Empowered Life

The psychiatric consultation is offered to anyone who would like to either understand their child’s diagnosis or treatment. Also to understand what questions are reasonable to ask when in the psychiatry office. I provide a little overview of how and why I am able to offer this consultation in the program area.

In addition to being a registered nurse for the past 4 decades, I spent the last 15 years of that time as an Advanced Practice Registered Nurse (APRN), boarded in child & adolescent psychiatry (APRN-BC). However, I am no longer actively practicing in the area of psychiatry, offering psychiatric assessments, diagnoses and medication  management. My board certification remains current as does my knowledge in this field.  I left the mental health world of prescribing because of the change and the focus on  medicating based on symptoms without understanding the “why’s" that often, in my own opinion, were incomplete.

You see, if a child has one behavior at home, another at school, and still a different one in social settings, this is not mental illness. This is an environmental problem in need of an environmental solution, not medication. I prescribed medication when I felt it was necessary. In some instances, they needed to be chronic, such as ADHD or bipolar disorder. However, even with this I started low and went slow to find the best fit for an individual at the lowest possible dose. I also discussed environmental factors, ways to manage symptoms, such as with some on the autism spectrum. I referred to and insisted on other support systems such as therapy because some youth could come off the medication (safely) with the correct environmental accommodations, processing and learning coping skills.

I was a partner with the child and their caregivers, wanting what was best for each of those with whom I worked. My extensive work with traumatized youth helped me to both understand how symptoms overlap between diagnoses in the diagnostic statistical manual (DSM) and at times even with what might seem to be psychosis. Having the ability to understand and tease out the differences is critical to not prescribing medications with significant side effects. Medications are a true necessity if psychoses are present. After all, kids are not little adults, their brains are still forming until the ages of 24 or 25. I worked with youth ages 5 to 25. My experience has taught me that  medication isn’t always necessary, can help in the short term until changes can be made, and in some cases need to be consistent. However, healthcare has become more interested in shorter assessments and more medication, to which I cannot personally  subscribe, especially for our youth.