I’m a Camhs manager

[MrsJohnSnow]

Ask me anything - it’s a tough one but I’m happy to help as best I can

@Noeuf Does emotional issues not come under mental health problems? It also depends on what you are trained in also. Counselling can provide many services.

Hi, my niece has such high anxiety that she hasn’t been to school for around 9 months, stays in her room, and rarely even ventures downstairs, let alone out.

CAMHS have said they’ll see her but only at their location. My sister can’t get her there, and if she forced her, it would be counter productive because she would be too traumatised to engage.

Do you have any advice? My sister is at her wits end.

My niece is 12.

@Noeuf depression is a mental health issue and it has been proving that CBT (Cognitive Behavioural therapy) is extremely helpful and beneficial to a client. This is one of many approaches used by counsellors. Something I have seen first hand with clients.

Why are so many children with autism blocked from mental health support.

What do you do about communicating appointments? DSs CAMHS psychiatrist consistently sends letters which arrive two days before appointments (though they are dated two weeks previously) and allow no time for teachers to fill out Conners’ scores or ‘strengths and difficulties’ questionnaires. Why are we relying on post in this day and age?

rainydays, the threshold for CAMHS is so high that counselling would not be an appropriate use of such limited resources. In an ideal world, counselling could be used to support young people before they become very unwell, but there are not currently the means to do that. Perhaps you could look at working with a school, as they are now somehow expected to be mental health workers as well as providing education.

I have a meeting with head of CAMHS next week so looking for advice. Dd has autism and anxiety and is seen at home by CAMHS worker and psychiatrist. CAMHS worker was to provide CBT but eventually (after my complaint) accepted that dd's needs mean she can't access it. A complaint secured 3 sessions with the psychologist from LD CAMHS who talked to me about Positive Behaviour Support. I put in place strategies based on discussions and dd has made huge improvements. CAMHS worker agrees it's the right strategy for dd but only LD CAMHS offer it and dd's IQ means she isn't entitled to support from LD CAMHS. I need somebody to oversee the PBS but regular CAMHS don't have anyone. I can do the work but I need support so as to move outside of home as it's six months now since dd left the house. Meeting with Head of CAMHS is to break it to me that they have nobody to oversee the PBS and dd will be supported instead by someone who has no knowledge of the strategy and confessed she doesn't work with young people with autism.

Why are so many children with autism blocked from mental health support.

The £1m question!

This may be unique to my camhs and I have knowledge as a parent and colleague
Why are there so many consultants and b7s who are all keen to develop themselves and so few who actually do any meaningful work with the children

@shockers the psychiatrist and CAMHS worker see dd at home because she couldn't attend a hospital so it does happen. For the first appointment I went to CAMHS alone which pretty much demonstrated that dd wouldn't be able to attend their clinic.

I don't know I don't think of counselling as cbt really that sits more as therapy in my head.
Counselling and mental illness don't seem an easy fit maybe because of my dc experiences

@Noeuf I'm interested to know what you thinking counselling is?
Counselling is therapy. It is not somewhere you go for a chit chat- I do believe quite a few ppl would think this but this is not healthy for for client nor counsellor. It needs to be a therapeutic relationship, with boundaries and equal levels (no one is better than the other or differences are made) so that change can be made otherwise what's the point.

Many approaches are used to help client over come an accept traumatising experiences but also it is used for people who want to change something in their life that they aren't happy with. Counselling can be used for many different reasonings. But like anything you need to find the right one that best suits your own needs and goals.

I'm not trying to be confrontational, just in the context of CAMHS, I guess I don't see counselling as a fit. Maybe because of my dc experiences - one saw a counsellor and they agreed she needed a therapist because her issues were mental health not real life.

I guess I'm thinking of CAMHS as dealing with stuff that's gone beyond counselling or never was there?

