What exactly are CAMHs supposed to treat?

[WhiteC0sm05]

Seems to be very little in our area.

My GP said child needs to at serious risk of suicide or of harming others and anything below this would be rejected

We’ve had a pretty awful experience with CAMHS. DD has Tourette’s and was referred to them 3 years ago...she finally got her first appointment just before lockdown. They lost her referral twice, gave us the wrong appointment, said that we hadn’t turned up..you name it!. Not great so far.

I work with vulnerable children. The limits to what cases CAMHS will accept angers me. My area CAMHS service is probably one of the better ones nationally, but there are so many children and young people who aren't getting mental health support who would be entitled to it if they were adults.
The reason the government and public services can manage not to support these children is because they all have the "protective factor" of parents (or alternative carers).
It just seems so wrong to leave so many families unsupported with their children's difficulties. Kids I've worked with have been turned down from the eating disorders clinic because they only have disorders eating and not an eating disorder. Fair enough if there was a suitable lower level service to help, but their isn't. Depression, nope, anxiety, maybe. Attachment disorders, yes, but only if they go round the merry-go-round of parenting work and maybe an asd assessment first. And make sure you phone to chase up your appointment because you could end up dna/ wnb because the letter was sent to the wrong address.
Adults with similar problems would get bear minimum GP support, iapt, and community mental health. But if you're a kid, you mum is meant to have endless the knowledge patience, understanding, and time. And spend all her time on Facebook support groups to navigate the local system.

@EuphieKat crosspost, but case in point.

IfNotNowThenWhen2 that pension comment was truly dickish
Cry me a river, it's still true. Otherwise, why else would staff who say "people are mean and that's why we can't be arsed" stay in their job? There are just too many stories out there of, not just shit, but dangerously shit service from CAHMS so I'm not really bothered about sparing anyone's feelings.

it took us 5 years and 6 referrals for camhs to see my daughter. when we finally got seen was told they would diagnose then discharge. so basically waited 5 years for a diagnosis and no help or treatment plan.
got given some generic info sheets and some numbers for charities in the area.

But Anne I have horror stories of immigration workers, they exist in every field.
Of course there are going to some in CAMHS regardless of the support the service gets.
There are also examples of good CAMHS workers and practice on this thread.
But if horror stories are nearly universal something else is going on, something more structural and fundamental.
CAMHS as a service was very frustrating to work beside and at times enraging but turning on individual workers and criteria lists is totally missing the wider context.

On the point of shit/uncaring/unprofessional camhs workers it's very difficult to recruit and retain highly qualified, high calibre staff to a service that is overstretched, underesourced and forces staff to deliver what they know is inadequate care. It's a viscous circle because making camhs better would require more high quality staff, but in lots of areas people don't work for camhs because they know it's such a shit show.

So they don’t treat autism, SEN, depression or anxiety caused by life events, suicidal teens that haven’t made an attempt more than twice, school issues.....

What exactly are they treating and why are we wasting tax payers money on a service not fit for use?

CAMHS treats all those disorders, just only the most serious cases. To give an example, on my current caseload I only have one child who is in the care of their parents, so I am not surprised that so many posters on mn have not been accepted.

I manage a large CAMHS team and we’re under resourced but staffed by excellent clinicians who each try to do the best for the young people in our service. Each CAMHS service will be commissioned by a local CCG so will vary slightly. However, in outs we provide assessment for asc & adhd, and ongoing management/support for those diagnosed with adhd. We support young people who have experienced trauma, provide CBT and DBT, and a raft of other other psychology and psychotherapy interventions. We provide a duty service and an a&e liaison service, a specialist clinic for young people who hear voices, services for looked after and adopted children, plus those with learning disabilities. We run drop in clinics for teenagers, provide input to the local youth offending team, produce and distribute advice via videos, and other social media vehicles. The list is endless.

CAMHS is for young people with moderate to severe mental health issues. It’s what used to be know as tier 3 (tier 4 is inpatient care, tier 2 is more low risk emotional well being). The problem. Is that tier 2 services have been eroded by recurrent cuts to local authority funding and without that available there is little to offer apart definitely CAMHS, and naturally without lower level, speedier intervention, a child’s mental health can worsen, so the burden on CAMHS is greater and the lists grown longer.

I truly understand the frustration of parents and carers, and their children, but CAMHS bashing isn’t the answer. Writing to your MP about the lack of funding would be more useful, complaining to your CCG about the waiting list could help. Repeatedly stating that CAMHS is awful only serves to further demoralise an already beleaguered group of staff.

I’m afraid lying and keeping the awfulness of Camhs hidden serves no purpose and ensures worse outcomes for children.

The service we have received has been truly appalling. It goes beyond funding.

My ds’s life has been turned upside down through no fault of his own.A zombie like teen curled up in a corner in his bedroom with the curtains closed 24/7 full of anxiety, self loathing and depression wanting to die and refusing to go to school in September deserves more than a few website recommendations. Some empathy would be a start alongside some expertise.

I condemn CAMHs because they are at fault.

Why aren’t CAMHs owning it? Why aren’t they shouting it from the rooftops? Why aren’t they saying to MPs look at the awful provision we are providing, look at how children you are allocating money from taxes for are getting treated, look at how suicidal, depressed, struggling children are only getting website links and very little professionalism, come and look at the awful provision we’re giving which ensures many children deteriorate ....

