A little vent.

[Dillyson]

My 14 yr old DS suffers with depression. He has had ups and downs since he was about 9.
He has periods of very low moods. The current low mood has been since Christmas when he self harmed. He has been seen by the GP and referred to CAMHS. He was assessed and has been having counselling.
The counsellor phoned this week to say she was concerned as he had been having suicidal thoughts. Straight back to the GP for an urgent CAMHS re assessment.
I'm worried sick about him but feel that he is being well supported.
I have confided in 2 close friends as I felt I needed a little support. Both have started with the sentence "well he is an only child".
I know he's an only child! I tried very hard to give him a sibling but I had multiple miscarriages and a termination for Edwards syndrome. They both know this, and have succeeded in making me made me feel absolutely shit.

My beautiful clever, witty, articulate boy is so troubled and I can't help him.

[MyKingdomForBrie]

Oh you poor thing, and your poor DS. I cannot begin to imagine what they mean about him being an only. Completely irrelevant and obviously unrelated to his illness. It sounds like you're doing an amazing job looking after your ds through this and your friends are totally ignorant.

[Hercules12]

Hi. Dd is 13 and we're going through similar. Dd has attempted suicide but didn't succeed fortunately. You have to trust in what camhs say and foLlowes their advice. Make sure he's never alone, school are aware and have a safety plan in place so there's an alert if he doesn't turn up for a lesson and clear your house of medication etc.

[Dillyson]

Hercules12 I am making sure he's not alone, other than at night. Glad you've said that as I was beginning to think I was overdoing things. I've locked up all the tablets in the house as well.
School have been brilliant, his housemaster is in the picture and keeping a close eye on him.
I take him to school and DH usually picks him up. Unfortunately DH has had to go away on business this week. I've managed to change my work hours to collect him.DH left last night and has already been on Skype 3 times.
My one supportive friend is on standby if needed.

[Hercules12]

Definitely not over reacting. We were warned by camhs but carried on as we had been leaving her at home after school. That's when she attempted it.

[Dillyson]

Oh Hercules that must be so difficult for your family. How is she now?

[Hercules12]

She's better thanks but I think it's life changing for everyone. Everyone expects her to get better quickly bit it doesn't work like that. You're doing all the right things. It's so sad to see our children who should be happy simplyou not wanting to live.

[Dillyson]

DS has had a bad weekend. Sent home from school today.
We've been back to the GP and now we're waiting for the CAMHS crisis team to call.

[Hercules12]

Poor you and poor ds. If things get bad and you're worried you can take ds to a and e. We've done that when we've felt it's beyond us at that moment in time.

[Dillyson]

He has an appointment on Wednesday but they're going to try and see him tomorrow.
I have been told to go to A&E if anything gets worse.

[Blossom789]

You sound like a brilliant family, both you and your husband being so flexible to look after your boy. Was so shocked to hear your friends made those comments about only child. I've worked with young people with mh problems for many years- never met a child whose low mood comes from being only child. Keep doing what you're doing and I hope the appointment goes well, don't forget you can ask to see the worker alone if you feel you want to raise any concerns without DS present.

[Dillyson]

Thank you @Blossom789, very kind words.

We saw the crisis team today. All good at the time. They made plans for keeping DS safe and have now spoken to his housemaster as school. The plan was to speak to the team and discuss the possibility of medication.

I've just had a call to say the doctor doesn't want to prescribe medication at the moment and to carry on with the counselling. The case will now be closed, and how did I feel about that?

I'm fuming. I feel that nothing has been done other than talking to someone different for an hour. I know there is no quick cure, but I'm still at home with a child who is miserable, having thoughts of harming himself and who has self harmed again.

I don't know what I expected in reality but I thought they might suggest some other kind of treatment/therapy. He isn't a candidate for a psychologist and doesn't need family therapy. I'm at a loss, I'll keep all the tablets hidden and carry on locking the kitchen door at night.