@AlunWynsKnee hello. That’s hard to answer definitively without knowing more. When referrals are received they are triaged for urgency and appropriateness, severity of issues. Depending upon what the local offer is for young people with ASD it may be more appropriate for the yp to access support through a specific autism service which would have adapted therapies. Some places have this, some don’t and it may be provided through paediatrics or other community health for autism. CAMHS is secondary mental health. People should receive an outcome of their referral - I would get in touch to ask. People with asd accessing psychological help is under funded and commissioned. Specialist mental health is not always the right place. This is an honest answer. Your question not aggressive at all - I completely understand where you’re coming from

Firstly thank you for all you do. My eldest DS has severe MH problems been under CAMHS since 12, know under transitional. This has included many sections and admissions. He got sent to a unit 10 hours drive away once and the way are local Cambs dealt with it was awful. So my question how are out of survive admissions meant to be dealt with?

@rainydays5 to work with CAMHS you have to a trained and statuatory accredited practitioner - nurse, psychologist, psych therapist etc. The NHS offers NICE compliant treatments for children, evidence based practice. CBT counselling “approaches” are not enough. It’s CBT that’s needed. Saying that people are offering their services voluntarily when there’s a shortage of money? There is a shortage of money, but we can’t fill the posts we have. The NHS are crying out for properly trained CAMHS staff. You haven’t said anything about about any specific intervention you are trained in providing or who you are accredited to.Therapeutic talking is not enough for the young people presenting with complex and possibly life long mental health needs (most diagnosis before age 14) or trauma. Counselling is best suited for people to voluntarily seek out themselves if they want to talk, usually older people. Kids don’t have the language or cognitions to tell you how they feel because their kids.

@Digestive28 school nurse rock. That’s a shame

@Catgotyourbrain that’s a shame and not very organised. We give appts on leaving the last one and have admin sending out and collating Conners pre appt. as without them at the appt how can you review if intervention effective across home and school? We also ring to remind. Parents with adhd have enough on already and we don’t want people to miss it. Give them some feedback!!

@timshelthechoice and @grasspigeons under funded and under commissioned. Funding pulled from voluntary organisations which support all people with autism. Due to no services people just get worse. Very sad. Wish I could help.

@Shockers it’s in your sisters interests to get her there. She’ll wait longer for a home visit. It’s unusual for a child to not even leave their room for nine months but not be offered help.... stay in touch with them

@Noeuf apologies if I have come across like that, it honestly wasn't my intention.
I've just never heard anyone make a difference so i became interested in hearing your views.
Could it have been possible the counsellor wasn't able to assist with your dc specific needs? I hope your dc got the help he needed.

I have had clients were I am unable to help or work with because of their needs therefore I'd refer them on to someone I know who would have better knowledge and experience.
For example, if a lady had bipolar disorder, I wouldnt able to help her in fact I could possible do more harm than good. But in saying that I hope to do more training and educate myself further down my journey.
Again, I do apologise. I very much understand everyone has the right to their own opinion- i ask questions cause I'm genuinely interested not because I want to change your mind. I do like to promote counselling.

MrsJohnSnow - thank you for your honesty

When DD2 was undergoing assessment for ASD, there was a year-long wait for her initial appointment. She should have had 3 more appointments before being referred for diagnostic assessments, but the worker was sure she had ASD and we had given a very comprehensive history, so she was nudged straight on to assessment.

The appointments for assessment took a further year to materialise. In fact, I think I'd still be waiting if they hadn't brought in an external organisation to take over the process. Once that organisation took over, she was rescreened, info collected from school, an appointment was made for ADOS and 3DI (on Sundays) and diagnosed within 4 weeks. Is it just down to money? How did they do that so fast, when CAMHS couldn't do a thing?

@Hiredandsqueak good that they have provided PBS. Why aren’t they training someone to provide in Camhs if they know it’s a need and successful for some young people who don’t have an LD. As a Camhs manager I’d be making a decision about how best to provide the service (which they clearly think is needed) to give a good outcome for the yp rather than stopping it because they don’t have an LD. Kids aren’t always straightforward. It would be in resource interests to get the pbs up and running and oversee it to be independently done by you as the hope would be long term for your up to not need services. Good luck with your meeting

@IfIShouldFallFromGraceWithGod Indeed!! Not in my service!