CAMHS Body Dysmorphic Disorder: How this unique service is supporting young people

CAMHS Body Dysmorphic Disorder: How this unique service is supporting young people

by | May 16, 2023 | Blog Post, News, Pears Maudsley Centre

CAMHS Body Dysmorphic Disorder: How this unique service is supporting young people

Body Dysmorphic Disorder (BDD) is a condition which is common in children and young people. It is a mental health condition where people spend a lot of time worried and upset over their appearance and spend lots of time trying to fix it. BDD impacts around one or two people in every 100 people and can be treated.

For Mental Health Awareness Week, the team at the BDD Clinic explain who they are and how they’re supporting young people at a time when the need has never been greater.

a young girl holding a leaf

We are the Maudsley National and Specialist Obsessive Compulsive Disorder (OCD), Body Dysmorphic Disorder (BDD) and related disorders service for young people. It is the only specialist BDD clinic in the UK for those aged 5-18 years old. We offer highly specialist assessment and treatment, as well as teaching and training.

Our clinic is made up of a multi-disciplinary team of clinicians with decades of collective experience in assessing and treating BDD. This includes psychiatrists, clinical psychologists, and a parent peer support worker. We provide evidenced-based, NICE recommended psychological and pharmacological therapy including Cognitive-Behaviour Therapy (CBT) and Selective Serotonin Reuptake Inhibitors (SSRI) medication.

What is Body Dysmorphic Disorder (BDD)?

BDD is a common mental health condition and affects at least 1-2 per cent of young people. It is a psychological condition where a person becomes very preoccupied with one or more perceived flaws or defects in their physical appearance. These appearance concerns cause significant distress and lead to engagement in behaviours to try to ‘fix’ or hide the perceived flaw that are difficult to resist or control (e.g., frequently checking mirrors or seeking reassurance). BDD can seriously affect a person’s daily life, including school, social life, and relationships.

What other mental health conditions can commonly occur for young people with BDD?

Social Anxiety Disorder, Obsessive Compulsive Disorder, Eating Disorders, and Depression are some examples of commonly occurring mental health conditions. It is very common for people with BDD to feel anxious, depressed and suicidal and many sufferers experience low self-worth and low self-esteem.

How do young people with BDD experience anxiety? 

BDD involves a cycle of anxiety where young people experience preoccupying worries about their appearance which cause strong feelings of anxiety, shame or sometimes disgust. These difficult thoughts and feelings lead to repetitive behaviours such as mirror checking, seeking re-assurance, hiding under baggy clothing, or avoiding leaving the house. These behaviours are often an attempt to try to fix or hide their appearance. These thoughts, feelings and behaviours can result in significant disruptions to a young person’s relationships, school, and home life. For example, feeling too anxious to leave the house without spending a long time on their make up or checking their appearance in the mirror.

How does the King’s Maudsley Partnership support children with BDD through research and clinical work?

Alongside evidenced-based treatment to support young people in overcoming BDD, we deliver a national teaching programme to raise awareness of BDD by highlighting the key signs and symptoms and the available treatment approaches. As a team, we also conduct a number of research studies to learn more about BDD and improve the treatments we offer. For example, we are currently researching how we can best adapt CBT for BDD for those with Autism Spectrum Conditions and exploring the role of difficult life experiences such as bullying in the development of BDD.

Once open, the Pears Maudsley Centre will accelerate research and clinical advancements with the closer partnerships that will form between the clinical and research groups.

How can young people be referred to your service?

We accept referrals from local CAMHS teams across the country. If you think you or someone you know might have BDD and would like advice please contact the National and Specialist OCD, BDD and Related Disorders CAMHS on:

020 3228 5222

ocdbdd.camhs@slam.nhs.uk

slam.nhs.uk/service-detail/service/child-and-adolescent-body-dysmorphic-disorder-service-102/

Please speak to your local CAMHS team if you would like to seek a referral to our service.

Are there any resources that can support parents and young people?