[Blossom789]

Doesn't sound great- what did you say when they asked how you felt about it?

Theyre following correct guidelines that talking therapies should be used first before medication. Can you ask that the case is kept open until the counselling is compete and then camhs review?

Can't see how they can go from making a keep safe plan to discharge.

I work for camhs and times are changing in the treatment that's offered which doesn't sit easily with us clinicians. Some of it depends on how services are set up (i.e. How camhs and counselling services link together) as you have concerns give them a call back.

[Dillyson]

I explained that we had come to them as they are the crisis team, he needs help. She explained that there are no overnight remedies.
I told her I understand that but we hadn't made any progress. I was already doing everything on their keep plan. He's had lots of counselling over the years and it's obviously not working as we're with the crisis team.

I now have a 6'2" crying 14 yr old as he is really struggling. I just don't know what to do now.

[OhTheRoses]

I'm sorry you are going through this. CAMHS refused to help dd too and she was depressed, anxious, taking small ods and cutting. They told me to find a counsellor off the internet. Some things you can do:

Everything CAMHS tell you reiterate in a letter, reg delivery, noting your disappointment, asking for reasons, noting you will hold them responsible for consequences. Copy your MP.

Arange to meet your gp at a constituency surgery nd explain lack of care and your concerns.

Call young minds parent helpline and arrange a parent support conversation.

Relate are offering good young people's counselling now and it's reasonably priced.

Make a monthly apt with the best gp yr surgery and use fr you if yr son doesn't want to go.

Royal School of psychiatrists website is helpful.

Look after yourself.

[Blossom789]

As I said above, I'd suggest you call them back and say you've had a think and you'd like them to reconsider. Explain your concerns again about risk and also his past intervention with counselling being ineffective and the current counselling is the same.

I feel unclear about how the services are set up - if you feel the same ask them to explain. It sounds as though the crisis team are gatekeeping referrals before they get to the main camhs team where young people are seen for longer term therapy/ treatment.

Did the crisis team talk to the counsellor? As it was thebcounsellor who raised concerns. If you give the counsellor a call to let them know what's going on and your worries - they can then contact camhs to discuss further.

You can go back to your gp to discuss and they can also refer back to camhs or write a letter to explain their concerns.

[OhTheRoses]

When I did that blossom they told me the decision had been referred to the multidisciplinary team (which was reliant on one nurse disseminating facts correctly in which I had little faith) and their decision was expert and final. These people really hve no interest in prevention or doing more than the minimum they can get away with.

Phone calls, ime, op are ignored or denied. You must put things politely and firmly in writing ensuring there is an audit trail.

For us when DD was in difficulty CAMHS team (nursing staff) said no. GP (qualified doctors) said urgent. Incredible how one tap from our MP to the CEO resulted in services being offered when the case had been looked at more carefully again.

Having said all that we invested in a private psychiatrist in the end who provided excellent advice, medication, good support and eventually a diagnosis for ADHD ADD variant which was the root of the problem. CAMHS closed the case of ab escalating teenager twice. They whine hard about how overworked they are (I don't work 9-5; they do) they whine hard about their personal politics and funding; I have never heard them raise the issue of the safety and wellbeing of the young people they aren't helping.

In my area it's a mismanagement issue not a funding issue.

[picklemepopcorn]

Outrageous. Bloody disgusting. I'm so sorry.

[Blossom789]

Sorry to hear such negative experiences with camhs.

I must stand up for camhs though, there are huge increases in referral rates for non mental health issues which clogs up the system. Gps whilst they are doctors have very little experience of child mental health. There does need to be more funding at the preventative end. Traditionally all child mh issues were dealt with by camhs but there are now many other commissioned services that do counselling or other aspects- imo this creates massive issues as people feel they need camhs and feel fobbed off when other services are involved. This is not the fault of camhs this is wider commissioning issues.

