1st appointment for assessment for CAMHS

[purpleme12]

What happens at first appointment for CAMHS?
What questions do they ask?

There was a big questionnaire we had to fill out - DD filled one out and I did as her parent. I can’t remember the questions sorry - there were lots of them!

Yes big questionnaire, lots of questions where you rate your answers.

My daughter had about an hours chat first so I went for a coffee, then I had about 15/20 mins then maybe 10 together. I didn't expect it to be so long but it's a good thing we didn't feel rushed at all.

The questionnaire was probably RCADS. It’s a depression and anxiety rating scale.

Assessment will depend on the nature of the referral, but will aim to determine the man problem, symptoms, what makes it better or worse, how long it’s been going on, how it affects different aspects of life, what keeps things going, what thoughts, feelings, behaviours and physical symptoms they have with their difficulties, what has led up to the difficulties, previous history. They’ll ask about family, any family history of difficulties, who’s at home etc. Brief medical history, social circumstances and if they’ve had contact with any other services. A very thorough risk assessment and risk management discussion. A discussion about what they want out of support and how they want things to look. Some sharing of information, advice for next steps and what support could be offered will come along with how to get emergency support. A lot will depend on answers to questions. They’ll ask you to complete certain questionnaires or share graphs from the questionnaires if they’ve been sent in beforehand.

That’s what I’d roughly expect to happen. It will be quite a long conversation to try and get a working understanding of the difficulties, what has brought them to this point and begin to think about what support is needed.

What were the questions please?

Because she's not depressed or anxious (as in she's not got anxiety) obviously some things do make her stressed
And I don't want that idea to be put in her head

I would like help with regulating her emotions
She has explosions and gets angry and she doesn't like feeling like that

One thing I didn’t expect was the questions about self harm/suicide. Probably naive on my part! DD was only 9 when she went and that wasn’t on her radar. I understand they have to ask but I hadn’t thought about it beforehand.

Oh right

This is making me have second thoughts

Did they ask your child that?

They will need to ask questions about risk and her safety, whether they do that with you, her or both will depend on her age and the practitioners professional assessment of the situation. Questions should be asked in an age appropriate way.

Yes. They asked if she had ever had thoughts of wanting to hurt herself or thoughts of not wanting to be here any more. She didn’t really understand at first so they expanded a little bit. They also asked this each week when she went in for a session. I completely understand why they have to ask it - I just wasn’t expecting it.

She's 12

But I know it's nothing like harming herself or suicide or anything like that

And it wouldn't be beneficial to ask her about anything like that

Neither is she depressed or anything. I don't really want her to go through a whole depression questionnaire

They ask questions
They don't listen
They make judgements that are incorrect
They make recommendations that are inappropriate because they haven't listened
They refuse any support or say they will then reassess after an emergency and say it's no longer an emergency so kick the can down the road.

All the while your child continues to struggle and gets worse, because they won't listen because listening means they might have to pull their finger out and do some work.

So, you find a consultant adolescent psychiatrist and remortgage if you have to.

Our CAMHS has failed for decades. 2009 review said it was failing and recommended changes. 2014 review because it was failing and change was needed. They got 2.5m and pissed it up the wall on a layer of bureaucracy. 2018 failing more, guess what? Another review. I dread to think how much has been spent on reviews. In 2024 the CEO was promoted to NHS England. Fuck knows how or why. One good thing Labour has done is to abolish NHS England - but she'll probably be promoted again.

These behaviours can be the result of masking constant low-level anxiety. The questionnaires are given names or codes - it won’t say Anxiety Questionnaire.

It sounds as though your DD doesn’t need a CAMHS appointment because you’ve already decided she doesn’t have the most common conditions children and adolescents experience.

My DD was 9 when she went and they still asked her the questions. Obviously everyone’s experience is different but ours was very positive and it helped DD massively.

From what I remember, the questionnaire will assess whether your DD meets to threshold to be taken on by them so may not necessarily lead to further sessions.

I'm confident she doesn't have depression or anxiety yes. (But that is not to say that she doesn't FEEL anxious sometimes of course)

I would like someone to help her with emotions and regulating her emotions

CAMHS professionals are trained to ask questions in an age-appropriate way. If your DD is having feelings that distress her, they are best placed to assess her and offer help. If she is neurodivergent for example, she is at increased risk of anxiety, depression, eating disorders, and PTSD. These are all treatable.

My daughter has been at a CAMHS school for 2 years and I fill these questionnaires in every term on my daughters behalf.

It usually starts with a range of questions that are based on the last 4-6 months, theres 5? I think options of i think often, not often, mildly etc, that type of thing.

The questions are generally things like:
Has your child been troubled by thoughts or compulsions
Has your child had difficulty attending their usual education
Has your child been effected by headaches or tummy aches
Has your child been affected by bullying
Does your child have friendships
Does your child have periods of intense anger or violence
Does your child gorge on food
Has your child shown sexualised behaviour not appropriate for their age
Is your child overly familiar with people they dont know

Theres some questions that are then within the last 2 weeks. I cant remember which is which.

The questionnaires for the children are similar but should be age appropriate. You can request to see the questionnaires beforehand.

The questionnaires aren't just for anxiety/depression. Each answer has a score for that question. The scores are put into a programme and into a graph, this then gives a range. Usually the sections are depression, anxiety, anger, and behaviour/personality or something like that.

In giving those scores, they can see where the significant issues are and what to target the intervention on. Any repeated questionnaires can then show if the intervention is suitable, if its helped etc.

Im pretty sure I have a load of information about the questionnaires somewhere. Probably some blank ones too in my emails. Id be happy to have a look and pass it on to you. But if youre unsure then ask them for more information, they wont mind

You can't catch anxiety, depression or suicidal ideation from a questionnaire.

Camhs do a huge amount of work around helping young people understand and regulate their own emotions, if that is what the young person wants.

This!

This is quite helpful

If you're able to send them that would be so brilliant

It is also worth bearing in mind that by age 12 many young people are considering carefully what information they share with their parents - often from a place of caring/protectiveness - and while it certainly doesn't happen to everyone, it isn't unusual for parents & carers to learn new information about their child's life during assessment/treatment.

I see what you're saying

But it all seems to come out with her

I'm aware that it might not always be like that

Don't be naive and think your daughter doesn't know about self harm and suicide at 12. She will. I knew at 9, when I shocked my parents by telling them I didn't see the point in living anymore ANZ wanted to die. At 12, I knew girls who were cutting themselves and had seen their scars at school.

It won't harm her to have the questions asked. She almost certainly already knows about this stuff.

I was a nice middle class child!

I think it would actually be quite unhelpful to give you a list - even if I could remember them, which I can't. You can't guarantee getting the same questions. Knowing some questions that might or might not come up doesn't really get you anywhere.

My DC's first triage appt was about deciding whether the main issue was potential neurodiversity or something else - because the forms we had filled in pointed more towards that than anxiety or depression, and they were assessing/validating that clinically.

I think what will happen is dependent on what went on your daughter's referral form and whereabouts in the country you are. I think you need to trust the process at this point. If possible help your daughter to write down anything she feels it's very important to say in advance, and make sure she has an opportunity to say it.

I'd also like to add, though, that the clinician who did that first appt was absolutely brilliant, had an amazing calm and gentle manner and very much put us all at ease.