If you would like to find out more about BDD, we recommend the book ‘Appearance Anxiety’ by the National and Specialist OCD, BDD and related disorders service. Further information regarding our service can be found at: Service Detail – South London and Maudsley (slam.nhs.uk). You can also read more about BDD here: www.bddfoundation.org

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When bad experiences trigger anxiety: childhood trauma and PTSD

When bad experiences trigger anxiety: childhood trauma and PTSD

by | May 16, 2023 | Blog Post, Research

When bad experiences trigger anxiety: childhood trauma and PTSD
Professor Andrea Danese

Professor Andrea Danese

Professor of Child & Adolescent Psychiatry and Consultant Child and Adolescent Psychiatrist

Shockingly, up to 80% of children are exposed to trauma by the age of 18 in the UK. With the theme of World Mental Health Awareness Week being ‘anxiety’, we have an opportunity to unpack how childhood trauma can lead to anxiety – and in some of the more serious cases, a particular type of anxiety disorder called Post-Traumatic Stress Disorder (PTSD).

a young girl holding a leaf

Traumas are events that involve danger of death, serious injury or sexual assault. After experiencing trauma, it’s not unusual for children to develop emotional and behavioural symptoms: they might become tearful, upset or clingy; struggle to pay attention or to sleep; or even get headaches and tummy aches. This is a normal psychological response and not a psychiatric disorder. However, by age 18, around one in four children exposed to trauma will have developed PTSD. This means they will begin to experience very severe, impairing or persistent symptoms, such as re-living the trauma, developing avoidance strategies, and experiencing physiological hyper-arousal.

Because not all children who experience trauma develop PTSD, it is important to understand how to identify the more vulnerable children in order to provide adequate support and treatment. Through my work in the Stress & Development Lab at King’s College London’s Institute of Psychiatry, Psychology & Neuroscience (IoPPN), my team and I aim to understand how traumatic experiences in childhood affect mental and physical health, how to identify those children at greatest risk of developing PTSD, and how to support children who have experienced trauma.

How traumatic experiences in childhood affect health

In PTSD, abnormal processing of traumatic memories leads to persistent re-experiencing of the event through unwanted and distressing memories or nightmares, particularly when there are triggers that resemble the context in which the traumatic event occurred.

Traumatic experiences require significant adaptations by the developing child. At a molecular level, the hormonal and immune systems are overactive to support facing or escaping from danger and recovering from injuries. At a neurobiological level, the brain becomes more aware of potential threats. At the psychological level, the traumatic experiences are encoded in autobiographical memories to minimise future threats. At the social level, the threats in the environment may lead to withdrawal and reduction in social connections.

The association of childhood maltreatment with biomarkers of inflammation. Graph from ‘Childhood maltreatment predicts adult inflammation in a life-course study’, Danese et al. (2007).

Although these adaptations can be helpful to reduce threats, they may lead over time to maladaptive outcomes including mental health problems. For example, inflammation levels are higher in individuals who have experienced maltreatment compared to those who haven’t, and are associated with mental health problems later on.

In the Stress & Development Lab, we have conducted several detailed epidemiological studies based on large population-based birth cohorts to, firstly, investigate the impact of childhood trauma exposure on mental health outcomes, and secondly, identify which children are most at risk of developing PTSD.

Through analyses in the Environmental Risk (E-Risk) Longitudinal Twin Study (which observed twins born between 1994-95 until they were aged 18 years), in a paper led by Dr Stephanie Lewis, Clinical Lecturer at the IoPPN, we found that children with PTSD are eight times more likely to self-harm and 10 times more likely to attempt suicide than those without PTSD. In absolute terms, this means that about half of children with PTSD report self-harming and one in five report attempting suicide. Children with PTSD are also significantly more likely to have a violent offence record and not be in education, employment or training (NEET). This is alongside being at increased risk of co-occurring psychiatric diagnoses, including depression, generalised anxiety disorder, conduct problems, substance misuse or attention deficit and hyperactivity disorder (ADHD).

 

These findings highlight that childhood traumas are key modifiable risk factors for psychopathology in childhood and onwards – if we target the processes involved in responding to trauma, we may then be able to reduce the prevalence of mental health disorders and other negative health outcomes. As a result, childhood trauma is a major focus for research and clinical practice in mental health.

