What exactly are CAMHs supposed to treat?

[WhiteC0sm05]

Seems to be very little in our area.

@OhTheRoses I do not work in CAMHS. You make a lot of assumptions...

@DobbinTheFool

We've taken the view DS1 needs medication to be able to get to the point of being able to access any meaningful support.

But I appreciate it's not the approach right for everyone

I totally agree with this! My son was so acutely ill he was first treated with drugs and then adjunct therapy. A therapeutic social worker came to the house and told us in no uncertain terms, 'Your child needs medication immediately.' Yes, we know! Can we get them? No, needs to see the emergency CAMHS psychologist (a month later) and then wait for referral to the child psychiatrist. Well, by that point we already had tickets to go abroad. FFS. Poor woman was beside herself her hands were so tied! She had a clicker counter. 'This child has ritualised 38 times in 2 minutes!'

He has not had any negative side effects, is on fluoxetine and Concerta.

Yes, he still has autism, we were not looking for a cure for that, but his conditions are so much better managed under drug therapy with adjunct therapy.

It's common, though! A friend had to re-mortgage her house when her daughter developed anorexia for which she had to be sectioned as a young adult.

I led a CAMHS service as a clinical psychologist before leaving to work entirely privately last year. I couldn’t stand the lack of resources and bureaucracy anymore. I also thought it was wrong that the service was inequitable for children with ASC and that many children needed to ‘fail’ treatment by PMHWs/basic CBT therapists before getting specialist support. The sad truth is, you will get a quicker (and therefore more effective) service if you are able to pay for it, which I realise is completely wrong and is why I personally offer some free support to lower-income families in the private sector. There is no need to fear that private practitioners are subordinate to NHS workers (many work for the NHS alongside), but what you do need to check is that they are accredited by the correct professional bodies. For psychologists, this is the Health and Care Professions Council (HCPC). Very best wishes getting the support you need for your child.

Trains would you go down the CP route before psychiatrist and drugs?We’re running out of time.

Yes, I would. A CP is very well placed to assess if further multi-disciplinary support (including psychiatry) is indicated and would be able to support you to access this - either privately or by writing to your GP to support you to access via the NHS following assessment. Many psychiatrists will request a psychologist assessment beforehand anyway.

Private CP has recommended a kind of umbrella approach treating the anxiety, depression and self hatred all together with a variety of techniques.Made so much sense. Waiting to hear back for recommendations. We’re not going to get that via CAMHs are we? Even if top lady offers anything? I will be complaining to PALs etc and shouting from the rooftops regardless.

No, I don’t think you would. In my experience, waiting lists are so long in CAMHS that you get the first clinician who is available when your child reaches the top (and this is not always the best suited person to your child). The psychologist you have seen sounds like they have completed a thorough assessment and have suggested a bespoke approach to treatment based on your child’s presenting needs. If I am completely honest, not all clinicians who work for CAMHS will have this skill set (e.g. they might be trained in one specific type of therapy).

Not sure the one I used does assessments. The case handler didn’t think so. 🤔Could ask. Would it be useful?She got ds to fill in some sheets and I sent her a lengthy email of the history and issues. She advised on next steps iykwim.She was def accredited and really good, used to work for CAMHs I think. She recommended somebody lower but trained almost as well, cheaper but experienced in a lot of techniques so we could have more sessions. She too works or worked for CAMHs.

My dd is another one who needed medication before she could access support which made all the months prior to the referral to the psychiatrist a waste of resources. If funding is short then services need to be better used rather than throwing inappropriate and cheaper services at everyone first.

So far they are a pointless service. I waited 6 months for a urgent referal where he was discharged at assessment ( he lied to them that he was attending school, I don't think k they e en looked at the referal evidence)

My other ds has a phone assessment with them tomorrow. I have zero faith this will be any better.

@BullshitVivienne Indeed. I imagine Tory voters prefer to point the finger at individual clinicians though rather than examine the consequences their voting choices have had on the young people of the UK.

She suggested the cheaper lady as she said we’d be able to afford more sessions which is what he needs to build up a relationship. This lady also offers face to face which she felt is important and she can’t at the moment.

Not sure if that lady can do it though.😩

I have never voted Tory. A MN campaign could highlight the shit show that is CAMHs and bring it out in the open.

Well that’s great. The CP will be in a good place to advise as they have specialist training in all the main approaches to therapy. I would go with that. It already sounds like you feel heard and understood by them and that the approach they have suggested resonates with your thinking. Very best of luck!

Ach, gypsy and Roses, aff wi' youse! Why are youse squabbling like a pair of wet cats on here? . Take it ootside, the pair of youse 😂😂.