You’ve just said it makes things worse for children so instead of protecting the jobs and wellbeing of adults why are you hiding it and why aren’t you saying we’re not fit for purpose and this needs to stop.

You are as complicit as whoever holds the purse strings.

I really do hope if there ever is a money increase the first crappy, pointless tier is got rid of and the money put towards more of the professionals children actually need.

@SushiGo

Ours excludes any child who sounds like they 'might have autism' but won't refer you on to a diagnostic service for autism either.

Absolutely shit.

Sounds similar to our experience. We tried to get medication for adhd for our son who has autism as well. CAMHS referred him back to the paeditrician as they said they could not prescribe as autism is a complicating factor. We then saw the paeditrician who referred him back to camhs as she said only camhs can prescribe the adhd medication. We are now on another waiting list. The whole process has taken 3 years so far!

God knows, two of them came round to see my son when he had a psychotic episode followed by depression so bad he couldn't hold his head up.
They were young, around 25, fired questions at him like why aren't you at work, is he always like this (to me in front of him), so on and so forth - I said no if course he isn't always like this he's suffering from acute depression which is why you are here, have you tried going for a walk? etc etc.
I asked them to leave and never come back.
They were as useless as a chocolate teapot. I got mu son better by myself.

Does anybody know if there are any commissioner/NICE guidelines parents can check are being met as regards their child? I am convinced the service my child is receiving can’t meet any guidelines.

Government funding is the issue, not individual practitioners. Too much money is being shovelled in direction of private companies, who do little to help individuals, but much to help themselves to taxpayer funds.

White I agree with everything you say.

Anyone know who works within a CAMHS screening team? They are the ones that sent a letter to our gp saying that Ds did not meet their criteria. It seems they knew enough from his referral letter to refuse to see him. I'm disappointed they could not even offer him even one mental health assessment. How on earth can the 'screening team' make their decisions and refuse help with such little information?

But then Ds is autistic and that means that he is not even entitled to the most basic of mental health care.

Sorry I disagree there is a problem with individual practitioners too. Ours has been dire.

Punx sadly I suspect you missed nothing re assessment. The assessment my ds had was so inadequate I came out thinking did that just happen?

I just wrote a long post about our experience with CAMHS and then deleted it as honestly it still makes me so upset about how our child was failed by them.
We have had to spend a fortune seeking private support as CAMHS are not fit for purpose around here (although they claim to have to no waiting lists and are incredibly defensive when you point out their obvious failings).

Anybody know if there are any NICE/ commissioner guidelines that need to be met?

The Young Minds Parent helpline is good, especially if you are struggling to get seen by someone.

Punxsutawney it is terrible you can't get your DS the help he needs. The problem with the screening lies with the GP for not making the referral detailed enough. The same happens in referrals to hospital consultants too. Apply for an EHCP and ensure specific and quantified therapeutic psychological support is in there.

NICE guidelines for depression.

For co-morbid anxiety and ASD

For social anxiety.

Other NICE guidelines can be found on the website.

We have found tier 4 services (not all tier 4 care is inpatient) better than local tier 3.

Thank you 10.

Are they supposed to adhere to those guidelines?

@justjuggling

Thank you for speaking from a Management perspective. Our CAMHS runs in the same way as yours sounds like might be on the same model. In the very large team I'm a part of staff are all committed to providing an accessible and supportive service to the local community, whilst ensuring clinicians have access to the most up to date and evidence based training in established therapies; which in turns means we can offer a greater range of treatments.

We are also receving a hugely inflated number of referrals because of cuts to local authority and other sector funding, and because it's now very common to hear that, other, really excellent smaller therapeutic services are also losing their funding so that children and their families who might've really benefitted from them, are turning to CAMHS. I don't blame them, so would I.The NHS plan is to offer open access and short term focussed treatments for a range of medium to high level mental health difficulties. That's organisational change on an unimaginable scale.

We try and form working partnerships with schools, early help services, local and other UK CAMHS teams, YOT teams, LAC teams, local and UK CAMHS inpatient services, local and national A&E units , community paediatric teams, crisis teams, eating disorder services, Adult mental health services and with the parents and young people who come to our service . These relationships are about agreeing joined up care with the YP's voice at the centre of these plans, with parents as partners in the care plan. Some of those conversation are about being realistic about what CAMHS can do. And sometimes (more often than people might think) we meet desperately worn out and frightened parents whose child does not want to be seen and won't agree to what we're offering. And unless there are grounds to consider use of the mental health act (which is rarely needed in my experience) we cannot force them to. It's shit and I hate having those conversations.

I'm a parent; my own son was declined a CAMHS service in the 90s because he had just turned 16 and he went straight onto an adult ward into adult services. I'm sorry that parents have had dreadful experiences and I hate that feeling of impotence I get each Monday morning when I know what the week will bring.

It's so sad and why I am planning my exit. And seeing so many parents say that what I, and my colleagues do is shit and useless and uncaring just adds another layer of contempt, on top of the successive government agendas to cut funding to mental health services.

My thoughts exactly.
Absolutely shocking.