How to identify children most at risk of PTSD

We know that childhood trauma is associated with negative outcomes. But why are some children resilient in the face of trauma, while others develop complex psychopathologies like PTSD?

From our research, we have identified several key factors which influence the risk of developing PTSD in individual children exposed to trauma. Firstly, the quantity and nature of the trauma has an impact: children exposed to more traumatic events are at greater risk of developing persistent PTSD. In particular, those children who are exposed to ‘interpersonal traumas’ (such as physical or sexual assault) are more likely to develop PTSD than children exposed to ‘non-interpersonal traumas’ (such as accidents or natural disasters).

Secondly, individual differences in the child impact risk for PTSD: research suggests that girls are at greater risk of developing PTSD than boys following trauma. Different children also have different responses both during and after trauma: during the trauma, children who believed that they were about to die, and those who believe they are to blame for the occurrence of the traumatic event, may be at greater risk for developing PTSD. Children who try to cope with trauma by pushing memories away, withdrawing or distracting themselves may also be more likely to develop PTSD.

Interestingly, the memory of trauma also influences risk of developing mental health problems. Research has shown that individuals who were maltreated as children but do not have memories of these experiences have the same rates of mental health problems as individuals who were not maltreated individuals. This suggests that biases in memory, core beliefs, and decision-making influence risk for PTSD and other psychiatric responses to trauma.

Autobiographical memory may be a risk factor for trauma-related psychopathology. The subjective experience (‘s’) of child maltreatment (including memory) is more strongly associated with psychopathology than the objective experience (‘o’) measured through official court records. Graph from ‘Objective and subjective experiences of child maltreatment and their relationships with psychopathology’, Danese & Spatz Widom (2020).

Although these factors are more common in groups of children who develop PTSD than those who do not develop PTSD, much more research is still needed to make accurate risk prediction for individual children.

Dr Alan Meehan, Lecturer in Psychology at the IoPPN, and others in my team are working to develop accurate prediction models to identify which trauma-exposed children are at greatest risk of developing psychopathology. This will enable interventions from the earliest stages, even before symptoms occur, in children who have experienced trauma.

Identifying the symptoms of PTSD and what we can do to reduce them

Many children (around 50%) fail to recover from the symptoms of PTSD without treatment. Yet, despite the high prevalence of trauma in childhood, our research found that only a small fraction of children who have PTSD end up seeing a GP or mental health professionals. Around one in three sought help from a GP and only one in five, ultimately, were in contact with a mental health professional. This seems to be because children can struggle to report the symptoms or even the traumatic experiences themselves, and it’s difficult for parents and teachers to really understand when a child has developed PTSD.

 

As part of my work to reduce the negative impact of childhood trauma and PTSD, I co-lead the National & Specialist CAMHS Clinic for Trauma, Anxiety, and Depression at South London and Maudsley NHS Foundation Trust, where we deliver assessment and treatment to children and adolescents who experience severe and/or treatment-resistant PTSD, anxiety disorders and depression.

The Maudsley Hosptital

When we undertake assessments of PTSD in children who have been exposed to traumatic experiences, we look at a cluster of symptoms that are typical of developing PTSD. For example, asking:

  • Does the child relive traumatic experiences through distressing memories or nightmares?
  • Do they show avoidance of anything that reminds them of their trauma, such as context or people that reminds them of their trauma?
  • Do they express feelings of guilt, isolation or detachment?
  • Do they still feel under threat, as we can understand because they continue expressing irritability, impulsivity or difficulty concentrating, for example?

There are several evidence-based psychological treatments for PTSD in children that have been endorsed by the National Institute for Health and Care Excellence (NICE) and that we use in the CAMHS Clinic. These include trauma-focused psychotherapies which target cognitive and behavioural factors that contribute to the reinforcement of PTSD. These therapies generally include psychoeducation to provide information to children and families about PTSD symptoms and the treatment rationale, coping skills training to better manage intense negative emotions, gradual exposure to trauma memories and reminders to address avoidance and build a coherent trauma narrative, and cognitive restructuring to address biased appraisals related to the trauma memory. Consultant Clinical Psychologist and Reader, Dr Patrick Smith, and others at IoPPN have developed one form of this evidence-based treatment.

