From what age do you see adolescents?

I see adolescents from the age of 15. For under-15s, the appropriate step is a referral to child psychiatry with specific training for that group. If you are not sure whether your child falls within the range, write to me and I will point you in the right direction.

Do I have to be present at my child's consultation?

The first consultation usually includes time with the parents and time alone with the adolescent. In subsequent sessions, the adolescent decides how far the parents take part. I explain the criteria in detail at the first interview.

My child does not want to come to a consultation. What do I do?

This is very common and part of the adolescent process. What tends to help: being honest about why you are proposing it, not presenting it as a punishment, and letting them decide how much they say. My role is to build an alliance with them, not to impose. After the first meeting, most stay. If you arrive with this situation, we handle it.

Will you tell me everything my child says to you?

No. The adolescent's therapeutic space is confidential. What is shared with parents is decided with the adolescent, except in situations of serious risk —suicidal intent, risk of serious harm to others, situations of abuse—. I explain this in detail at the first consultation so you know exactly how it works.

Will my child be put on medication?

Not necessarily. In adolescents, psychotherapy is the mainstay, and medication is considered with prudence and only when indicated —never as a first step in mild cases, and always with close monitoring and conversation with the family. The decision is individualised for each case; I do not make it in advance or over the web.

Can the first consultation be by video?

It can, but for adolescents the first one is ideally in person. It is the most delicate assessment of all: it involves the family, it requires building an alliance with the adolescent, and it rests on a great deal that is hard to read through a screen. If coming to the practice is not feasible —you live outside Lima, you are travelling— we discuss it when arranging the appointment and look at the case. Follow-up can be in person or by video.

Do you see LGBTQ+ adolescents?

Yes, and it is a routine part of my practice. One clarification that matters: sexual orientation and gender identity are not in themselves a reason for psychiatric treatment. What is treated is the anxiety, the depression or the distress that sometimes appears around them —often because of the environment rather than the person—. The setting is the same as with any other adolescent: confidential, without judgement, and with the patient deciding the pace at which things are discussed with their family.

Do you see adolescents living in Peru who prefer care in English?

Yes. I practise in English as fluently as in Spanish, which can matter for adolescents from expatriate families in Lima or other Peruvian cities, students at bilingual or international schools, or adolescents who prefer to express intimate matters in English.

Adolescent Psychiatrist (15+)

Adolescent psychiatrist in Lima — assessment and treatment from age 15.

It is not just "a phase" — and you are not alone in this. Adolescence brings intense biological, emotional and social change, and it is also the point in life when many mental health conditions first appear. When a son or daughter changes in a sustained way —withdraws, shuts down, stops functioning as before— a parent's doubt is legitimate and worth listening to.

In person in Miraflores (Lima) or by video · First consultation preferably in person · Spanish and English · WhatsApp reply the same day

Book an assessment on WhatsAppDra. Daniela Málaga · CMP 76202 · RNE 42512

What is adolescent psychiatry?

Adolescent psychiatry assesses and treats mental health disorders in the age range where most conditions first appear. This is not a minor detail: an estimated one in seven 10-to-19-year-olds lives with a mental disorder.¹ And the timing follows a clear pattern: the largest meta-analysis conducted to date —192 studies, more than 700,000 people— found that around a third of mental disorders begin before the age of 14 and close to half before 18, with the peak age of onset at 14.5 years.²

Much of the mood fluctuation, irritability and push for autonomy at this age is a normal part of development. A psychiatric consultation is not there to pathologise that. It is indicated when signs appear that exceed the expected range and begin to affect the adolescent's functioning, relationships or safety —at home, at school or with themselves.

Unlike an adult consultation, here the adolescent is the patient, but the family is part of the treatment. International clinical guidelines agree that assessing a minor in the context of their family, school and community is central to any psychiatric assessment at this age.³ The approach therefore almost always combines the adolescent's voice, the parents' input and coordination with their environment.

In my practice I see adolescents from the age of 15. For younger children, the appropriate step is a referral to a child psychiatrist with specific training for that group.

This is not a parenting failure, nor a whim of the age.

