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”?

I can sense your frustration with CAHMS for not helping your dd access the call. CAHMS are not a magic answer the same things that made hour dd feel suicidal will need to be removed from her life. Will she tell you what is making her so unhappy and what would make her feel better? I hope she keeps well and enjoys herself over Xmas.

I’m a paediatric nurse and in my trust, Camhs have been working from home since lockdown began. We have had so many children admitted to our acute hospital beds over this period with little to no support form Camhs. We can easily have 10 teenagers on our ward at one time all who need 1-1 or 1-2 supervision. How is this sustainable? Not to mention that staff get beaten up by these patients and the wards wrecked and broken. We aren’t trained to look after these children, we aren’t mental health nurses. No one cares.

Postmysecret

Medications are not a ‘fix’ either, they work well for some, but they’re not meant to be taken long term.

What an unhelpful (and incorrect) comment. Medication absolutely can act as a 'fix' - I've got both professional and personal experience of people with MH issues no longer experiencing terrifying hallucinations, suicidal thoughts, intrusive thoughts, etc after having been found the right medication. Often with the expectation that they will take them indefinitely to manage their condition. I can't stand the notion that taking medication for MH issues should be for as short a time as possible - yes, if you reach a point where you no longer feel you need the medication and have coping mechanisms to manage without, that's wonderful. But there are a lot of conditions which are more than just mood, and involve brain chemistry, and which can be successfully managed and treated through long-term medication. You wouldn't tell a diabetic they shouldn't take insulin long term because they would die without it, so let's not lump all mental health conditions in together as fleeting and solveable with an 8 week course of CBT offered by a barely-trained counsellor.

OP: I'm sorry you're struggling with CAMHS. As everyone has said - it's a lucky dip in terms of areas, funding, waiting times etc. When I was using the service I found that once I complained (quite rightly, about a counsellor who was wildly unfit for purpose), it was actually not terrible service. But they are hugely mismanaged and in some cases underfunded, and I would always advocate going privately if you can afford to - some counsellors offer a sliding scale for payment so if it's too expensive, consider that. I hate that that's the case and wish we just had a functioning social healthcare system as we should, but your daughter's health comes first so do what you need to!

@caringcarer

I can sense your frustration with CAHMS for not helping your dd access the call. CAHMS are not a magic answer the same things that made hour dd feel suicidal will need to be removed from her life. Will she tell you what is making her so unhappy and what would make her feel better? I hope she keeps well and enjoys herself over Xmas.

Again, this isn't necessarily true. I'm not calling you out caringcarer, just think it's important that OP knows she isn't a bad parent or her DD is hiding something deliberately from her because she may not know why she is suicidal.

Sometimes, despite everything else seeming fine, our brains go haywire. Don't push your DD for a reason if she says there isn't one: you might end up making her feel as though she's somehow weak or wrong for not having a 'real reason' to feel the way she does. Sometimes you just don't.

Of course, sometimes there are external factors, but it isn't always the case.

OP, not sure if it has been mentioned already but if you can find an adolescent-specialist psychiatrist in your area privately, get in touch with their secretary and explain position and ask for urgent appt. If they operate in your area you could possibly use the ‘Priory’ group to track one down; having used counsellors previously and been let down by cahms, they will almost certainly be able to see you without a direct referral. A psychiatrist can provide medication if needed - it will be a private prescription but often the cost is quite low. They can probably direct you to other local support services as well as putting a plan in place that can work alongside cahms.

Hopefully when we get through to the other side of Covid, everyone will release how much we rely on and need full funded NHS services so that people don’t fall through the gaps. Yes it will cost us all more in taxation but worth it for everyone’s health and well-being.

Realise not release !

As others have said CAHMS was in desperate need of an overhaul before CoVID but now it simply cannot cope. David Cameron promised more funding for childrens MH and it never came. CaHMS is not the magic cure that people think it is, not their fault but people wait years to be seen and then told they cannot help. I am so sorry OP you are having this experience, if you can afford it private therapy and support might be your best route. Youth mental health has only got worse this year, it is a disgrace more is not being done.

You've got to be strong in you and, unfortunately, not be so trusting. I've been called for an attendance review meeting but also received a text today congratulating DD2 on 100% attendance.

Suicidal feelings can be caused by all manner of things including damage from things you can’t take away, personality traits, life events etc

Saying just take away what is causing it is a bit silly.

@BathshebaKnickerStickers

She has had private counselling before and she sees a counsellor every week at school. It was her school counsellor who she told about her plans, which got the school involved as the counsellor had to contact her SLT who then contacted me

Did she just see a "counsellor" though, or a proper psychologist? There is actually a big difference in the way they approach counselling. DD saw the school counsellor for various reasons, then we went to the GP who advised us to avoid CAHMS at all costs, and go private. Which we did. Found a fantastic psychologist who DD saw regularly for a year or so, and now can just dial up when she needs her. It really helped DD, but of course you do have to have the ability to pay, and it costs £100 per session.

I really think CAMHS and GPS need to do more to facilitate parents finding appropriate counsellors. The GP and CAMHS both told me to find a counsellor off the Internet because it wasn't safe for them to recommend . I was perfectly happy to go the private route but as a lay person, in shock at discovering my dd was cutting herself with razorblades I needed some expert advice and guidance. I found a consultant psychiatrist through BUPA which we were exceptionally lucky to have. Further on in the journey having gained some experience and read widely I was more comfortable to source care but it's an extraordinary suggestion for parents new to the game and those who can go privately could be better helped to do so swiftly. Regrettably ime private was a bit of a dirty word in the CAMHS teams but as I got to know my way around then found many of the more senior CAMHS staff worked part time because they have their own private consultancies. It was all a bit twisted really - we had to play the camhs game a bit because there was no help to secure care otherwise.