There is also limited but growing evidence to indicate that eye movement desensitisation and reprocessing (EMDR), which involves recalling traumatic events while performing tasks that generate bilateral sensory stimulation, may be beneficial for young people with PTSD.

Barriers to support and how to overcome them

We know it is impossible to implement interventions if child trauma and trauma-related psychopathology go undetected. As a result, our team is currently trying to map barriers to access healthcare to improve recognition of PTSD in children and adolescents.

One of the barriers to getting professional support for childhood PTSD are the symptoms and thought patterns themselves. Children may experience trauma-related avoidance, low motivation, hopelessness, distrust, shame, guilt, or fear of not being believed or being reprimanded by the perpetrators of the trauma. These factors may make them less likely to open up about the traumatic event or how they are feeling.

Another key barrier relates to the parents or caregivers’ response to their child’s trauma. For example, deliberate concealment of trauma by perpetrators or to avoid reprisal by perpetrators, fear of being blamed, fear of having their child taken by child protective services, or poor understanding and stigma around mental health. There may also be structural barriers, including lack of insurance, access to mental health care facilities or transportation.

Family can act as a great support system for children exposed to trauma. Children who received a family intervention which taught parents and caregivers about trauma symptoms, how to improve family communication, and coping skills to manage symptoms were significantly less likely to have a PTSD diagnosis three months after the intervention.

It is also important to remember that PTSD is not the only or even the most common mental health problem in children exposed to traumatic events, and parents and professionals need to also monitor symptoms of other anxiety disorders, depression and substance misuse in particular.

The future of mental health care and research: The King’s Maudsley Partnership for Children and Young People

Through his work in the Stress & Development Lab and National & Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, Professor Andrea Danese is one of the many experts who are transforming our understanding and treatment of young people’s mental health as part of the King’s Maudsley Partnership for Children and Young People. The Partnership, which will have its home in the Pears Maudsley Centre for Children and Young People, is a unique collaboration between specialist clinicians from the South London and Maudsley NHS Foundation Trust and leading academics at King’s College London.

Together, King’s and The Trust host the largest group of mental health scientists and clinical academics in Europe. Through the Partnership, clinicians and researchers will collaborate even more closely to find new ways to predict, prevent and treat mental health disorders, such as childhood trauma and PTSD. This will enable us to translate research into practical treatments in the shortest possible time, and will benefit children locally, nationally and across the globe.

The Pears Maudsley Centre for Children and Young People

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Let’s Talk About It: Eating Disorders Awareness Week 2023

Let’s Talk About It: Eating Disorders Awareness Week 2023

by | Mar 3, 2023 | Blog Post, News

Let’s talk about it: Eating Disorders Awareness Week 2023
Organised by the charity BEAT, National Eating Disorder Awareness Week highlighted the realities of living with an eating disorder. This year it took place on the 27th February – 5th March 2023.

Approximately 1.25 million people in the UK have an eating disorder. Throughout the week, we shared information and tips to support parents and carers on the many eating disorders affecting children and young people’s mental health.

What is an eating disorder?

Children’s mental health has never been so critical, this week offered a vital opportunity to reflect on how we can support young people.

Last year, NHS Digital found 12.9% of 11 to 16 year olds and 60.3% of 17 to 19 year olds had possible eating problems but what is an eating disorder?

An eating disorder is a mental health condition where you use the control of food to cope with feelings and other situations. Unhealthy eating behaviours may include eating too much or too little or worrying about your weight or body shape.

Anyone can get an eating disorder, but teenagers between 13 and 17 are mostly affected. Are you supporting a child with an eating disorder or need support yourself? Watch the videos below to see four ways you can support a child or young person with an eating disorder.

As part of the Mind of the Matter series, Professor Ulrike Schmidt from King’s College London, discussed how eating disorders have manifested in groups of people over the pandemic, exposed health inequalities and a disparity in access to treatment – you can find the full video below.

With treatment, most people can recover from an eating disorder. Cassius, an ex-service user, shared his story of recovery adding that “Recovery is more than possible. It happened, and it’s made me who I am today.”

What are the different types of eating disorders?