Warning signs: when an assessment is worthwhile

Not every adolescent who is suffering shows it the same way: some shut down, some become irritable, some simply "stop being themselves". Some signs that justify an assessment:

Sustained changes in mood — deep sadness, marked irritability or loss of interest in what they used to enjoy, over weeks.
Intense anxiety — panic attacks, paralysing social anxiety, incapacitating fear of going to school.
ADHD becoming visible in secondary school — underperformance out of proportion to effort, disorganisation, chronic procrastination.
Drastic changes in eating or weight — restriction, bingeing, excessive preoccupation with body image.
Self-harm — behaviour that damages their own body. It always warrants assessment, even when it seems mild.
Thoughts of not wanting to live — direct or indirect expressions, including on social media, about death or suicide. This needs attention without delay.
Marked social withdrawal — no longer seeing friends, shutting themselves away for months, losing their whole network.
A sharp drop in school performance — with no academic reason that explains it.
Alcohol or other substance use — that goes beyond the experimental.
More serious symptoms — hallucinations, paranoid ideas or sustained depersonalisation. These require urgent assessment.

A note for parents: you do not need to be certain that something "is" a disorder to ask for a first consultation. The doubt itself —is this normal or not? is it a psychologist or a psychiatrist?— is reason enough to get your bearings. And where there are signs of risk, the prudent thing is to consult soon, not to wait until you are sure.

When to consult

An assessment is worth seeking when:

1
The signs described are sustained over time (not a bad day, but weeks) and affect your child's school, relationships or mood.
2
There is risky behaviour —self-harm, substance use, thoughts of death—. Here you do not wait: you consult.
3
Support from home or school has already been tried and the situation is not easing or is getting worse.
4
As a parent you have the doubt as to whether what you are seeing is part of the age or something that needs help. That doubt deserves a professional answer.
5
Another professional (paediatrician, psychologist, school counsellor) has suggested a psychiatric assessment.

Asking for an assessment is not pathologising or labelling your child. It is giving them one more tool, at the point in life when doing so yields the most.

How I approach care

A psychiatric consultation for adolescents differs in important ways from one for adults. This is how I work:

Confidentiality and the adolescent's voice.
The adolescent is the patient; the therapeutic space is theirs. From the first session I explain what is shared with their parents and what is not. The limits of that confidentiality are discussed with the patient and the parents at the outset.³ The exception is situations of serious risk to themselves or others, which are explained in advance.
Working with the family, with judgement.
The first consultation usually includes time with the parents or guardians —to understand the reason from their perspective— and time alone with the adolescent. Interviewing people separately often helps each of them share their history more freely.³ Psychoeducation for the family is part of the treatment.
Coordination with the school when it helps.
In conditions that affect school performance, coordinating with the school can be useful —always with the adolescent's and the parents' authorisation, and with clear criteria on what is shared.
Psychotherapy as the mainstay.
In adolescents, psychotherapy is central. International guidelines recommend a specific psychological therapy as first-line treatment in depression, and are explicit that medication is not offered on its own in moderate to severe cases, but alongside psychotherapy and with close monitoring.⁴ I work in a network with therapists trained in adolescence.
Pharmacological prudence.
When medication is considered, it is done with careful assessment and conservative judgement: not all treatments are studied or approved in minors, and the decision is individualised according to the condition, the age and the context. The conversation is always with the adolescent and the family, with clear expectations. Nothing is prescribed over the web or automatically.
Accompanying development.
The clinical condition is treated, but the life process is also accompanied —identity, autonomy, relationships, a sense of direction—. That includes LGBTQ+ adolescents, who come to the consultation like any other: not for who they are, but for whatever they may be going through. Adolescent psychiatry is not only about managing symptoms: it is about being available at a critical moment.

My approach is evidence-based, respectful of the adolescent's autonomy and honest with the parents. Decisions are made together, with the clinical picture properly understood.

Is it "the age"… or is it something more?

These contrasts are meant to orient you; they do not replace a professional assessment. Where there are signs of risk (self-harm, thoughts of death), you do not wait until you are sure: you consult.

Is it a normal phase or a clinical condition?
Ups and downs, irritability and the push for autonomy are part of development. The difference lies in persistence (weeks, not days) and in impact: when it affects school, relationships or the adolescent's safety, it exceeds the expected range and warrants assessment.
A psychologist or a psychiatrist for my child?
They are not mutually exclusive: in adolescents, psychotherapy is the mainstay of treatment. A psychiatric assessment contributes the differential diagnosis, the ruling out of medical causes and the judgement on whether medication is indicated — which in mild cases is not the first step. If the doubt is where to start, an assessment points the way.
ADHD that "appears" in secondary school?
ADHD does not appear suddenly in adolescence: it was there before, but greater academic demand makes it visible. Underperformance out of proportion to effort and chronic disorganisation justify assessing it.

