BUP / BUPA

BUP stands for Child and Adolescent Psychiatric Outpatient Clinic. It is an outpatient specialist health service within mental healthcare for children and young people. They offer services to children and young people under the age of 18 and their families. Outpatient means that you get appointments there, but are not admitted. BUP's main tasks are to help children and young people, and their families, in the form of investigation, treatment, counselling, guidance and facilitation related to psychological difficulties, behavioral difficulties and learning difficulties.

Read more about BUPA further down in this article.

What can BUP help with?

At BUP, you can get help to deal with things that make everyday life difficult, for example depression, anxiety, concentration problems, behavioral difficulties, after-effects of traumatic experiences, language difficulties, learning difficulties and sleep problems. BUP can also help with difficult relationships, for example in relation to parents, siblings, friends or teachers. Some children and young people have a form of mental illness of a more serious nature.

At BUP you can meet a psychologist, child psychiatrist, family therapist, clinical pedagogue, clinical social worker, doctor, psychiatric nurse and other professional groups. Sometimes several people work together.

How to get help from BUP?

A referral from a doctor or psychologist must be sent in order for BUP to be able to offer you help. A hospital doctor, emergency room or GP, psychologist and head of the child protection service can send such a referral. It should contain a detailed description of the problem and concerns, as well as what, if any, has already been attempted. By ensuring that BUP receives sufficient information in the referral, it will give BUP a better basis for assessing the need for help and investigation.

Children and young people who are referred to BUP have the right to assessment of the referral within 10 days. If the child is admitted to BUP, you are usually given an assessment plan with a call for several hours and tests. There is also usually a form that parents must fill out in the first summons letter.

Investigation

Anamnesis (the child's and/or the family's history) is the first thing to review. The investigation is always based on the anamnesis, both what the child/young person has mastered and what has been difficult is essential. BUP therefore uses the first time to get a good overview of the situation of the person who is to receive help. They get that primarily by talking to the child/youth and the parents, and perhaps others who know the situation well.
Questionnaire is important in the mapping. There are different forms based on the challenges you come in with. If the child is referred with suspicion of e.g. autism, you would like to be given a different form to fill in, than if the child has been referred due to depression/anxiety Which tests and form to complete is individual and depends on the reason for referral. There may also be a need for more tests during the investigation.
Tests is often carried out to survey the child's abilities, concentration, language, working memory, acting out and possibly other psychological challenges. These tests may involve concrete tasks that the child must do, such as drawing and imitating, tasks that require good concentration or challenge perfectionism.
Play observations that challenge the child on role play, contact skills, interaction, rigidity etc. can also provide BUP with useful information about the child. Other elements in the assessment can be observing the child at home and/or in nursery school and school, as well as educational assessment where they look at the connection between learning capacity, abilities, emotions, coping experience and school adjustment.
Physical examination done by a doctor, possibly in collaboration with a physiotherapist, often with a special focus on the nervous system where reflexes, various movements and coordination skills are examined. It is often also relevant to carry out other examinations such as blood tests, EEG (to check for activity in the brain, such as epilepsy), X-ray and MRI (magnetic examination of the brain inside a "tunnel machine").

Conclusion / diagnosis

When BUP has formed a better picture of both challenges and what is working well, they can conclude about the cause and possibly make a diagnosis. A feedback meeting must always be held with parents where information is provided about BUP's conclusion, diagnosis, need for accommodation, current treatment and further rights. In this meeting, it is also good if you agree on which areas it is important to work on and how you will do it together, as well as what BUP can do and who they can contact to ensure good follow-up and further help.

It is also common to have a new feedback meeting with relevant bodies, e.g. kindergarten/school, PPT, occupational therapist, etc., after the feedback meeting with the parents has been completed. It can be important to ensure good arrangements and follow-up of the child further.

Complaint rights

If you are refused an investigation/disagree with BUP's conclusion/missing conclusion, you can complain or ask for a "second opinion" from another BUP department (possibly BUP at the hospital, often called BUPA).

If you believe that the child has received poor help (rejection of assessment, started too late, spent too much time, etc.), unreasonable or unfair treatment, you can complain on that. The complaint is first sent to the treatment center (in this case BUP). If BUP disagrees and does not approve your complaint, it is sent to The State Administrator.

BUPA: Department of Child and Adolescent Psychiatry

If more intensive measures are needed, BUP's outpatient clinic can apply further to BUPA's intensive outpatient clinics and/or day services. BUPA is an admission and assessment unit for both children and young people, and families, who need services at a more advanced specialist level. Here you can find services such as emergency services for children and young people, treatment services, assessment services, dining teams, autism teams, outpatient youth teams, OCD teams and family departments. The offer may vary somewhat in the various healthcare institutions.

In the case of serious mental disorders and more complex conditions, there may be a need for urgent or planned admission to BUPA for a thorough assessment or to ensure a sound offer for children and young people who are struggling. Such a stay can be short-term or last for several weeks/months.

For children and young people who are admitted, some of the investigation will be similar to that described above, but the investigation will also be based on observations in the bed record, which is an important part of the investigation.

BUPA also offers advice and consultation services to professionals in municipal bodies who work in mental health, as well as guidance and courses for parents.

Good to know

BUP can recommend arrangements and adaptations in kindergartens and schools.
If cooperation/facilitation in a nursery/school is difficult, you can talk to BUP and ask for help from them in meetings, or a certificate to show.
BUP can also write certificates for various applications (aids, basic and auxiliary allowance, care allowance etc.)
If ADHD is suspected, an EEG should, as a general rule, be carried out.
Through parent interviews at BUP, you get the opportunity to describe and air concerns about the child. Don't withhold information just because you think it's irrelevant and dare to be direct about concerns and suspicions you may have. In this way, you give BUP a good opportunity to form a comprehensive picture of the child. It can be small details, which we parents may think are not that important, which actually become the deciding factor!
Document behaviour/statements/actions from the child in advance and during the process which you can include in the investigation to give BUP insight into the challenges you experience in everyday life. E.g. can you make a note on the mobile phone that you can continuously note down when the child says special things or behaves in a strange way, and possibly film a bit (without the child getting it) to be able to show to BUP.
The BUP polyclinic can refer you to a more advanced examination/examination stay at BUPA if necessary.

When it comes to the issue surrounding the need for care money for children and young people who have had follow-up in BUP in the past, but who no longer have a treating doctor in the specialist health service, or who are followed up in BUP, but where a doctor refuses to write a medical certificate, we have written a little about this and their rights in that regard here.