Dr Paul Bain

Consultant Child and Adolescent Psychiatrist

The type of problems I see

I treat the range of disorders encountered in child mental health. These will usually include: 

  • Attention and hyperactivity problems including ADHD and related neurodevelopment conditions,

  • Anxiety disorders including obsessive-compulsive disorder and phobias

  • Tic disorders and Tourette’s syndrome

  • Depression

  • Difficulties with social interaction, in particular when autism spectrum disorder is suspected.

  • PANS/PANDAS Paediatric autoimmune neuropsychiatric syndromes

I have extensive experience in adolescent mental health: I can help with adolescent emotional crises, preferably adolescents who are willing to be helped, although with a bit of patience and strategy, I have been able to successfully engage some rather difficult adolescents with the help of their parents.

If you are concerned about your teenager and cannot bring him or her to accept psychological help, please make a brief appointment of 30 or 60 minutes with me to discuss the best strategy. This has been a very  successful approach. . 

I also treat most adolescent mental health problems:

  • Mood disorders including Depression and Bipolar illness

  • Anxiety and obsessive-compulsive disorder

  • I am very experienced in dealing with teenagers who have suicidal urges

  • I can be helpful with drug misuse problems but usually if this is part of a wider problem

  • Trauma related conditions. I will administer EMDR (eye movement desensitisation and reprocessing) when indicated.

  • Eating disorders: anorexia and bulimia.

I will refer to my adolescent outreach treatment project named the Bear Project YPT  when indicated, where a multidisciplinary team can offer a broader treatment package.

I am trained in a range of psychological interventions but I will usually integrate the following therapies as appropriate in my practice: EMDR: Eye movement desensitization and reprocessing, Mentalisation based therapy, Mentalisation based family therapy. If formal CBT is required, I will usually refer to an appropriate clinical psychologist when a more structured and extended course of therapy is required.


What happens on the first appointment

In order to assess the situation I have to ask many questions to both parents and the young person. I ask these questions in a conversational way. Some questions can only be answered by the parent others by the child or teenager. It is important that I meet both parents. I usually start by seeing the child with his parents because this allows me to gain an understanding of all the concerns, as well as to obtain everybody’s perspective and assess the young person’s disposition in the presence of their parents. There is usually more than one problem and more than one view to each problem. It is also easier and less embarrassing for the child, if I see him with his parents initially.

If I am seeing a teenager I will give the teenager the choice, as he or she might want to speak to me alone initially. Parents should of course not be put off by this as it is mostly an attempt to engage the teenager in the process.

There is no immediate need to see brothers and sisters unless of course they are part of the problem in question.

Parents are often uneasy about giving a full account of their child’ s problems in front of them. I sometimes meet with parents without the child during the course of the assessment. I also like to see the child on their own if they are old enough and accept. This can usually be done within the first appointment.

It is sometimes very useful to have a report from school. I will however not contact them without your permission.

I may need to carry out a physical examination on a child but can usually manage this without taking all their clothes off. I don’t often need to take bloods for tests. I rarely need to request a brain scan, which will need a separate arrangement. After the first appointment, I will write a report about my assessment to you and to the referring doctor. If there is a need for psychological treatment I will sometimes refer on to a clinical child psychologist or psychotherapist. If medicines need to be involved then I will manage these myself, jointly with the referring GP or paediatrician.

It might be helpful to explain to your child what sort of person you are taking them to see. I suggest that you say the following: That you are taking them to meet a doctor to see if there is a medical reason for their problems, They will return home afterwards, The doctor will ask them some questions but that it is not a test or an exam. There will be no injection or operation.

A first appointment lasts about an hour and a half. If I need to see your child again it will be for a shorter period. I can meet with parents rather than the child for follow-up. This is not because I think parents are causing the problems –they are usually not- but because they have the power to make a change for their child. It is often the case that changing the way a teacher or parent handles a child helps to resolve the problem.

Indeed, I can do very little in any case without your support and cooperation. I am looking forward to meeting with you.


What happens if you are unhappy with the services you have been provided

If you are unhappy with the services you have received from me, I would like to know about it as soon as possible, so I can investigate your concerns and explain, apologise, and take positive action where necessary. In most circumstances, if you tell me about your concern quickly, I can resolve matters straightaway. To let me know about something with which you are unhappy please speak with Emese on 07792 576 432 in the first instance or email my office on drpaulbain@35greatjames.com.

If you are not fully satisfied you can put your concerns in writing and use our formal Complaint Resolution Procedure, which meets with the requirements set out by the Independent Doctors Federation (IDF) for its members, and also the Independent Sector Complaints Adjudication Service (ISCAS).

The Complaint Resolution Procedure has three stages and reflects the principles of the ISCAS Code of Practice:

Stage 1 Local resolution within the individual building.

Stage 2 IDF Complaint Resolution Procedure to review the complaint.

Stage 3 Independent Adjudication from ISCAS.

 

Stage 1

To start the formal Complaint Resolution Procedure you should write to:

Prof Peter Hill,

Consultant Child & Adolescent Psychiatrist,

35 Great James Street, London WC1N 3HB

You should state what has caused you to have concerns and make your points clear. Please document when the relevant events took place, and what results you expect from your complaint.

You will receive an acknowledgement of your letter within one week of receipt of the complaint.

A full response to your complaint will be made within twenty days of the receipt of the complaint. If the investigation is still in progress after twenty days, a letter will be sent to you explaining the delay, and a full response made within five days of reaching a conclusion. In any event a holding letter will be sent every twenty days where an investigation is continuing.

 

Stage 2

If you remain dissatisfied following the final response from the practice, then you can request a review of your complaint, known as Stage 2 by writing to:

IDF Administration,

Second Floor, 126 Harley Street, London W1G 7JS

The IDF Complaint Resolution Procedure will consider your complaint and may undertake a review of the documentation, any correspondence, and the handling of the complaint at Stage 1. The Chairman of the IDF Complaint Resolution Procedure Committee will write to you according to the IDF procedures, and in any event within twenty days, to either confirm the outcome at stage 1, or to offer an alternative resolution.

At this time the IDF will advise you of your right to take the matter further to Independent Adjudication, known as ISCAS, and stage 3 in these procedures.

Throughout the process all information, documents and records, relevant to your complaint, will be treated in the strictest confidence and no information will be divulged to any parties who are not involved in the IDF Complaint Resolution Procedure, unless required to do so by law. 

 

Stage 3

This stage is only available to complainants who remain dissatisfied once Stage 1 and Stage 2 are exhausted.

A complainant should then request the Adjudication by writing to the Secretariat: 

Independent Adjudication Secretariat,

Independent Sector Complaints Adjudication Service,

1 King Street, London, EC2V 8AU

This written request for adjudication must be made within twenty-five days of the final determination by the IDF at Stage 2. The complainant at Stage 3 should provide reasons to explain the dissatisfaction with the outcome of Stage 2. The ISCAS Secretariat will seek confirmation from the IDF that Stage 2 has been completed.

The ISCAS Secretariat will notify the IDF of a request for Stage 3 made directly within ten days. The Secretariat will then be the main contact for the complainant, once Adjudication is started. A complainant accessing this service will be asked to consent to release of records from the practice, and the IDF relevant to the complaint, and a report will be made to the complainant, the practice and the IDF.

Additional information for patients about ISCAS can be found at:

http://www.independenthealthcare.org.uk/index.php?/complaints-information-for-patients.html 

IDF – www.idf.uk.net                                                IHAS - www.independenthealthcare.org.uk

January 31, 2020