Imaginary Friends, Voices and Psychosis
Adult mental health services are focused on major mental illness, such as schizophrenia and manic-depression, and the treatment of psychosis. Psychosis occurs in only a minority of clients under 18, so child mental health services are in contrast focused far more on problems of living. Imaginary friends are at the normal end of this continuum. Young often endow soft toys and pets with human characteristics. For some, the imagined being is disembodied, and may be a close companion, confidant, playmate or commentator. Children commonly experience voices. These are not necessarily indicative of disorder. Often they may be merely one part of the child's mind that expresses a different view from the rest. Management is simple. The treatment of psychotic symptoms in young people is not appropriate within primary care, so the only decision that needs to be made is whether or not the symptoms require further assessment.