To refuse early help referral

The issue is perhaps one for health and why the CCG does not have a neurodevelopmental service to support children and families with autism-related disorders, if it takes the view that CAMHS will not support autism-related MH and behavioural problems?

The lack of these services is a national scandal, as the lack of support is leaving children traumatised, and unable to participate in aspects of everyday life, leading to unnecessarily poor educational outcomes, and in some cases preventable brushes with the criminal justice system, and families in crisis, leading to parental mental ill health, difficulties sustaining employment etc. Even if we treated the damage to children and families as 'collateral' and just considered the cost of this damage to the state/economy, it is blindingly obvious that adequate and timely support for autism-related mental health or behavioural disorders is in everyone's interest.

Sorry OP, that doesn't help with your personal dilemma. Perhaps there is an option to have an exploratory chat, see what's on offer, and whether you feel the EH worker is a reasonable match with your families needs and you feel confidence will be able to respond appropriately to you? If you get a sense this will increase stress for you, rather than act as a source of support, you'll find a polite way to decline. It's one of the frustrations of the situations that relatively unskilled people, trained to deliver one-size-fits all interventions to families can sometimes be inflexible and critical of families who do not do things 'their way', and be dismissive of parental insights, making parents and children feel blamed for not meeting normative expectations. On meeting skilled health care professionals, there is an entirely different level of sensitivity for individual child and family situations and coping strategies, and more tailored, open-ended and collaborative problem solving, based on a thorough appreciation of the challenges faced by individual children and families.

I manage a camhs service, we honestly try our best to meet young people's needs.
People often think that we are the support they need when in reality we offer short term interventions.

and here is the problem. Neither CAMHS, nor social work, nor early help are set up to provide the support these young people need. There is only one service that provides anything like in my area and it charges. As I've said upthread social services are regularly asked to fund this support for families who are struggling but simply put the money isn't there to do it. Central government don't allocate enough funds to social care departments to cover the cost of autism specialist support. Families usually can't afford that support either - almost £2k for 12 sessions which is not enough to scratch the surface. But hopefully people can see why social services can't fund this for families regularly.

And as for the idea that autistic children in significant emotional distress must be denied appropriately skilled support until they can be made to conform with a service's 6-8 session goal-based model is bizarre. It is quite common that clinical work may need to be undertaken with a parent, rather than directly with a distressed child who is unable to participate.

Here is the problem.

OPs DC has two neurodevelopmental conditions, related anxiety and behavioural difficulties. These are complex clinical needs. We have a CAMHS manager who has convinced themselves that despite the fact that qualified SWs with a disability specialism have been unable to help, relatively unskilled EH workers are the answer. These workers can sometimes cause major problems for families of neurodiverse children because of their very limited understanding of neurodevelopmental conditions and appropriate parenting strategies. It's quite possible that OP's child's clinical needs will need to be met through longer term work with OP and her child. This is for clinicians to determine. It is a national scandal that these needs are not being properly assessed or met.

EH gets offered as a sop to parents in extremely challenging circumstances on waiting lists. Sometimes it's better than nothing, sometimes it is inappropriate and puts families under greater stress.

To add as a parent myself I absolutely understand, I have a dd who is also diagnosed with autism.
After diagnosis there is no support available, nothing changes except we have a diagnostic report that states she is autistic.

I've not read the full thread, but I do think refusing early help is short sighted.
They can offer so much as well as liaising with other professionals and school to ensure support is looked at holistically both for your dd, your other children and yourself.

I manage a camhs service, we honestly try our best to meet young people's needs.
People often think that we are the support they need when in reality we offer short term interventions.

Realistically is your dd ready to access support that will offer 6-& sessions?
Do you think she would be able to engage with the clinician in that time and be able to work to goal based outcomes?

I don't mean to be goady, quite the opposite.
Camhs will have suggested early help to the ground work so your dd is in a better position to access support.

Private support for the needs OP describes can be extremely expensive. It is not a case of a few therapy sessions and all is well. The support OP’s DC will need is beyond what the majority of parents can fund, which is why an EHCP is important.

Is there not private help available if your struggling this much with getting the correct help?

It is just awful that autistic children with complex needs get frozen out of expert mental health support. It is a bit bizarre that relatively unskilled EH worked get positioned as the answer to these clinical needs. @SearchingForSolitude is right; if you can get experts to evidence DC's MH needs, getting provision in an EHCP may be the path to delivery of sufficiently skilled support.

I work for an EH service. We do help with parental conflict and trying to help work out patterns of contact but we are a voluntary service so usually referrals are from schools where parents have consented to the referral and want the support. It's a bit strange for someone to anonymously refer you to early help. Unless the referral was made to children's services and was then passed to early help because it doesn't meet threshold.

No, they don't get involved in contact. Early help won't work with you if you don't consent.

I'm just wondering do early help get involved with contact arrangements for separated parents? I've had someone anonymously make contact with them however it's only for one of my children. But doesn't say which one. I'm just wondering don't you also have to have parental consent for there to be a refferal made to early help?