Anorexia Nervosa

Anorexia can cause severe physical problems because of the effects of starvation on the body. If you’re worried about a child or young person’s eating habits, weight or shape – the best way forward is to get help and support early.

 

Binge Eating Disorder (BED)

There are a number of ways that binge eating disorder can impact a young person’s life. Often (though not always) it can cause weight gain, and in terms of physical health, can be associated with high blood pressure, high cholesterol, type 2 diabetes and heart disease.

 

Bulimia

There are several reasons that someone might develop bulimia, and many factors that can contribute but know that just being there for them can also play a crucial role in helping them to get better. If you’re worried about someone you know, even if only some of the signs are present, you should still seek help immediately, as this gives the best chance of recovery.

What is EDIFY?

EDIFY (Eating Disorders: Delineating Illness and Recovery Trajectories to Inform Personalised Prevention and Early Intervention in Young People) is a four year project, led by researchers at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s which aims to revolutionise how eating disorders are perceived, prevented and treated in young people.

By combining the arts and science, researchers will build a detailed picture of why young people develop eating disorders, how they progress over time and what we can do to help.

The EDIFY project, involving over 1000 participants, ensures young people with lived experience of eating disorders are at the heart of the project, serving as advisors and co-producers throughout.

Through this work we will expand professional and public perceptions of eating disorders, share under-represented voices and encourage advances in policy and clinical practice.

In their PaperMate series, the EDIFY team speak to eating disorders researchers about recent projects, such as the experiences of men and the impact of COVID.

What is FREED?

FREED is the First episode Rapid Early intervention for Eating Disorders service for 16 to 25-year-olds who have had an eating disorder for three years or less.

Young people getting help for their eating disorder through FREED are given rapid access to specialised treatment which gives special attention to challenges we know young people face during these years of their life, and in the early stages of an eating disorder.

Originally developed at South London and Maudsley NHS Trust and King’s IoPPN, the Health Innovation Network and Academic Health Science Network have since supported Mental Health Trusts across the country to adopt FREED. More than 2,000 young people nationally have benefitted from the service since 2020, with an initial evaluation suggesting FREED can reduce waiting times by 32% for assessment and 41% for treatment

Most recently, in her BBC documentary Zara McDermott: Disordered Eating, Zara met with our experts and service users at FREED to explore disordered eating. Filming took place at Maudsley Hospital in Summer 2022.

The new FREED-Mobile study, which is now recruiting, is exploring whether online resources could help young people in their decision to seek support for eating difficulties to help facilitate early intervention.

“We want to encourage everyone who thinks they may have an eating disorder to seek help, as it is possible to get better. Wherever someone may be on their journey, there is hope and help out there.  Thank you to Zara for coming to visit us and spending time with people who have used our services.“

Giulia Di Clemente and Charmaine Kilonzo

Senior Psychologist and Psychology Practitioner, Eating Disorders Service

External Support:

Beat – Eating Disorders: https://www.beateatingdisorders.org.uk/

 

Kooth: https://www.kooth.com/

 

First Steps: https://firststepsed.co.uk/

 

 

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Let’s Connect: Children’s Mental Health Week 2023

Let’s Connect: Children’s Mental Health Week 2023

by | Feb 10, 2023 | Blog Post

Let’s Connect: Children’s Mental Health Week 2023

Children’s Mental Health Week is an annual event led by Place2Be which is dedicated to raising awareness about children and young people’s mental health. This year it took place on the 6th – 12th February 2023.

a young girl holding a leaf

Throughout the week, the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London shared some of the world-leading research happening across the Institute to raise awareness for some of the risk and protective factors associated with childhood mental health difficulties.

Day 1: Partnering for better children’s mental health

Children’s mental health has never been so critical. Before the pandemic, one in nine children had a probable mental health disorder. In 2022, this figure was at one in six and, for young people aged 17-19, one in four. Children’s Mental Health Week offers an important opportunity to reflect on what’s being done to support young people, and what we can do better.

The King’s Maudsley Partnership for Children and Young People brings together clinical and academic excellence in a unique collaboration between the UK’s largest NHS provider of specialist CAMHS services, South London and Maudsley NHS Foundation Trust, and the leading child and adolescent mental health research team in Europe at King’s College London – supported by the Maudsley Charity and leading philanthropists.

