What exactly are CAMHs supposed to treat?

[WhiteC0sm05]

Seems to be very little in our area.

Blaming individuals for having the audacity to have a bloody lethal orange allergy (you couldnt make this up!!) misses the point spectacularly

I rather thought the point was the overboard information on the orange allergy whilst failing to provide basic information about the service employer the person with the orange allergy.

@C8 Nah, it's just a vitriolic and unnecessary personal attack.

The reality is that this country overwhelmingly voted for the current poor provision. It isn't the people struggling on doing extra hours and buying resources out of their own pocket. Blaming them is the easy option

I agree services are underfunded but that doesn't excuse unprofessional and downright incompetent treatment so many experience in MH treatment (because adult care is not much better).

I've been one of those "best cooks" who left a public service (not MH) out of sheer frustration at not being able to do a proper job but at no point did chew gum during sessions, fail to maintain accurate records or simply chuck problems over the fence to blame on someone else.

So yes money is an issue but pretending its the only one does a disservice both to patients and staff trying to hold up some degree of services in a professional manner.

Yes I completely got the irony of all that care and attention towards their own staff, but no information to help the service user!
Thinking that Oh the Roses was Blaming individuals for having the audacity to have a bloody lethal orange allergy is missing the point spectacularly!

I'm sorry white and I'm so sorry for your son, poor lad. Is there any way you can access private care? I know it's really expensive for ongoing treatment though.

@C8 Nah, it's just a vitriolic and unnecessary personal attack.

So it was fine for the service to focus on sending information which may not even be relevant whist failing to provide basic info on the location/appt etc?

I've experienced very similar, in particular navigating MH services for a family member and supporting people attending disability assessments(notably one DLA centre which sent a glossy leaflet on their equal opportunities policy whilst failing to inform the wheelchair user that there was no step free access).

So whilst it may seem picky to talk about the orange, the gum chewing etc its the overall experience which causes people to highlight them.

As I've said, I agree funding is woeful and I have always exercised my vote against those cuts but its disrespectful to those struggling to provide good, if limited services to excuse the gum chewing liars which bargain basement commissioning seems to love so much.

I hope I can help some parents with this post, because if there's one thing I've learnt over these last three years is if your child has a mental health issue, you are well and truly on your own.

1. Any parent based in Derbyshire or on the Sheffield/Notts border I run a support group for parents coping with all the issues mentioned above. Currently on hold due to Covid but hoping to resume soon. Please DM me if you are interested.

2. For parents who have children who have issues with school attendance and are facing fines, social service intervention etc again I provide an advocacy service. There are also two documents that provide lots of very helpful information: The DoE "Ensuring A good Education for Children Who Cannot Atttend School Because of Health Needs", statutory guidance for local authorities Jan 2013 and "A Guide to Supporting a Child When They Struggle To Attend School" by Beth Bodycote notfineinshool.org.uk. There is also something called the "Special Educational Needs and Disability Code of Practice 0-25 years - you should find it if you google it.

3. For those with girls and suspected ASD, the Lorna Wing centres found via the National Autistic Society provide everthing you need to know about pathways for a referral. The diagnostic tool that is most widely used, ADOS, is less sensitive to how girls present and they are very often being misdiagnosed with other disorders.

4. Someone else mentioned body dysmorphia. The BDDFoundation.org provides lots of useful information about the condition, referrals and what treatments should look like. South London and Maudsley Trust leads treatment in this very under-researched and under resourced disorder, you can find more at:
   www.national.slam.nhs.uk/services/camhs/camhs-ocd/

Parents supporting parents is the only way forward here because put very simply our children, the future of this country, don't count and are not deemed worth the investment. I refuse to settle for that.

@OhTheRoses

Ive got no experience of that ccg, its just one i knew had a plan uploaded to share as i was aware of some of the previous difficulties between virgin care offering some services etc, and that their commissioning had been called in to question.

Surrey can be a clear example of where the commissioning doesnt work in the way you'd expect and the intricacy around it. Prior to working in other services, Id always expect for example surrey services to be delivered by surrey nhs trust, when they are actually were "outbid" by other contractors including private health care providers, and equally Surrey provides some services in other parts of the country rather than their own local nhs trusts.

Totally agree that sometimes services agree to provide things (thus are paid to provide them) and do not. This is never excusable when it amounts to unsafe care.

Sorry forgot to mention the SLAM website is also a great resource for OCD.

The diagnostic tool that is most widely used, ADOS, is less sensitive to how girls present and they are very often being misdiagnosed with other disorders

That is a really key point for any parent. Many MH diagnostic criteria treat male symptoms as "default" resulting in underdiagnosis or wrong diagnosis for women and girls and this is not a new situation.

My niece went undiagnosed with ADHD for many years. Whilst her brother received help and treatment (this was about 10 yrs ago when CAMHS/equivalent seemed to be better funded) she was discharged as not fitting criteria for any specific condition.

As CAMHS services dried up her brother shifted to private care - they were fortunate to have the money to pay for it. His psychiatrist also assessed my niece who was then clearly ill (multiple issues including anorexia, severe anxiety etc) as having worse ADHD than her brother. Treating the ADHD was the primary path to recovery for her. He spent a lot of time treating misdiagnosed girls and young women.

