility for all young people.
Great psychiatrists are always part of an amazing team of mental health professionals. The Wave is proud to be part of a psychiatric community in Asia that is striving for excellence in practice for all young people.
Dr R. Suliaman is Medical Director at The Wave Clinic in Kuala Lumpur. He is Asia’s premier psychiatrist, with a specialist interest in addictions, eating disorders and early interventions in Borderline Personality Disorder.
Dr Rasyid, or Dr R as he is affectionately known to his colleagues and young people in his care, contributes to professional development in psychiatry in his role as Senior Lecturer at IMU. He is also instrumental in the development of Early Years Psychiatrists, leading steering committees. Dr R loves travelling and is looking forward to revisiting his favourite European cities. He is currently reading ‘Sick Enough’ by Dr Jennifer Gaudiani.
Fiona Yassin is the International Clinical Director at The Wave Clinic in Kuala Lumpur, working with teenagers, young adults and their families. Fiona is a UK registered Psychotherapist and Supervisor of Clinicians. EMDR trained and a member of EMDRIA, Fiona recognises the role of complex trauma in eating disorders and is currently developing Trauma-Focused Eating Disorder Services in Asia and the Middle East. Fiona is an International Chapter member of IAEDP, CBT-E, and RO-DBT trained. Fiona is also a Fellow of APPCH, and she loves her cats 🙂