CAHMS - Absolutely Fuming

[BathshebaKnickerStickers]

Sorry, wide awake in the middle of the night because I’m so angry.

My dd - almost 17 - was urgently referred to CAHMS last month because of suicidal feelings and plans.

She had an initial appointment quickly which was an appointment with a very nice nurse to do a background and initial information about how she was feeling and why etc.

She was then posted out an appointment for March.

Sorry, school and the gp both said sorry March is too far away, she needs seen before then, GP intervened and she was due a virtual appointment on Monday afternoon. She was told it wot be done via FaceTime.

She took the afternoon off school so she could be at home for this appointment.

No-one contacted her.

I asked her if she had maybe missed an invitation to a “virtual room” that she had supported to join at her appointment time - no all she had was a text confirming the time - no “joining” link.

No-one contacted her by FaceTime - I’m going to FaceTime someone it’s essentially an outgoing call I make to their number...

No-one phoned her - they have her mobile.

No-one phoned me - they have my mobile

If it was a virtual room that she was supposed to join rather than a FaceTime call, surely when she didn’t jjoin someone should have called - it’s a new system so they must understand that maybe people haven’t used it.

This is a suicidal 16 year old who now has had 2 urgent GP referrals in 6 weeks - the initial one and then this appointment being brought forward.

No joining instructions if it was a virtual room rather than a direct FaceTime call.
No call to her to find out where she was if she had failed to join
No call to me to find out where she was (she was of course sitting at home waiting for the phone to ring.

I am beyond furious. Obviously calling them first thing tomorrow but expecting to be told there is nothing they can do now until mid January or whenever.

Are they so jaded that she is “just another suicidal 16 year old”?

Or to put it another way, how many hours of your son's working life does he spend trying to work around poor organisation and coordination across various fiefdoms? I don't know because he hasn't mentioned it, he has mentioned lack of funding and low staffing.

"How many patients does he see at weekends/nights due to lack of coordinated availability from community services such as CAMHS?* None as far as I know, he works in a unit where people are treated long term.

@ancientgran I fully appreciate your son is on a ward but we are talking here about community CAMHS so it's a bit like comparing apples and potatoes.

@notdeliasmith I appreciate if staff come into contact with Covid19 they have to self isolate and not go to work and conduct face to face appointments but if they are well why on earth can't they make video calls and hold telephone consultations?

If they can’t or won’t rebook the appointment, you do always have the option of A&E for mental health emergencies. I hope you and your DD are ok.

My local NHS is getting 500 million for a new hospital. It will still be spending close to £900 on overnight admissions for CAMHS patients presenting to A&E because CAMHS only assess between 9am and 5am Unless they had more staff what difference would it make? If one third of CAMHS worked 9 -5 another third worked 5 - 1 am and a third worked 1 am - 9 am they wouldn't see any more patients. They'd just see fewer people 9 - 5. The only way a 24 hr service would improve things is having more staff.

The state always does things badly. The sooner we have much less state provision and much lower taxes the better.

@RosesAndHellebores I fully appreciate your son is on a ward but we are talking here about community CAMHS so it's a bit like comparing apples and potatoes. The shortages of staff goes for both, you don't magically have fewer staff going off sick because they are in community CAMHS, the mental health services across the board are underfunded. Also the pressure on CAMHS is increased if there aren't beds on wards for young people who need them.

Would you say the pressure on community medical services are ever affected by the ability to get sick people into hospital? I would say it has a big impact. I do some voluntary work in a care home, when a resident is ill, say pneumonia, and we can't get them a bed it is more pressure on GP and community nurses. It works just the same for mental health.

Thinking of you OP. As a family we've been working with CAMHS in Scotland for 4 years now.
DS1 had the huge 'advantage' of being seen regularly by the community paediatrician so the CAMHS referral for an ADHD diagnosis was straightforward. After his diagnosis (took 18 months) he was already in the system when he started self harming etc.
I'm not sure how helpful it has been tbh. He sees his psychologist usually fortnightly (via NearMe) and she is very nice, but I don't know if it's helping.
With DS2 we are paying for a private ASD assessment as he'll be going into S1 soon and the waiting list is now 2 years.
Good luck.