It is shocking that in this day and age that diagnosis for women still uses male symptoms.

I have had a couple of experiences with CAMHS and unfortunately neither was very productive or positive. I know they are chronically underfunded but it is terribly frustrating for those that need help. I felt many of our concerns were dismissed.

You go through the process of lengthy questionnaires, interviews etc only to be discharged with no other offers/suggestions for help.You have to fight for everything. It does leave you wondering who they are actually able to see. I’ve given up with them now and trying to get the support for my son via educational psychologist instead. I couldn’t face any more dealings with them, talking to them is like wasting your breath. I have never met anyone who has had anything positive to say about the service. The people we have seen have never been rude or anything like that, it is just that it is a pointless exercise.

It's been mixed for DS.
He was diagnosed with asd at age 5 and had very challenging behaviour in all settings until he went to a specialist school aged 9.
Camhs don't see kids under 7 in our area.

Age 12 ds attempted to jump out of a 1st floor window because he was suicidal. GP refereed to camhs, they rejected the referral. Spoke to school nurse and she wouldn't refer. Rang camhs myself and was told "he's autistic what do you expect". So I complained to PALS and an appointment was offered within 2 weeks.
During the 2weeks camhs tried to bounce the case back to school. School have an onsite psychology team who set up a meeting with camhs and camhs agreed to 6 sessions and school would continue ongoing weekly psychologist sessions.
Apparently camhs only offer 6 sessions then look to discharge. Ds got 9 sessions and was discharged back into the care of the school psychologist.

This year he has been referred back into camhs because he has self harmed, behaviour has deteriorated at school, he has low self esteem and low mood. Camhs agreed to "guide" school on the support their psychologist should give ds. I feel that DS is depressed and needs medication. Camhs apparently don't diagnose depression. They can't point me in the direction of a private psychiatrist who can prescribe antidepressants. Gp won't get involved because DS is under 18 so it's camhs job to sort out care for adolescent depression. School are at their wits end.

2 weeks ago ds announced he was going to jump off a bridge. He ran out of the house barefoot towards a main road. The police were called. Social services were called. Camhs then called us at home and spoke to ds on the phone. They agree he is low mood. I asked again about depression because if DS was 18 then following an episode like this he would have been prescribed antidepressants without hesitation. Camhs agree that is the case for adults. 9 days later they manage to fit DS case into their mdt meeting and agree to offer a psychiatrist appointment so I can discuss possible medication. Ds will be transferred to the long term camhs team so that he can have more than 6 sessions and a peer support worker will be allocated, although nobody knows what a peer support worker actually does.
Psychiatry appointment is next week but I'm not hopeful that I won't be fobbed off.

So Fair fo they not treat depression? I’ve seen depression listed as something they treat. How can they not treat it if they don’t diagnose it?

Only the psychiatrist can diagnose depression apparently. Sorry I didn't clarify that in my post. Camhs are the gate keepers to the psychiatrist though. They said it's very rare for children to be depressed, yet the link between autism and depression is very well documented.

Well ,I can tell you ,that they have been seeing my school refusing son ,for 2 years .he gets a 15 minute appointment every 3 months ,where the doctor takes a brief history of the past 3 months ,then waves us of on our merry way .
I am 100% sure once my son is in school ,all appointments will stop

My experience with both my ds is that they only care about getting the child back in school
And that regardless of the childs problems,if the child is attending school ,camhs won’t see them

So do they diagnose anxiety?

It’s £800 for a psychiatrist diagnosis. Who can afford that?

Gatekeepers. The very phrase conjours up images of fortresses and barriers that parents have to battle through and this is exactly how it is.

@fairgame84 it is absolutely not true that CAMHS do not diagnose depression as they dispense anti-depressants - often as a first port of call despite being told it would be the last. There are enough trained clinicians within the 'service' to diagnose once you've waited the two or so years for help.

All NHS Service and Commissioned Services have a key role to play in safeguarding and promoting the welfare of unborn babies, children and young people. This is a statutory duty under Section 11 of the Children Act 2004 and in accordance with Government guidance Working Together to Safeguard Children 2018. Can anyone here please enlighten me as to how CAMHS are meeting these obligations when they are turning away suicidal children? & schools and GP's for that matter. We've been bounced around the system often enough by them as well.

Also why can’t CP diagnose depression? Why is it just psychiatrists?

Our experience with Learning Disability CAHMs has been fantastic, the support they have given us has been amazing. It felt like someone was finally taking us seriously and giving us practical help.

If my child breaks a leg, the treatment pathway is decided by an appropriately qualified doctor. If my child has a broken brain or mental health the gateway is school or via a CAMHS nurse. In no other branch of medicine does this ludicrous system prevail

I know of at least one service where the treatment "gateway" is more like a labyrinth.