Frequently asked questions

From what age do you see adolescents?
I see adolescents from the age of 15. For under-15s, the appropriate step is a referral to child psychiatry with specific training for that group. If you are not sure whether your child falls within the range, write to me and I will point you in the right direction.
Do I have to be present at my child's consultation?
The first consultation usually includes time with the parents and time alone with the adolescent. In subsequent sessions, the adolescent decides how far the parents take part. I explain the criteria in detail at the first interview.
My child does not want to come to a consultation. What do I do?
This is very common and part of the adolescent process. What tends to help: being honest about why you are proposing it, not presenting it as a punishment, and letting them decide how much they say. My role is to build an alliance with them, not to impose. After the first meeting, most stay. If you arrive with this situation, we handle it.
Will you tell me everything my child says to you?
No. The adolescent's therapeutic space is confidential. What is shared with parents is decided with the adolescent, except in situations of serious risk —suicidal intent, risk of serious harm to others, situations of abuse—. I explain this in detail at the first consultation so you know exactly how it works.
Will my child be put on medication?
Not necessarily. In adolescents, psychotherapy is the mainstay, and medication is considered with prudence and only when indicated —never as a first step in mild cases, and always with close monitoring and conversation with the family. The decision is individualised for each case; I do not make it in advance or over the web.
Can the first consultation be by video?
It can, but for adolescents the first one is ideally in person. It is the most delicate assessment of all: it involves the family, it requires building an alliance with the adolescent, and it rests on a great deal that is hard to read through a screen. If coming to the practice is not feasible —you live outside Lima, you are travelling— we discuss it when arranging the appointment and look at the case. Follow-up can be in person or by video.
Do you see LGBTQ+ adolescents?
Yes, and it is a routine part of my practice. One clarification that matters: sexual orientation and gender identity are not in themselves a reason for psychiatric treatment. What is treated is the anxiety, the depression or the distress that sometimes appears around them —often because of the environment rather than the person—. The setting is the same as with any other adolescent: confidential, without judgement, and with the patient deciding the pace at which things are discussed with their family.
Do you see adolescents living in Peru who prefer care in English?
Yes. I practise in English as fluently as in Spanish, which can matter for adolescents from expatriate families in Lima or other Peruvian cities, students at bilingual or international schools, or adolescents who prefer to express intimate matters in English.

Fees and formats

Fees and payment are arranged over WhatsApp. The first consultation lasts an hour; follow-ups around 50 minutes. I issue the receipt you need to claim reimbursement from your insurer — with experience in the Peruvian formats of Pacífico and Rímac. Care can be in person in Miraflores or by video; for adolescents the first consultation is ideally in person, and if that is not possible we discuss it when arranging the appointment. Care in Spanish or English.

If you are worried about your son or daughter —or if you are an adolescent and think you need help— the first consultation is there to orient you, with no commitment.

Book an assessment on WhatsApp

References

World Health Organization. Mental health of adolescents [fact sheet]. Geneva: WHO; updated 1 September 2025. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
Solmi M, Radua J, Olivola M, et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry. 2022;27(1):281-295. doi:10.1038/s41380-021-01161-7
Josephson AM; American Academy of Child and Adolescent Psychiatry (AACAP). Practice parameter for the assessment of the family. J Am Acad Child Adolesc Psychiatry. 2007;46(7):922-937. doi:10.1097/chi.0b013e318054e713
National Institute for Health and Care Excellence (NICE). Depression in children and young people: identification and management. NICE guideline NG134; 2019. https://www.nice.org.uk/guidance/ng134

If your son or daughter is in crisis, has harmed themselves or expresses thoughts of taking their own life, do not wait for an appointment: Línea 113, option 5 (mental health) · 106 (SAMU) · or go to the nearest emergency department. Please note that these lines operate in Spanish. This page is informational and does not replace an individual medical assessment.

Dra. Daniela Málaga — Psychiatrist · CMP 76202 · RNE 42512 · More about me