Child and adolescent mental health
Adolescent mental health, self-harm, eating disorders, ADHD and autism, and confidentiality with young people.
High-yield points
Use the HEEADSSS framework (Home, Education/employment, Eating, Activities, Drugs, Sexuality, Suicide/depression, Safety) for adolescent psychosocial assessment.
Offer the young person time alone and explain the limits of confidentiality (serious risk of harm).
Anorexia nervosa: assess medical instability (bradycardia, hypotension, hypothermia, electrolyte disturbance) and refeeding risk; admit if unstable.
Family-based treatment is first line for adolescent anorexia.
Self-harm is common; every presentation needs risk and needs assessment and a follow-up plan.
ADHD and autism frequently co-exist and are associated with anxiety.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Confidentiality | Parents usually present and informed. | See the young person alone for part of the consult; HEADSS assessment. Confidentiality has limits for serious risk. Own Medicare card from 15. |
| Services | Few child psychiatry services. | headspace for 12-25 year olds; CAMHS for severe illness. |
| Eating disorders | Less often recognised. | Common exam theme. Medicare eating disorder plans; family-based treatment for adolescents; watch for medical instability. |
| Self-harm | Assessed similarly. | Largely the same assessment, with collaborative safety planning and family involvement. |
Confidentiality
India (MBBS)
Parents usually present and informed.
Australia (AMC): what the exam expects
See the young person alone for part of the consult; HEADSS assessment. Confidentiality has limits for serious risk. Own Medicare card from 15.
Services
India (MBBS)
Few child psychiatry services.
Australia (AMC): what the exam expects
headspace for 12-25 year olds; CAMHS for severe illness.
Eating disorders
India (MBBS)
Less often recognised.
Australia (AMC): what the exam expects
Common exam theme. Medicare eating disorder plans; family-based treatment for adolescents; watch for medical instability.
Self-harm
India (MBBS)
Assessed similarly.
Australia (AMC): what the exam expects
Largely the same assessment, with collaborative safety planning and family involvement.
The Australian context
headspace centres offer free youth mental health care for 12-25 year olds. Medicare-subsidised eating disorder treatment plans provide extended psychological and dietetic sessions. Young people can have their own Medicare card from age 15.