Here, there is a Byzantine pathway for adult orthopaedics. The GP has to get a radiology report, then refer to the "musculo-skeletal service", run by a private company. The wait for an assessment appointment with their phsyio is 9 months. If they think you need to see a surgeon, you have to see an "advanced practitioner" physio as the first one isn't authorised to make the referral. But the "advanced practitioner" now needs their own radiology report, because the one the GP got is over a year old. And then blood tests. And then an MRI. I'm 18 months into this palaver, and will hopefully hear in a couple of weeks time if I'm going to see a surgeon. We live in a Trust area with a high proportion of elderly people, I'm convinced that all these delays are built in in the hope that patients will shuffle off before they get seen by a surgeon, let alone have surgery.

I'm sure that in a lot of specialisms, including MH services, the delays caused by trying to save money end up costing more in the long run because people deteriorate while they're waiting for the next stage of the process. And many people would go private if they could, like you did, if they could afford it.

@WhiteC0sm05

So do they diagnose anxiety?

It’s £800 for a psychiatrist diagnosis. Who can afford that?

We had to take on debt, now paid off. Couldn't get near a psychiatrist for months. CBA'd trying to conform my child to their tickbox bullshit so went to a private clinic with him after getting diagnoses and he sees a child psychiatrist. He has adjunct therapy and support in school but ultimately he needs two different meds for OCD and ADHD. Can't be dealing with do-gooders or tickboxers who try to get him off meds, either. Nope.

@fairgame84

Only the psychiatrist can diagnose depression apparently. Sorry I didn't clarify that in my post. Camhs are the gate keepers to the psychiatrist though. They said it's very rare for children to be depressed, yet the link between autism and depression is very well documented.

Co-morbidities are startlingly common in people with autism, but you wouldn't know it from CAMHS. Who knew, autism is an umbrella for everything else - depression, OCD, ADHD, eating disorders - bit like menopause or 'hormones' for women being responsible for all their ailments. Magic!

My experience of CAMHS in Derbyshire has been this. Two referrals from the school refused because dd hadn't been out of school long enough. GP then made a referral using the buzz words which he stated needed to be used to get a referral accepted. That referral was accepted. Appointment was given for seven months time.
GP, school, myself and MP pestered weekly for an earlier appointment and was given a cancellation.
First appointment I attended as dd wasn't leaving the house by then. PMHW was fishing for reasons to blame me, our family as a reason for dd's problem when we are pretty boring and dd only felt safe and happy surrounded by family.
PMHW then decided dd would attend CBT at CAMHS. I asked how she proposed to get dd there and after she explained what would happen I asked how did she plan to tailor this for dd who had been diagnosed with ASD at 2? She said it had worked with children with ASD previously. I said it won't work with dd I have a very good understanding of her needs and I can tell you she won't be able to access this. I explained she needs medication to lower the anxiety and ASD specific therapy. PMHW then stated she would have to fail at this CBT before any other options were considered.
PMHW visited at home every four to six weeks to carry out this therapy (although every report I received stated dd was being seen weekly) After six sessions getting nowhere she stated her intention to discharge dd.
I hit the roof, made a complaint through PALS. response was as a result of my complaint dd could have more sessions of what wasn't working.
I wrote another complaint direct pointing out that dd had had no therapy of use and was no better and asking them to explain what was their reasoning behind first deciding to discharge and then deciding to offer more of what they already acknowledged wasn't accessible to dd.
That brought the head of CAMHS to my door and as a result a referral to a psychiatrist (who is actually very good) Head of CAMHS stated dd needed PBS input but it wasn't available to somebody without a learning disability. I stated my intention then to make another complaint to which he agreed three sessions of PBS training for me to enable me to put it in place for dd and a different PMHW with experience of PBS as he acknowledged that the first one had no experience of ASD.
The three sessions of PBS training were all I needed and I used the strategies effectively and dd made outstanding progress. I still use them. I asked CAMHS for a report to support placement at a secialist school that uses PBS and they did that and dd started at her new school at the end of January. The school have their own psychiatrist psychotherapist and ASD specific counselling service so in effect CAMHS offloaded the cost onto education as LA pay the £68k fees.
CAMHS will keep dd on their books and the psychiatrist will liaise with school psychiatrist but in effect all therapy will be provided through the school.

I had a very interesting link for Camhs intervention criteria but I didn't take a screen shot and it was deleted the next time I tried to access it.

It basically said that if a child was experiencing psychosis or had seriously intended almost succeeded to kill themselves then they were top level and would be seen.

I used to joke (dark humour) that they needed a death certificate before they would treat.

They are so very underfunded, I know they want to provide so much more but they can't. The best way is to bring this up with PALS or your MP. Anything to help them get more funding.

They are not at fault, they are an incredibly underfunded much needed service. They are doing their best with nothing.

Having said this we have since had a positive experience of Camhs intervention. But my daughter was psychotic at the time.

I think it depends very much where you live and which Camhs you can access.

And yes, they definitely diagnose depression and treat with medication. It's part of what they do.

Why aren’t CAMHs owning it? Why aren’t they shouting it from the rooftops?

Probably because they'd get hauled over the coals if they did. I've certainly seen it happen in housing and adult social care when a member of staff is openly critical of the service they work in. People get frozen out, relocated to somewhere 2 hours drive away, their posts are abolished in the next "restructuring" and so on. Not to mention marked down for negativity at their next performance review.