How much trouble should kid be in before we send to child psychiatry?

Depends: Is the emotional/behavioral problem a threat to their or others safety? Is there disruption to day to day functioning or reality? Is there a change without a significant/obvious/recognized precipitant? Any chronic medical problems? Any history of abuse, neglect from others? It may be worthwhile to consult sooner than later.

Do it soon: When in doubt, get a consultation. You may be reassured, or you may have a chance to intervene early before the child gets into more trouble.

Now: If you are asking this question on this board, then your child needs to get professional help.

Trouble is wrong: Why make this decision based on severity of trouble? Kids suffer just like adults. They should be treated when they suffer, not when they get into trouble. Talk to them, they can tell you how they feel and what's going on. Find out whether they are enjoying life, school, learning, friends, family. Can tell a lot in a few minutes. Note any changes in sleep, appetite, grades, energy.

Troubled kid: When behavior starts to affect other functions outside home, such as school, social milieu, friends, as well as other family members.

Not to much!!: The idea behind an evaluation is to help before the problems are very serious.

HOW MUCH?: When you ask 'how much' there probably is some, enough to make you concerned. The kindest thing for you and the child is to consult a child psychiatrist to evaluate what is actually going on. From that point there is everything from watchful waiting to treatment. Usually we ask parents to attend a form of consultation to learn the dynamics of their family and keep the therapist up to date.

Example below: Child psychiatrist evaluation useful for Young Children & adolescents: poor grades despite trying hard, severe anxiety w/refusal to go to school, go to sleep, or take part in age normal activities. Constant disobedience, hyperactivity, concentration/attention behavior. Temper tantrums, threats to harm self or others. Changes sleep/eating, sexual acting out, depression/mood swings, use etoh/drugs

Intervene early: It may not be necessary to involve a child and adolescent psychiatrist as a first step. School counselors and community-based therapists who see children and families typically assess the situation first and recommend interventions. Referral to a child psychiatrist, a physician who specializes in diagnosis and treatment of pediatric mental illness, can be facilitated by those professionals.