@WhiteC0sm05

Private CP has recommended a kind of umbrella approach treating the anxiety, depression and self hatred all together with a variety of techniques.Made so much sense. Waiting to hear back for recommendations. We’re not going to get that via CAMHs are we? Even if top lady offers anything? I will be complaining to PALs etc and shouting from the rooftops regardless.

Probably not because if your wee one has OCD, ADHD, depression or the like he or she might well need drug treatment alongside other therapies and any drug treatment must be prescribed by a child psychiatrist.

Care decisions made by a multi-disciplinary team tend to be better

It is mostly cheaper which is what this is mostly about.
Multi disciplinary team when organising a mix of services around home care, enduring care makes sense. However somebody not appropriately experienced doing a screening checkbox exercise is not care, nore is it treatment - its just a barrier to keep costs down.

[being called 'mum' would be and less odd to the child than calling them Brenda!

This is nonsense. Children know their parents have names - were you born in some quaint northern satire where adults in the family refer to each other as "Mother" and "Father"? Confused the hell out of one of mine first time it happened.

Many jobs are hard work and require engaging with large numbers of people. I can't think of any where the service providers persist in addressing you by their choice of term even after being politely asked to use a name.

This is the same level of nonsense which excuses people who insist on calling me Mrs his initial hisname after being asked not to so do so, or employers who used to call the tweeny "Dorothy" because they didn't care enough about the recipient to learn the name.

These small things do matter. The small behaviours engender and reinforce a culture which really doesn't help either side. When I look back over my experiences taking children for medical care its notable to me that those who addressed me by my name or actually asked how I'd like to be addressed were also those providing more effective care and treatment.

@TrainsandDiggers

I led a CAMHS service as a clinical psychologist before leaving to work entirely privately last year. I couldn’t stand the lack of resources and bureaucracy anymore. I also thought it was wrong that the service was inequitable for children with ASC and that many children needed to ‘fail’ treatment by PMHWs/basic CBT therapists before getting specialist support. The sad truth is, you will get a quicker (and therefore more effective) service if you are able to pay for it, which I realise is completely wrong and is why I personally offer some free support to lower-income families in the private sector. There is no need to fear that private practitioners are subordinate to NHS workers (many work for the NHS alongside), but what you do need to check is that they are accredited by the correct professional bodies. For psychologists, this is the Health and Care Professions Council (HCPC). Very best wishes getting the support you need for your child.

Yes, our child's psychiatrist also works in the NHS alongside.

@gypsywater. And CAMHS was great in the 0's was it. When Bliar introduced the PCTs just as GP fund holding was working, introducing another layer of bureaucracy at huge expense and sending the NHS down the rabbit hole of PFI.

Austerity prevailed regrettably for too long because yet again Labour destroyed the economy. Although I hasten to add that Boris has done just that with Lockdown.

The UK's healthcare system is utterly broken. It is stuffed with key workers who since 23rd March, a raft of which has been doing bugger all. "Work at home if you can". CAMHS couldn't so they did. It is one part of the NHS with no invasive procedures that could easily have carried on.

The Continental systems are so much better in:France, Germany, Austria.

Private CP said they’d say if it wasn’t working and medication needed. How would we get that if needed, they are only psychologists, would they recommend a psychiatrist?

Yes, they would recommend a psychiatrist - if it was needed. I treat all range of anxiety disorders (including OCD) very successfully without medication (as is recommended by NICE guidance as a first line approach).

@WhiteC0sm05

Private CP said they’d say if it wasn’t working and medication needed. How would we get that if needed, they are only psychologists, would they recommend a psychiatrist?

You know you don't have to stick with them if you are paying for it? I'd seek out a comprehensive clinic if already paying, tbh. But again, it's your call and we went how we did because it was very patently obviously our son needed medication, he was ritualising far too much for adjunct therapies at that point (because CAMHS did nowt for 8 months). Of course it's not a cure, it's a tool in a toolbox. Having lived in both the US and Canada, I do think there's a lot of resistance to drug treatment here, on both the side of the practitioners and the parents, and the former two do are often quicker to medication, but when you have UK people saying the child needs medications, he does.

I think there is also some tension inherent in the service between medication/non medication.
Which I have been reflecting on since moving to the USA and observing how child mental health is addressed.
My personal view is that the USA is too quick to give dc formal diagnosis and medicate and the UK may actually be too slow.
I don't think the UK's dc would benefit from everything becoming a diagnosis with medication but I do think that there are some dc who would benefit from easier access to medication, which in the area I worked in was extremely hard for anyone to access.

Some cross posting with @DisobedientHamster on accessing medication in UK.