You're right they are no help

I liked having a EH worker, she was someone to listen, she didn't do much work with my disabled children but she did with one of mine who was quite anxious and I think that was helpful for him. She also coordinated meetings with schools and I think having someone external meant schools were more proactive. When she first came out I was pretty anxious and she met with me and that she would come the next week and I must have pulled a face, and she said she didn't need to, it's all voluntary etc. if asked for the support though, I have access to CAMHS and neurodivergence and many others, but I was just struggling under the pressure of everything. I have two children with multiple diagnoses. Like for us, everything looks and looked perfect but I have just struggled to deal with the pressure of doing everything.

My advice would be to work out what COULD help you and your family. Maybe an autism parenting course? SEND play sessions? Play therapy? Respite? Support with resources? Furniture needing to be replaced? Go into the meeting and ask whether any of these things are possible.

Just as an aside, we were quite happy with our Early Help Worker, she was kind, offered a listening ear, and supported with the admin if arranging and documenting TAF meetings, which held various parties to account and kept things on track. I was struggling to juggle all the balls as I have one severely ADHDer in a special school, and one AuDHDer who was really struggling to attend school.

There was an incident with one of them that lead to an arrest and we were escalated to SS. I was very clear that we really needed to keep our EHW and was assured we would.

SS visited once, and said they could offer nothing more unless we wanted to consider a Section 20, which we didn't, so they closed us. It then turned out that we had been closed with EH too, and despite me asking we were never re-opened.

TAFs never happened again, as no other professional found facilitating them to be in their remit.

I'm sure I could ask to be referred again, but I have decided I haven't got the bandwidth at the moment.

It's just bloody stupid.

Obviously I'm not going to give details about the family but I'll say

• for professionals, the type who have long commutes and big salaries, they often have large outgoings. They usually have options in relation to work, and could earn less and have smaller outgoings if they choose.
• if the children were entitled to free school transport they would have had it, not all SEN means disabilities and not all means entitlement to funds
• parents can be present and capable (and I was referring to both parents not just the WFH one) and also not manage things very well. I didn't actually say they couldn't cope with the SN. There's more to parenting and coping than that. Sometimes it's a simple as not being able to get all your kids out the door on time without screaming rows.

the role of frontline social work isn't to 'help' families with children with SEN, no. They don't have the budgets for that. If you disagree with this then vote accordingly but that's the reality. The role is to safeguard children where the care they are receiving will significantly impair their life chances if no support is provided. You say far too much pushing back but sometimes there is too much expecting the state to step in and parent for you.

This is terrible IMO. Suggesting that the parent who works further away should just magic up a job closer to home. No one has a big commute for the fun of it.

On the one hand you say there was a parent who was present and capable and yet on the other hand you say they couldn't cope with the SN of their children - so which is it? are they capable and coping or are they not coping? What is the role of social care if it's not to help families who can't cope with their SN children?

School transport should be provided for children with SN if they aren't able to walk to school - are you saying these children could safely walk to school? Finding childcare for children with SN can be really, really difficult did you not help them with that?

Far too much 'pushing back' on anything and everything in this country sadly.

I have it the opposite way, my dd is 15 and the school put a referral for a ASD assessment.
That was declined and instead she was referred to CAMHs (she has already seen them 2 years ago after a 2 year wait and because of covid and the long wait times she was sent to group sessions which were totally inappropriate for her!).
It is clearly obvious to me,her teachers,the family support worker the EP that she has ASD apart from the people that are supposed to know.

we had a family support worker and she was a good listener but unfortunately I knew more than she did so wasn't great on the help part.

I sympathise OP. but I just take whatever they offer

there is no state funded mental health support for children in the Uk - that is the reality. That is what I've seen - we have been an ermergency referral for a year waiting for help.

An EHCP can provide support with MH without the need to go via a normal CAMHS referral. With an EHCP support can be in excess of what is otherwise typically available and without the need to sit on the normal waiting lists. Although you might have to appeal. So request an EHCNA if DD doesn’t already have an EHCP - IPSEA has a model letter on their website you can use. Or request an early review if she does already have an EHCP.

@Sureaseggs44

ive never known CAMHS come to school, we got stuck in a ridiculous bind once where a pupil was refusing to attend CAMHS but they couldn’t send anyone out so it was assumed he was alright cos he wasn’t coming (they were not alright)

I have never known CAHMS achieve anything for any pupil I worked with in 6 years of working in SEND, I really hope and want I believe there are success stories out there but I have never heard one and that’s from the very small sample of children who actually got seen by CAMHS. Very unfortunately and wrongly I think you might have to accept that help is not going to come and do anything you can in the meantime.

often interventions defer to the school anyway. They are essentially the service that is in the best position to deliver support so I would work with them at any rate.

Those who have been through CAMHS does it actually help ? Do they provide counselling and help within the school environment ? They seem overwhelmed with referrals atm and the waiting list is long ? Just wondering as we have a family member awaiting referral .

The thing is, there's nothing to lose by trying. We haven't used EH, but we have had CAMHS, ISS, SEN caseworker, and now are on our second children's disabilities social worker. The ISS lady and our new social worker are absolute whirlwinds of brilliance, and their persistence and drive has worked wonders for us.

What I've learned from all this, I suppose, is it's not about which service you have access to, it's about how good the person you get is. You may find you get an epic EH support worker who really helps - may as well try!