I'm in a similar position, just given phone numbers to call in an emergency. March is a pretty good time, ours will be at least June.
Thinking of getting a loan and going private.
CAMHS will not involve you if she is 16 - 18 they only deal with the child unless they agree for your involvement.

The state always does things badly. The sooner we have much less state provision and much lower taxes the better. Tell that to Americans where people have died because they can't' afford something like insulin which we see as routine.

@ancientgran one can't help but wonder if all these trusts have robust enough absence management protocols.

Op, I sympathise with you.
My goddaughter had mental health issues.
Her mother paid for private counselling/therapy. Is this something you could do?

Xenia I’m a doctor working somewhere with both private and public systems in parallel and I laughed out loud at your absolute naïveté.

@RosesAndHellebores one can't help but wonder if all these trusts have robust enough absence management protocols. Gosh yes they should all be at work with covid, I mean they are only working with the mentally ill so it doesn't matter if they infect them does it? I'm sure your patients shouldn't be exposed to the virus but then they matter so much more don't they.

@ancientgran

The state always does things badly. The sooner we have much less state provision and much lower taxes the better. Tell that to Americans where people have died because they can't' afford something like insulin which we see as routine.

There are myriad other health systems which exist between the two extremes of the NHS and the USA. It is extremely ignorant to assume they are the only two options. We could have an Australian system, French system, Swiss system... it isn’t an NHS/USA binary choice, and you make yourself look silly by implying that it is.

My teenage son was prescribed ADs by a consultant child psychiatrist through CAMHS. He had a brilliant counsellor who brought the psychiatrist in once she'd assessed DS.

When his DB became suicidal we paid for private appointments with another consultant child psychiatrist. It got results a lot quicker than private counselling.

Keep plugging away. That's all I can advise.

The state always does things badly. The sooner we have much less state provision and much lower taxes the better.

Only you could suggest that the answer to a shortage of state provision is to have even less of it Xenia

A link for a virtual consultation would usually go to an email address, I’m not sure it could be sent by text.

I don't think I have once said NHS staff should be at work either with Covington or self isolating as a result of it. I do however wholeheartedly believe that unless they are too unwell to do so, they should be working from home, particularly when they are receiving full pay which should mean they are rendering a full contractual service to their trusts, their patients and the tax payer. I shall be deeply concerned if that has not been the case and shall have no hesitation raising it with my MP and Sir Simon Stephens - might even address him as Guvnor so he is afforded the same degree of courtesy as I have been afforded by NHS nursing staff.

I am still waiting on a call back with an explanation. I will call back at 1pm

We should have received a leaflet explaining how to access the online platform. That is now being emailed to me with an appointment arranged for Monday morning next week.

I'm sorry, OP, that sounds incredibly stressful. I hope you get something resolved ASAP.

I am glad you are angry OP. You need to be. This is not something to be ignored and batted off

If you need her to speak to someone over the weekend, this organisation are pretty good - a charity though so who know how they are coping at the moment

www.papyrus-uk.org/

@crackofdoom

The state always does things badly. The sooner we have much less state provision and much lower taxes the better.

Only you could suggest that the answer to a shortage of state provision is to have even less of it Xenia

Without this turning into a political discussion, it is pretty clear that the state provision for mental health services is absolutely not fit for purpose. I don't know how anyone can argue differently.

I’m sorry you daughter is suffering so much with her MH. I am going to echo what other have said though, CAMH’s is not a magic fix, obviously it is the pathway you have to use but be realistic, source a therapist your DD clicks with.

Medications are not a ‘fix’ either, they work well for some, but they’re not meant to be taken long term. I wish there was a wand that could cure all MH problems