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Threats to kill (himself and others) - DS with ASD(32 Posts)
I'm waiting to see CAHMS with DS (9, HFA) becuase of anxiety and self harm. Things have actually been really good lately, but this morning he started to treaten to kill himself and me again.
He didn't want to go to school, which spiralled into him trying to jump out of his bedroom window (on the 1st floor). On the scale of how bad things get, this is a low-key and easily dealt with situation for me. My question is, should I be chasing up CAMHS? Some people reccomended going to A&E for every suicidal episode, so that there's a paper trail and to speed things up.
What do you think? Watch and wait, or try to get ahead of things so they don't deterioriate?
He also tried to run away last night in just boxers at about 8pm, so things are definitely on a downward trajectory.
It sounds stressful! Going to A&E sounds like sound advice. We haven't had the joys of CAMHS yet but it sounds like you have to be prepared to really fight as they are so desperately underfunded. Definitely start chasing them up, if necessary go to MP etc.
If you go to A&E, CAMHS will assess there and must follow up in 7 days.
Thanks Claw! Might be worth it next time we hit a crisis. I didn’t know that.
We have used GP route, referral was declined! Age 5/6. It took my son being hospitalised for self harm for 10 days to be accepted! Son had a year of 1:1 therapy. Worked with school. Wrote a report.
Following this at about age 7/8 emergency A&E referral. More therapy and working with school. Wrote a report. Signed ds off from school.
Age about 10/11 a referral from school, backed by GP, assessment, no therapy, just working with school. Wrote a report.
Age 14 a referral from school, backed by GP. Also in my area, my son could self refer on line at his age. Which he did and got a phone call immediately from CAMHS duty worker. Had assessment, worked with school. Wrote a report.
Each report has concluded my ds does not have any mental health problems, just difficulties due to ASD impact negatively on his mental health. So basically CAMHS are saying, we have identified difficulties, it’s an education/school related issue, sort it out with education!
By ‘work’ with school, I mean have one meeting in school! Write a report highlighting difficulties, leave it education to sort.
CAMHS cannot make educational recommendations, not their remit. Just wish washy ‘suggestions’.
But isn't difficulties caused by ASD on mental health the same as mental health difficulties? I really don't understand their reasoning on this one. Ok, ASD may be the trigger but the mental health issues are still there.
I also struggle with the distinction. We had our first referral refused because DS was being assessed for ASD. After diagnosis, immediate referral because of self-harm and suicidal statements, but we are still waiting to be seen.
I can cope with almost all of what comes up at the moment, but DS is violent and getting bigger every day. I do worry that I won't be able to cope for long.
What they are saying is with the appropriate support, to support ASD, his mental health would not be negatively impacted on. Therefore it’s an education/school related issue.
Any CAMHS intervention, is ineffective as the issue is education/school. They can patch him, however it’s the school environment that needs to change.
It is a vicious circle.
Ultimately it is going to come down to finding the right secondary school to be able to brake the cycle.
It still seems like a bit of a cop out because if the environment doesn't magically change then it's a definite mental health issue and children need to be taught techniques eg CBT. Sounds a bit discriminatory too!
I agree it is a bit of a cop out, ASD/mental health issues, you can have both! Or suffer with mental health issues intermittently due to your difficulties, like a trauma or bereavement for example. I think CAMHS look at it, as you can recover from those, as ASD and associated difficulties are life long.
CBT therapy is about changing your thinking, to someone with ASD, that would difficult/impossible, they cannot change the way they experience the world, it’s more about managing/coping.
For example a person with ASD might suffer with anxiety due to sensory issues or processing difficulties. CAMHS can help with coping with the anxiety. They cannot help with the sensory or processing difficulties which are the underlying causes of the anxiety. If that makes sense!
Thank you! I think I get it now. to both of you for having to go through this.
Ah, but CBT can be really effective in people with ASD, and we can change our way of thinking. It's true that you can't change your sensory issues, but you can learn coping strategies and learn to change the way you respond to the anxiety that they induce. I think that it is harder for someone with ASD to change the way they think about the world, but it is possible.
I'd love my son to get some CBT (not just from me and workbooks, but from a professional).
I’m not saying people with ASD cannot change their thinking.
I’m saying more along the lines of the cause of the anxiety, is often related to difficulties relating to the ASD, which cannot always be changed by thinking differently.
For example my son gets anxious in group situations, he has slow verbal processing, no amount of thinking differently is going to speed up his processing. It has to be managed.
Another is sensory difficulties, touch for example, no amount of thinking differently is going to change that. Managing it is.
My son has social difficulties and social anxiety due to his slow processing and not keeping track of a convo and being defensive of touch.
Thinking differently can change the way we behave once anxious, however it doesn’t change the underlying cause of what made us anxious in the first place.
Personally I think being asked to change your thinking, when there is good reason for that feeling for example your processing is slow, you are confused, feeling overwhelmed and anxious cannot be helpful! A better solution would be to manage your processing!
Sorry, I’m waffling now
We were lucky that on our second referral to CAMHs they took the anxiety side of things very seriously and eventually we did even get to see the physiologist but even with a supportive team we still have a lot of ups and downs and because of his level of understanding of emotions is so poor it is
Hard for whatever we try to really work. We are on the verge on medication now because it is a case of all that may help now
Claw - Thanks that makes a lot of sense. It makes me ever more certain that the right thing to do is to find an appropriate school so that the underlying causes of the anxiety is better managed.
Childhood is such a difficult time, really. I can now control my environment to minimise the stressors that cause me anxiety. My DS can't because he has to go to school etc...
We did it arse upwards! We tried CRB before appropriate support in school. It didn’t work!
Now my son has more appropriate help in school, his anxiety, self harm has decreased significantly. I’m now just ‘fine tuning’ his support and appealing his EHCP.
Does your ds have an EHCP?
Claw01 not yet. I’ve just applied, because up to now I’ve been gobbled off by the schuss he is achieving academically (just).
I’m looking at specialist secondary school.
My son is and always has been above average academically. Which creates even more stress for him, trying to maintain that and keep up!
My son attends indi, out of Borough SS. Don’t let them fob you off!!
Let me know if you need any support or a hand hold during the process
So we are in A&E now, after a very bad morning.
I have concluded that when I cope at home it does him no favours as we then get no outside support. Time to let the world see how bad things are.
Oh Springer I hope that you aren’t kept waiting at A and E for too long and going there actually gets your DS’s difficulties recognised and then appropriate support.
After only 4 hours we have an emergency plan in place, CAMHS appointment in 7 days and a social worker due to contact me next week as well.
Hopefully the start of getting things turned around.
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