The partnership, which will be based at the new Pears Maudsley Centre for Children and Young People, will allow clinicians and researchers to collaborate even more closely to find new ways to predict, prevent and treat mental health disorders. This will enable us to translate research into practical treatments to benefit young people locally, nationally and across the globe in the shortest possible time.

Watch the Pears Maudsley Construction Time-lapse

Day 2: Protecting young people’s wellbeing on social media

Although smartphones are useful, there is concern about their effect on mental health and wellbeing. For example, studies have found that night-time use is related to poor sleep as well as mood changes. However, we don’t know exactly how social media and smartphone use can impact on mental health, including self-harm, nor do we know how usage can change in association with changes in mental health.

The 3S-YP study (Social Media, Smartphone Use and Self-Harm In Young People) aims to understand how social media and smartphone use are associated with changes in mental health and wellbeing in young people over the course of a year. The findings will help us learn when and what type of support would be useful for young people who are experiencing difficulties.

The study is led by Dr Rina Dutta in partnership with YoungMinds and funded by the Medical Research Council and Medical Research Foundation.

For Safer Internet Day and Children’s Mental Health Week, Dr Dutta shares her top three tips for young people to protect their wellbeing while using social media:

  1. Think about where you charge your devices. Charge them outside your bedroom to avoid the temptation to use them at night.
  2. Diversify your social media & keep communication open. Use a diverse range of platforms. Parents and young people should try to have conversations about what those platforms are and why they are appealing.
  3. Balance social media use with other everyday things. Don’t forget to go outdoors, play sports or cook!

Learn more about the 3S-YP study and hear Dr Rina Dutta’s top tips for young people in the video below:

Day 3: How does childhood social isolation impact mental health?

Katie Thompson, PhD Student at the Social, Genetic and Developmental Psychiatry (SGDP) Centre at King’s, explains how social isolation levels can vary across childhood, and discusses which children are most at risk of developing poor mental health later in life.

Her research, published in JCPP Advances last May, found that socially isolated children are more likely to experience ADHD symptoms and loneliness as young adults despite other risk factors in childhood.

Using data from the Environmental Risk (E-Risk) Longitudinal Twin Study, researchers examined social isolation through childhood and identified three types of developmental progression which were associated with emotional and behavioural challenges before and after the onset of isolation.

The study revealed that the experience of social isolation in childhood was associated with a range of difficulties in adulthood, even when the isolation itself had reduced. The findings suggest that childhood social isolation can indicate co-occurring mental health difficulties, which can be used to guide intervention in young people.

Watch the video below to learn more about Katie’s research, and what she’s currently working on:

Day 4: Listening to the voices of neurodivergent young people

Dr Myrofora Kakoulidou, Post-Docoral Researcher at the IoPPN, shared some of the work she is doing on the ‘My Emotions and Me’ sub-stream of the RE-STAR project (Regulating Emotions – Strengthening Adolescent Resilience). Through her research, Dr Kakoulidou is trying to understand what factors contribute to young people’s learning and wellbeing to help develop evidence-based school interventions.

RE-STAR is a four-year, interdisciplinary programme, led by Professor Edmund Sonuga-Barke, which brings together science and arts to understand emotional difficulties in neurodivergent young people in order to help develop effective support.

Many young people with ADHD and autistic traits develop depression during adolescence – but we currently don’t know which individuals are at risk, what underlying processes increase that risk or, perhaps most importantly, the best way to intervene to increase resilience to reduce that risk.

RE-STAR aims to address these gaps by testing the specific role of emotion regulation difficulties, commonly observed in young people with neuroatypicalities, in driving developmental pathways to depression.

“For decades, the voices of neurodivergent young people have been neglected. RE-STAR puts young people with ADHD and autism at the heart of research.”

Dr Myrofora Kakoulidou

Post-Doctoral Researcher at King's IoPPN

Find out more about Dr Myrofora Kakoulidou’s work on the RE-STAR project:

Day 5: How can fathers impact children’s mental health?

