Child and adolescent anxiety

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Target exams

Red flags

• Active suicidal ideation, intent or plan, or escalating self-harm in an anxious youth — same-day risk assessment and safety planning, not 'anxiety only' reassurance
• Severe school refusal with medical red flags (weight loss, dehydration, unexplained neurological signs) or prolonged complete non-attendance — urgent MDT and medical review
• Acute panic with chest pain, syncope, or first presentation needing organic exclusion before pure psychiatric labelling
• Marked behavioural activation, new or worsening suicidal thinking after starting an antidepressant — urgent review and dose/treatment reassessment
• Safeguarding concerns (abuse, neglect, bullying with safety risk, exploitation) disclosed in anxiety assessment — escalate per local child protection pathways
• Inability to leave home with extreme avoidance and carer collapse — escalate intensity of care and legal least-restrictive options if capacity and risk require it