It's commonplace for a single clinician to assess- only competent and experienced clinicians do this. Team discussion allows a wider perspective.

Of course raise concerns in writing, I know where I work we would take concerned phone calls as seriously but I appreciate your experiences may be different.

[JaxingJump]

Very rubbish rubbish friends. The most you could say for them is that they were trying to shoot the breeze about a reason but even so, deeply insensitive.

Being an only child is not the problem here. He is unwell at the moment and like any illness needs treatment and support. There's no rhyme or reason to these things often. He's lucky to have a great mum looking out for his wellbeing.

[OhTheRoses]

I'm not sure what one has to do blossom when your child is cutting and taking overdoses and CAMHS keeps closing the case.

I dispute your assertion that a CAMHS nurse knows more about what is required than a family doctor. Had those CAMHS nurses been right, then the psychiatrist we used wouldn't have arranged urgent CBT, followed by more general counselling, wouldn't have prescribed fluoxetine in a now non standard dose, wouldn't have assessed for ADHD, wouldn't have prescribed Ritalin. Where would dd be without that I wonder? Certainly not on an upward trajectory and looking forward to uni.

The CAMHS device is disgraceful and I'm afraid the nurses I saw were not to be trusted with a kitten in competence terms. Yes I did complain, yes they did apologise but they made an awful lot of excuses nd communication was very opaque.

[OhTheRoses]

But none of that helps the OP. I am sorry you and your son are going through this. You sound a loving, caring and committed parent and it is a hard and confusing journey with little expert advice from those paid to provide it.

There is a huge issue accessing medication. It has been very beneficial for DD but GPs won't prescribe without a CAMHS recommendation because of the risk issue vis a vis heightened suicidal tendency in young people. However in our experience the young person is often not in a good enough place to engage wit counselling until the mood is better. It is therefore rather chicken and egg. But you can keep a diary of all contact with CAMHS, date, time, who you spoke to what they said. And it really is worth getting support from your MP.

[Dillyson]

Thank you for all your messages.
The lady from CAMHS rang this morning. She asked how I felt about the conversation yesterday, I said I was very disappointed. She said she had been thinking about my son's case a lot and hadn't realised that he had lots of counselling in the past.
She kept asking me what I wanted. What I want is someone to do something to help my son!

She went away and spoke with the doctor again. She is now going to review him in 2 weeks and possibly refer him on to the mental health doctor.

I'm still not impressed and find their lack of treatment appalling. They are the crisis team, young people are not referred lightly. DS is showing some signs of depression but not enough for them to be worried. I think self harming and suicidal thoughts are quite serious.

He's gone to school today, but I'm getting texts about how he isn't coping, but he won't speak to anyone. I've had a good talk with the pastoral care teacher and they're keeping a close eye on him.

Back to the GP tomorrow, going to ask about private options.

[OhTheRoses]

Lovely, please confirm what you have agreed with this lady in writing. Also get GP to write in again.

With love

[Dillyson]

I will put everything in writing. Just need to get my head together.

[Blossom789]

Glad to hear things are moving forwards allbeit slower to what you'd prefer. Medication can be really helpful to help the talking therapies and sounds like you'll be able to meet with the psychiatrist to discuss this. You may feel like a broken record but perhaps you need to reiterate each time you talk (or write) to someone at camhs that DS has had a lot of counselling in the past to no positive effect and if anything you're noticing a decline in his mental health.

When you write, make your letter nice and clear with headings- e.g.
Current concerns - mood, risk, decline (which is noticed at school - include details of the contact person in school)
Past treatment - describe a little about DS mh presentation in the past (i.e. low mood, anxiety and the counselling he's had)
Moving forwards - appointment with psychiatrist, reduce risk, alternatives to counselling
You don't need to use fancy language just describe how DS is rather than say he's depressed. I find the word depressed and depression is used a lot but it means different things to different people, but by explaining the change to his mood and how he is different to before to make it clear what you mean.