Thirty years ago, fathers spent just 15-30 minutes a day with their children. Today, it is more like two hours. However, fathers’ increasing involvement with their children is not always well represented in developmental research and family policy. With changes in family roles, fathers may have a crucial role to play in improving child wellbeing. Alex Martin, Research Associate at the IoPPN, explores some of her research in this area and explains the protective role fathers can have in her Children’s Mental Health Week blog.

Her team at the Developmental Psychopathology Lab investigated whether the relationships between fathers and their partners (father-mother relationship), and fathers and their children (father-child relationship), can reduce the risk of adverse mental health outcomes in children when mothers are experiencing postnatal depression symptoms.

They found both the father-mother and the father-child relationships were important; when both relationships were strong, risk of emotional and behavioural outcomes in children was reduced by around 10%. But what do these findings mean? Read more about Alex’s research, the role of father’s in child wellbeing, and what needs to be done to improve children’s mental health in her blog.

Understanding very early brain development with the Brain Imaging in Babies Study

Did you know that in the first year of life your brain triples in size?

The Brain Imaging in Babies Study (BIBS) aims to improve understanding of how a baby’s brain develops from before birth, up until 3-4 years of age. Working with children from a variety of backgrounds and communities, they use a combination of state-of-the-art diagnostic tools such as MRI scans alongside traditional behavioural assessments to capture the earliest information on infant brain development.

The BIBS team are focusing on how brains develop in babies who go on to have conditions such as autism spectrum conditions (ASC) and ADHD, and how different factors might influence brain development, such as levels of vitamin D, stress and infections (such as COVID-19) in mothers. To date, they have recruited 470 families, and aim to collect data at the very beginning of children’s lives. They have conducted 21 fetal scans, 234 neonatal scans and 128 six month scans.

The study is being co-led by Professor Grainne McAlonan, Theme Lead for Child Mental Health and Neurodevelopmental Disorders at the NIHR Maudsley BRC and Professor of Translational Neuroscience at the IoPPN. It is part of the EU-AIMS project – the largest mental health study in Europe.

Watch a short video about the project below:

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We need more than ambulances to help kids’ mental health in the UK

We need more than ambulances to help kids’ mental health in the UK

by | Feb 10, 2023 | Blog Post, News, Pears Maudsley Centre

We need more than ambulances to help kids’ mental health in the UK

Children’s mental heath has never been so critical, in the next five years, 1.5 million childlren will need new support with their mental health.

a young girl holding a leaf

Our Interim Partnership Director, Professor Emily Simonoff, discusses how clinicians and academics will work together to deliver effective, timely and inclusive mental health care for those who need it most in the new Pears Maudsley Centre when it opens in 2024.

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Where to get help in a mental health crisis

Where to get help in a mental health crisis

by | Dec 23, 2022 | Blog Post, News

Where to get help in a mental health crisis

For some people, Christmas can be a joyous occasion but for many, the festive period can welcome unwanted feelings of stress and discomfort, which in turn can have a detrimental effect on mental health.

Members of the South London and Maudsley CAMHS team

Many situations could trigger a mental health crisis in any young person. Around this time of year, it can range from a change in routine, loneliness, overwhelming amounts of pressure, a recent bereavement, and other scenarios.

A mental health crisis means different things to different people. You may feel your child’s mental health has been getting worse over time or that something has happened to make them feel this way. Young people that struggle with their mental health often have more difficulty and react differently to triggering situations.

In these circumstances, there are times when you need urgent support. It can be overwhelming, and you may feel unable to cope. No matter what your situation is, we are here to help.

How do I know if my child is having a mental health crisis?

There are several signs your child may be experiencing a mental health crisis, these can include:

  • They might want to hurt themselves, or someone else
  • They might hear voices
  • They might see things that are not real
  • They might think people are watching them or trying to hurt them
  • Making threats to others or themselves
  • Feeling low
  • Suffering from intrusive thoughts

This list above contains many but not all of the possible signs that your child may be experiencing a crisis. It is best to follow your instincts. If you feel your child is behaving much differently than normal and the situation seems like it is getting out of control, then your child is most likely experiencing a crisis.

What do I do if I suspect my child is having a mental health crisis?

