I'm a CAMHS adolescent therapist AMA

[CAMHSadolescenttherapist]

I have worked for many years in a CAMHS adolescent team in the NHS. We get referrals mostly for high risk and complex presentations: self harm, suicidality, emerging psychosis, intense anxiety, long term school refusal, family crisis and (recently lots of) gender dysphoria. This last year has been intense in our team, with many changes.

As the title says ask me anything. I've name changed for this.

It's such a bloody disgrace. I am so sorry @wouldlovetogoonholiday.

@Lougle if you are dealing with Psicon are you in Surrey/Sussex dealing with SABP. If so you have my absolute sympathy.

@RosesAndHellebores

It's such a bloody disgrace. I am so sorry *@wouldlovetogoonholiday*.

@Lougle if you are dealing with Psicon are you in Surrey/Sussex dealing with SABP. If so you have my absolute sympathy.

Hampshire. They cover 5 health areas.

@HamnetandJudith

Is my case unusual then? Everyone talks of long waiting lists. Dd took an overdose on Dec 1st. She was seen by CAMHS in A and E and seen for the assessment within two weeks. She started therapy at the beginning of Jan.

She put herself in a situation where they had to act. If she'd been referred as 'thinking of OD' she'd still be waiting. DD1 put herself in a situation where they had to act by failing to a BMI of 13.6 (68%WFH), then saying that her brain kept telling her to go to the kitchen, get a knife and stab herself. She'd likely have never got to the top of the waiting list without that, because having a LD is often seen as the root of all their issues and they're ignored.

@Lougle yes of course. I am so angry and dd's experiences are five years old now. I have written to the commissioners, my MP (Grayling), Surrey Children's Services, Jeremy Hunt as Health Sub Committee Chairman, Norman Lamb and the Children's Commissioner. And attended meetings vis then independent inquiry into SABP/CAMHS provision. Sick and tired of the excuses.

Have you contacted your local Health Watch?

Yes I did go to the GP with dd when she was having suicidal thoughts and gp basically said we should go private as the waiting list was so long. Once we were in the system though, I found CAMHS swift to act. It’s a shame it got to that though.

To be fair, although we got nowhere with CAMHS itself, once Psicon were involved we were quite quickly seen and DD2 was assessed on a Sunday and the following Saturday, then diagnosed.

Likewise, although we got nowhere with CAMHS with DD1 last year (and school ignored the recommendation for Ed Psych assessment), now we are having weekly appointments with the Psychiatrist, I presume until she's safe to downgrade to nursing review.

It's just a shame that she's had to drop a further 2.5kg to get there.

Have you had any experience with young people influenced / affected by Parental Alienation?

I am glad you are getting somewhere @Lougle. I recall Psicon were brought in to deal with the shambles arising from the Mindsight debacle of 2016. £2.3m tiddled up the wall.

It's so terribly hard and the unhelpfulness makes it worse.

I have experience of working in CAMHS (I was a Psychiatrist, and gave up work for my family) and I will name change after this, but I know they are not interested in working with Tourette’s. I briefly went back to work and not one clinician asked me about what was it like having two children with Tourette’s

It’s a really complex illness. And most people do not understand it - including Doctors. But seriously- the one specialty that is supposed to telo our children says ‘sorry- not our problem?’ . Come on!

So OP - apart from all the other pressing problems in CAMHS- what are you going to do about supporting children with a horrible condition they never ever asked to suffer?

@WouldLoveToGoOnHoliday I'm pretty ignorant about Tourettes but when we were in hospital there was a girl next to us who I presume had it (she was in for a physical reason, but would continually sneeze/snort when she was awake, and it completely stopped when she slept. I'm pretty sure her Mum said her tics were worse). Is the frequency of the tics a stress related thing? What is the best support for someone with Tourettes?

I guess- thinking about it. There’s too much psychotherapy in CAMHS. They should be honest and press for neurologists to manage Tourette’s. It’s a brain illness, and CAMHS isn’t up to it

What adjustments would you make when treating a 12 year old with OCD who also has ASD please?

Do you need to know a general history before treating them?

@Diverze I'm confused why you don't agree 'mild' autism exists? Have you never worked with severely autistic, non verbal people? Surely you can see there is a world of difference?

[quote Lougle]@WouldLoveToGoOnHoliday I'm pretty ignorant about Tourettes but when we were in hospital there was a girl next to us who I presume had it (she was in for a physical reason, but would continually sneeze/snort when she was awake, and it completely stopped when she slept. I'm pretty sure her Mum said her tics were worse). Is the frequency of the tics a stress related thing? What is the best support for someone with Tourettes?[/quote]
There’s not much support where I live. CAMHS weren’t great. My children are in adult services now - and that is beyond rubbish. Tics don’t necessarily stop in sleep - they can stop sufferers getting to sleep
Our local support group is anti medication- yet there’s evidence that medication can improve prognosis in psychiatric conditions.