I agree CAHMS is not a magic cure.
They are there to help you fix your own child, and to help the child to help themselves; they are not there to fix the child themselves.

Oh dear - I am so sorry - what a worry for you. I am afraid that as a general rule CAMHS are under-staffed; but when you get through to them they are often very good. It is just a problem getting in through the gate.

A troubled young relative of mine tried this app and found it helpful: www.kooth.com/

There are lots of others.

Sadly I agree that CAMHs will be limited in what they can do. People often expect miracles, but change can take years.

CAHMS is currently failing people at the minute. There isn’t currently enough resources to help with the mental health of children and Infact adults who are suffering. At 16 she can be prescribed medication for anxiety and anti depressant tablets I was given them at 15. Unfortunately at the minute unless you are physically acting on the thoughts it’s not a quick fix and the nhs can’t help quick enough. I would personally carry on with the private therapy if you can afford. You could be waiting weeks or months now for help if not

I've been there (pre covid) and urgent isn't something they seem able to deal with. I ended up taking dd(17) to a&e who were brilliant and arranged daily home visits and followed up with cahms U.K. get her an urgent referral. Unfortunately since turning 18 we have had a few more trips to a&e (if you think camhs are bad, adult services, well...) and this year despite covid she had a month of home visits released to our care rather than sectioning, then twice weekly virtual visits until recently. Hopefully it isn't at that stage but calling 111 or 999 if you are at crisis point is the best thing to do, or scoop her up and go to a&e (unfortunately ive had to have the police search for dd and they were brilliant)

So I was being emailed a guide to amazing dd joining whatever on MondayZ. No email

So the plan tomorrow is to call them again with an offering of email addresses - I have a personal one where spelling mistakes are hard.

Hopefully by tomorrow I’ll know how to access their platform and know how to get DD there

That I am afraid Bathsheba is why you confirm everything in writing. "Dear xxx xxxx, Thank you for speaking with me earlier today (15th December). I am noting that you agreed to send the guide and joining details for dd's rearranged video consultation which you agreed would take place on Monday, 21st December, at x time, with y.

Looking forward to hearing from you and best regards.

Bathsheba

cc: Trust CEO

It really is the only way, they really are slithers little buggers and you have to pin them down to stop them slithering.

Really feel for you.

Interesting that private psychotherapists are still seeing people face-to-face with COVID measures in place. Are we at less risk than CAMHS staff?

Tell that to Americans where people have died because they can't' afford something like insulin which we see as routine

The choice isn't between a badly managed NHS and no health care at all.
The NHS was set up to suit the needs of the 1950s and then bastardised to protect the vested interests of consultants and GP groups, both of whom had large factions wanting to protect their private practice. Since then various attempts at modernisation have been either resisted by the myriad of little emperors or badly conceived out of political ideology.

Most of Europe now delivers better health care per £ than the UK whilst retaining a statebacked health care system. I have always voted to pay more tax to support state healthcare and I agree there are funding issues in many areas but I have no idealogical requirements for the model of delivery. If German or French style health care models are more effective then I'm fine with those models.

The whole concept of "a" NHS is a fiction. Anyone who lives near a commissioning boundary or who has fallen foul of a postcode lottery or tried to get basic accountability when things go wrong can tell you that.

Large organisations don't implement expensive custome/patient service systems because they love us, they do it because its cost effective and delivers better services. Absence management identifies problems in the business - a pattern in one department is a good early warning of issues with the management. NHS empires are notorious for a culture of poor management causing illness in staff. More accountability for consultants leading departments and senior managers in the system is going to help staff at ward level.

I’m sorry you’re going through this.

Please remember CAHMs is a very stretched, very underfunded service. Many areas struggle to recruit and retain staff.

Lots and lots of teenagers have suicidal thoughts and MH problems. Too many for the service to cope with unfortunately.

Have you considered private therapy in the meantime?

HikeForward whilst I fully appreciate CAMHS is overstretched, do you not think it could be better managed and a little more honesty would be helpful along the lines of:

I've assessed your daughter and feel she needs x, y,z support but I have 250 young people who need it more urgently. The waiting list is therefore (insert number of months). We appreciate this isn't ideal but if you can afford to support her privately, here's a tool kit with tips and advice about sourcing a counsellir/therapist/psychologist privately.

Wouldn't that be better than "nah can't help you with that" but here's some group therapy that's inaccessible and inadequate" and when you question its efficacy for your child and point out that missing the same lessons at school will make her worse, immediately close the case because the family declined an intervention missing out the reason why in the formal letter.

The practice of relatively quick triage followed by nothing merely serves to cloud the actual facts with Trusts reporting that 96% of children at risk are assessed within 14 days but conveniently leaving out that is pretty much all they are doing and that there are thousands of children on waiting lists, escalating and getting zilch support. It is wholly disingenuous and for as long as Trust CO'S manipulate figures thus the system will remain under resourced because what is reported hides the problem.

@RosesAndHellebores

Exactly. And the NHS isn’t the only service to fudge the truth by completely removing context.

It’s disgusting behaviour.

CAHMS is a disaster but that's because of government funding and planning.

How many qualified Clinical psychologists graduate across the UK every year? Under 150? How many are still practicing full time after 5 years? Well out of a class of 15, 2 of my siblings class still are!! Yet we know there's thousands of folk graduating with psychology degrees so how come there's so few Clinical doctorate places available? Simple - the govt won't fund anymore

I wonder how many Mental health Nurses qualify every year? I bet it's shockingly low! It's been "mainstream" for the last decade that this country is facing a mental health crisis so why are we not training staff to work in these areas?