Once you have identified that your child could be having a mental health crisis, you may want to consider the following questions:

  1. Do you feel your child is in immediate danger to themselves or others?
  2. Can you handle the situation yourself or do you need help?
  3. If you need help- what type of help do you need and from who?

If the answer to question one is yes, then please call for help immediately. We can offer telephone advice, support, or crisis counselling for young people concerned about a deterioration in their mental health. We also support parents and carers who are concerned about a young person.

  • For South London and Maudsley CAMHS support, out-of-hours call the Crisis line on 020 3228 5980.
  • Monday to Friday from 5 pm to 11 pm
  • Weekends and Bank Holidays from 9 am to 11 pm

Opening Times over the Christmas holidays are 9 am to 11 pm on the following days:

  • 24th December (Christmas Eve)
  • 25th December (Christmas Day)
  • 26th December (Boxing Day)
  • 27th December
  • 31st December (New Years’ Eve)
  • 1st January (New Years’ Day)

Who do I call when the CAMHS Crisis Line is closed?

The 24hr Mental Health Crisis Line supports children and young people when the CAMHS Crisis Line is closed:

  • Lewisham, Lambeth, Croydon, and Southwark call South London and Maudsley services on 0800 731 2864
  • Kingston, Merton, Richmond, Sutton, and Wandsworth call South West London and St George’ services on 0800 028 8000
  • Greenwich, Bexley, and Bromley call Oxleas services on 0800 330 8590

What do I do if I am unable to keep people safe?

If you are with someone who has attempted suicide, call 999 and stay with them until the ambulance arrives.

What if I’m unsure whether my child needs help?

If you are not sure, it could help to have a conversation with the young person you’re concerned about. We understand that having this conversation with your child is not an easy thing to do. It can be terrifying and overwhelming. Here are some steps and tips below to help you start the conversation.

  1. Tell your child what you have observed that is worrying you
  2. Let them know you are here for them, and you want to help
  3. Ask them as calmly and directly to explain how they’re feeling – just listen
  4. If they are not willing to talk, please do not force them
  5. Do not leave them alone if you feel they are at immediate risk
  6. If your child is not in immediate danger, you should still seek assistance

For the CAMHS crisis line, call 020 3228 5980 during the hours above, or call 111 www.111.nhs.uk

How can I calm the situation down?

If your child has a safety plan, follow any planned strategies you have in place. If you do not yet have a safety plan, try any strategies you feel may be effective in this situation. The intensity of the situation can cause us to project our fears or opinions so do your best to stay calm.

Keep in mind that, your child may be frightened by the feelings they are experiencing. Symptoms such as suspiciousness or distorted thinking can cause your child to be fearful and not trust other people – even you.

You may also want to consider some of the following tips to help de-escalate the situation:

  • Try to not raise your voice or talk too fast
  • Try not to challenge your child even if what they are saying seems unreasonable to you
  • Try to use positive words or phrases
  • Stay with your child but try not to restrict their movement
  • Listen actively and try to give positive support and reassurance
  • Ask simple questions and repeat them if necessary
  • Try not to take your child’s actions or comments personally
  • Don’t handle the crisis alone if you have people who can support you
  • Try to remove all sharp and dangerous objects from your child’s room and the home that might be thrown during a rage or used to harm themselves
  • If you care for more than one child, it could be beneficial to have a plan and a safe place for other children to go when a crisis occurs, if available to you

If you’re worried about a young person’s mental health, we can support you in the following ways:

  • If you need support call the CAMHS Crisis Line on 020 3228 5980 or South London & Maudsley’s 24hrs Mental Health Crisis Line on 0800 731 2864
  • If you are with someone who has attempted suicide, call 999 and stay with them until the ambulance arrives

Extra help

You can also get support from the following places:

Childline

Childline offers a free confidential helpline for children and young people in distress and offers support from counsellors online. Call 0800 1111, or get in touch via www.childline.org.uk

Shout

Shout is a 24-hour text service for anyone in crisis or struggling to cope. Text Shout at 85258, or visit www.giveusashout.org

Samaritans

24-hour confidential emotional support for people experiencing distress, call 116 123.

Kooth online counselling service

A free, safe, and anonymous support online wellbeing community is available at www.kooth.com

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