I’m a Camhs manager

[MrsJohnSnow]

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

Are you mad?

(Adv nurse pract MH and MH manager young adults here 👋🏻)

@mindgoinground12 I’m so sorry to hear that. How is your son doing now? Admission are so difficult. There are very few yp beds and units have to think about the ages of the children they have on the ward when admitting ie 17 year olds self harming with a naive 13 year old, if you get my meaning? That said finding a bed is so hard as there are so few. We always try to admit as close to home as possible but it is hard and often whilst a yp is waiting at home or in an general hospital this can increase theirs and family’s distress. So hard to get right. The government have pledged to stop this and should do - see Future In Mind

@doublebarrellednurse

🙌👋

@Lougle sounds like they got a contractor in to provide assessments. They probably couldn’t recruit the right staff to provide the assessments but wanted to stop people waiting any longer. Locums can command money due to staff shortage. If the government paid nhs workers properly they wouldn’t have this issue so much as working in the nhs would be attractive

Do you think the new EMHP role is going to be beneficial ?

@rainydays5 no you weren't I just didn't want to start a discussion that might go wrong in writing if you see what I mean?

I think counselling is a really valuable service but in my head it's a positive whereas therapy is more negative - like something needs curing. I don't think I'm explaining it well. My dc dx are severe OCD and some other stuff so maybe that's where my rigid thinking comes in. They wouldn't respond to reasonable suggestions or conversations.

how do you deal with the trail of death and misery due to not being able to help everyone timely and adequately?

@HRH2020 yes. Yp need help early and without having to wait. Having support in schools for quick easy access is the most sensible thing in years. Not soon enough

@red by being honest with staff and parents, making patient led decisions. And wine.

Apologies for the long post.

Other than additional funding what do you think would improve the care CAMHS provides?

I appreciate there is a lack of funding that negatively affects the quality and quantity of care you (a general you, not you specifically) can give, but poor communication with a) children and YP themselves, b) parents and c) other HCPs - both within CAMHS and other teams causes just as many issues. How do you think communication could be improved?

Why is communication from tier 3 CAMHS so poor compared to tier 4?

If your child had PTSD but could not engage with EMDR or trauma focused CBT what treatment/therapies would you want them to have?

Do you have any advice for improving sleep? I am desperate for help with DS(9), referrals to a few sleep clinics have been refused and CAMHS can't advise anything we haven't tried. It isn't safe to leave him to self settle. We have tried everything we can think of - different lighting, music, audio books, 2 way monitor, ear plugs, white noise, relaxation, various apps, dream pad pillow, worry book, doodle book and pillowcase, brushing, tents, weighted blanket, teddy, star chart. He takes melatonin and the Mirtazapine he has makes him drowsy. They have improved his sleep but still a way off enough. He has just started a small dose of Clonazepam to help with anxiety that I'm hoping will also help his sleep. We have a good routine. I tried adapting gradual retreat but couldn't carry on because he became so anxious. DS has poor insight so discussing nighttime difficulties during the day isn't useful. I would be grateful for any advice.

My question similar to one asked previously. My daughter is also adopted and has attachment issues, extreme anxiety and disassociative absences. All of these I believe are the result of neo natal abstinence, exposure to domestic violence pre birth and time in foster care. CAMHS have said they won't see her as the issues are to do with early start and trauma. I agree, they are but surely they are also mental health problems too.

@MrsJohnSnow- that’s the point- she can’t get her there, which is why she needs CAHMS. There was a trauma (a sudden bereavement) in our lives which affected both my niece and my daughter very much. My daughter is receiving home visits from a clinical psychologist from the learning disability team, but my niece has no sn, and my sister is really struggling to get support for her.

@MonsterChopz sorry to hear this. Is there looked after children’s therapeutic service within Camhs or local authority? Is there an adoption social worker who can help you access or source therapeutic work? This is a very needed support for adopted children. If you’re yps distress and need for mh help is significant, Camhs should help irrespective of any adoption circumstances. So sorry you’ve not been able to get help

Thanks @MrsJohnSnow social work say CAMHS should see her. It doesn't seem to be her adopted status that's the blocker it seems to be the fact that her struggles come from early experience so.I guess are.more environmental, my argument is that it's poor mental health regardless of how it came about. I worry as she's 8 now so heading towards puberty and she already experiences many dark periods. I dread to think how she'll cope when teenage hormones are thrown in to the mix. It's a crying shame that mental health services are so underfunded.

@1stepforward2back

Good organisation, fully recruited, staff with the right training, motivated workforce, NICE compliant care pathways for known conditions ocd, depression etc.

Good systems for communication and enough staff to do them

I’d want to think with a psychologist about why they couldn’t engage and what the barriers are to this, how we could overcome them.

Re the sleep: this is hard to answer helpfully without any clinical context. Sorry. Camhs would help you think this through thought if you talked to them.

@MonsterChopz I agree. Poor mental health is poor mental health.

@MrsJohnSnow thank you for answering.
I should have asked at the time dd's referral was declined, it is probably too long ago now.
Autism help here seems to be through a charity who have to charge for their services and seem to practise ABA which I don't think is right for her. As I say we have been referred to another emotional support service but we're a year into waiting. They do ring periodically to let us know they haven't forgotten her.
Anyway. I don't envy anyone working in MH in the NHS (and I'm public sector), so hope this thread isn't too hard on you and that the funding in real terms improves.

Thank you for taking the time to answer Mrs. It is a useful insight into how you, as an 'insider', see the provision CAMHS provides.

DS can't engage with EMDR or TF-CBT because he is socially and emotionally very immature, and has complex MH problems including co-morbid SM which makes engaging and communicating with others overwhelming for him. On the whole I am happy-ish with CAMHS care but wanted to see if you had any other ideas because DS doesn't seem to be making much progress.

I have discussed DS' poor sleep with CAMHS multiple times, I ask every professional we meet for help. While CAMHS are now otherwise brilliant they haven't been much use advising us on night time difficulties.

thanks for answering
must be hard doing great work for the ones you are able to treat and having to leave people behind due to lack of funds and long waiting lists.

@OhTheRoses you sound very frustrated but I think your comment directed towards OP was very unfair. CAMHS staff work very hard and work long hours in a very underfunded service. They work there because they want to make a difference. They get lots of anger and frustration directed towards them as because of issues they no control over. It's hard when you're overworked, underpaid and you're trying your best but you get anger and frustration directed towards you. You've obviously had a difficult experience with CAMHS but I think it's unfair to generalise across the board. If you want to blame anyone, blame the government.

@OhTheRoses Well you’re an absolute treat aren’t you? “Thanks” for using this opportunity to abuse someone you’ve never even met who is attempting to offer well intentioned support and help. You’ve showed this forum a lot about yourself and how you operate in your life by what you’ve written - abusive, entitled and ill informed. Don’t post again. You’ll get nothing back. You’ve made a complete tit of yourself and by your own sentiments, spell properly if you’re going to take the time to insult people in writing

Hmm yes, wonder why the CAMHS team might look at the role the parents are playing in someone's presentation @OhTheRoses... You seem so nice!

Not nearly as much of a treat as the CAMHS tits I had to deal with. It is a disgrace My dd got no support whatsoever from CAMHS. They didn't work hard, they didn't even work their 9-5 hours. Thank goodness we were able to pay for her.

The issues have far more to do with mismanagement than resources.

My cousin is 16 and wants to go into the mental health field, but she want to help younger people and teenagers.
What path would you advise.?
Best courses etc

My SIL twin works in the field and had advised me strongly to try and convince her to rethink her choice due to the pressures the job entails and the feeling of failing due to cuts and understaffing.