I was a psychiatrist. For me it’s the most complex psychiatric condition there is and I wish people would take it seriously. I feel because it affects children they don’t have a loud enough voice, adults either grow out of it (and are grateful) or, because they know how Tourette’s is perceived, keep quiet out of embarrassment.

How many teens have you counselled with trans identity issues also have other issues, such as autism, anxiety etc?
How would you advise a mum who is gc but has a DD who identifies as trans?

[quote Tumblebugsjump]@Diverze I'm confused why you don't agree 'mild' autism exists? Have you never worked with severely autistic, non verbal people? Surely you can see there is a world of difference? [/quote]
Yes, there is a world of difference, but not necessarily on a linear mild to severe scale.

Who are we to tell a person who has high intelligence but whose social.anxiety is so crippling that they are unable to leave their bedroom, advocate for their physical or mental health, or work for a living that because they can speak and may have a host of academic qualifications that their autism is "mild"? Or someone who is desperate for s friendship peer group and awfully lonely but is socially awkward and shunned by peers that they are "mild" in their autism because they don't have meltdowns and cause behaviour problems?

Too often, 'mild' autism is about the transactional impact (how it makes others feel) of an autistic person's behaviour and not about the person's lived experience. It means 'other people experience my autism mildly'.

So no, there is no such thing as a diagnostic category of mild autism. At any point an autistic person, depending on their context, mental health etc may be more or less impacted by their autism and frankly, that experience is the only one that matters.

Fwiw my highly able son is one of the most "severely autistic" people I have ever worked with in 20 years, in terms of his communication and interaction differences and his vulnerability in the world. He has never posed a behaviour management problem and is verbal, and no learning difficulties, so by your criteria he'd be mild. No way are his issues mild. He is the most severely compromised on his specialist college course - and also one of the most advanced.

THANK YOU, Diverze! 100% spot on. So thankful we now go private with our child and are fortunate enough to be able to pay for it.

@Diverze

Fwiw my highly able son is one of the most "severely autistic" people I have ever worked with in 20 years, in terms of his communication and interaction differences and his vulnerability in the world. He has never posed a behaviour management problem and is verbal, and no learning difficulties, so by your criteria he'd be mild. No way are his issues mild. He is the most severely compromised on his specialist college course - and also one of the most advanced.

My son has behavioural issues, ADHD and OCD but is considered 'mild' due to being verbal and not having learning difficulties and above average intelligence. Is he fuck! Just got approved for higher rate. He can't even go to the toilet on his own on bad days. He's extremely vulnerable. Even more so for so-called professionals who are clueless about ASC - it's not linear, as you so well stated. Such folk are right up there with 'bereavement counsellors' who told us 'The 5 Stages of Grief' apply to child bereavement. Do.they.fuck.

Oh, yes, the initial diagnosis: High-Functioning Autism/Asperger's Syndrome (6 years ago).

If we hadn't gone private, ALL his co-morbidities were laughed off and fobbed off by CAMHS and the whole sorry system and he was left to suffer. Because once they get one diagnosis they latch onto it like deckchairs on the Titanic. So many are left in utter tatters due to co-morbidities on top of zero support for their initial condition.

It's really interesting, isn't it? DD1 has 'mild' ASD, in that she doesn't cause any trouble. But I have to email her teachers to say "DD1 is struggling with..." because she can't do it herself. Her teacher said that it's so hard to know when DD1 needs help, because she just will not ask.

@Lougle

It's really interesting, isn't it? DD1 has 'mild' ASD, in that she doesn't cause any trouble. But I have to email her teachers to say "DD1 is struggling with..." because she can't do it herself. Her teacher said that it's so hard to know when DD1 needs help, because she just will not ask.

Mine's a 'mare just now. We would sooner see a vet than have a thing to do with CAMHS again. NEVER again.

Not your fault poster but I think that department needs shutting down. It’s cyps in my area and the official complaint I put in the whole team needed retraining It’s now with the ombudsman. I’ve never met such cold, careless, people in my life. All the people who they aren’t helping please put a complaint in, it is so easy to do and you have someone who takes care of the case for you.

Yes - our local inpatient service shut down very suddenly and with no notice. Must have been a big complaint to bring that about.
Unfortunately I think CAMHS is run by people who have no experience of living with (and caring for) the children they are trying to treat.