In these cases, review authors urged practitioners in CAMHS teams to listen carefully to young people and avoid being too optimistic when interpreting the messages they communicate both verbally and non-verbally. If young people do not feel practitioners are listening to them, they will lose confidence in them. They need professionals to act on what they have been told and help them achieve change. Young people need to be fully involved in their own treatment, providing input and feedback which practitioners can use to direct treatment, set meaningful goals and develop services.
Not fully exploring and understanding a teenager’s "inner world" is a significant barrier to listening to young people and can result in practitioners drawing over-simplistic conclusions. One case review noted teenagers’ tendency to withdraw from adults, becoming “secretive” and relying on their peers to support them and reinforce their view of the world and their place in it. Professionals in CAMHS teams need to avoid taking conversations with young people at face value; look out for any discrepancies between what a teenager does and what they say they are doing; and be aware that not all teenagers who are intent on harming themselves will present with obvious symptoms of depression. In fact, some teenage girls in particular may go to great lengths to maintain an image of high achievement and be reluctant to acknowledge any personal struggles.
Practitioners also need to be prepared to explore what young people write about themselves and their feelings (for example in diaries, or in posts on social media platforms or online discussion forums). One case review underlined how a girl’s diary entries helped to prepare her psychologically for taking her own life. Most practitioners were unaware that she kept these diaries, and those that knew about them held back from discussing them with her for fear of breaching her right to privacy. Her writing actually presented a missed opportunity to explore and challenge her self-harming and suicidal thoughts.