Is there a camhs policy not to return calls?

[SouthWestmom]

I'm being serious. Second child to go through the system and I can feel another complaint looming. Does anyone know if (because they are so busy) there is a policy not to return calls asking for an update if there isn't any therapy on offer yet?

I think there's a policy to fob people off, I experienced that with three of mine.

I'm wondering if it's actually a decision though. Quite tempted to ring and ask what the response time is

When was your call to them?
If you know the name of the person you need to speak to I would give them a ring tomorrow.

three times over two months, have dates and was told each time that X would call me back but was busy / on leave/ on another call. I've explained dd has got worse.

Does the service have a duty worker? Most CAMHS do. Ring and ask to speak to them, let them know that your child's mental state has deteriorated. If nobody calls you back ask to speak to a team leader.
I'm sorry this has happened to you. I can't defend you not being called back as that's clearly unacceptable, but I do know how horrifically hectic and over stretched CAMHS services are as I am a CAMHS clinician, and sometimes call backs do occasionally get lost when urgent crisis management or emergencies need dealing with (which is on a daily basis!)
One other option is to go back to your GP and ask them to chase up the referral. Good luck, and sorry again.

hi selks thanks for answering. We've had the first appointment now waiting for an outcome. I've explained she s got worse, its middle gcses, she plucked up courage to speak to them etc and thought I might get a call back but nothing.

I have had nightmares with CAMHS not taking dd's issues seriously. She is 15 and her mental health has deteriorated terribly.

We were referred to a young peoples counselling service which was disastrous.

I turned up at CAMHS with dd and basically refused to leave until someone talked to us. It was very dramatic but it got results! I was desperate.

Blimey that sounds very stressful

I think the problems people are experiencing are due to CAMHS being chronically underfunded, I say this as I work in a CAMHS team. It's not to say that what you have experienced with no one returning your call is ok. Services have been slashed and so thresholds for getting mental health services keeps going up as only way to cope with massive demands and no staff to do the work. People are firefighting and just trying to manage emergencies as they come in.

Why though? Camhs has had a poor reputation for years - it's the only service that regularly gets slated by parents nationwide. What has gone wrong?

We have lost half our workforce but can't comment nationwide although suspect will be a similar picture.

Oh okay so just frantic busy no time to write up/ return calls/ just appointments and urgent cases? Thanks for posting about it, its very hard to understand from this side.

Huge funding cuts and under-investment year on year combined with a massive rise in referrals and numbers of crisis and emergency cases.
It's a national issue and one that is being looked at at a governmental level currently.
Still, not fair on families and children, whatever the reasons.

It's interesting, I don't remember Camhs existing when I was a teenager in the late 80s - it was GP, consultant, inpatient.

So I have OCD as does dd. Camhs have been useless in terms of offering support and we are endlessly waiting.
Today I realised that I had three verrucas on my fingers , probably from treating little DS and his foot. I rang my mum, fairly hysterical and upset, I can't do skin stuff etx. At home today, dd refuses to eat. For some unfathomable reason my mother decided to tell her. So she would be nice to me.
Dd will, instead, probably develop anorexia and wash everything in sight.

I work for a CAMHS team. A recent audit showed that in 2010 we were getting 5-10 new referrals a day. Now we get 40-60 and we have half the number of clinicians we had back then. That's no excuse for people failing to return your calls. I just think it's important to be open about the reality of CAMHS services as it's unfair to give parents an unrealistic expectation. Your best bet is to go back to your GP. Tell them that you feel your DD's mental health has deteriorated (be as specific and detailed as you can about any deterioration in her mood, behaviour, functioning and level of risk) and ask them to contact CAMHS requesting that her referral be re-prioritised. I have to be honest though, unless there is evidence that she is at risk or her illness is significantly impacting her day to day functioning she is unlikely to be prioritised as "urgent".

Whilst I feel for those working with CAMHS, I almost lost my dd several times through lack of follow through/ therapists leaving and cancelling etc. I think there needs to be transparency from camhs in this crisis, the changes in tiers treated, and for parents to be given a clear idea from the first assessment if camhs will help rather than people wait for months, not knowing. My advice for parents is put everything in writing, including changing symptoms etc. I got my local councillor involved and changed camhs within the borough. Get schools/GPS on board to push for urgency and escalate a complaint via the Trust. You shouldn't have to, and its not a reflection on practitioners, but if you don't shout loud, you wont be heard. With those statistics from CAMHS, I wish more working with CAMHS would make their voices heard, as I have sat with government ministers massaging statistics to say otherwise. Also do support charities like Young Minds who offer an invaluable phone service to parents .....you have the best chance of helping your child if you can get support from CAMHS, as when they turn 18, its nigh on impossible to access support, even if you transfer from camhs as a tier 4 patient. My DD has been told adult services only ever offer 6 weeks therapy, and as she needs more support than that, they simply cant offer anything...

Where I work we are very open with parents, when they come in for their initial assessment they are told in no uncertain terms "this is just a one off assessment, if we decide today that you need ongoing therapy then it may take up to X weeks (depending on current waiting list) before that begins". One of the biggest problems is that Tier 4 (inpatient CAMHS) services have been slashed ruthlessly in recent years. That means that kids who really should be in hospital aren't because there are no beds so we're left in a position of trying desperately to keep them safe in the community. Meanwhile, kids who aren't as seriously ill/risky but still absolutely need support have to wait. Often they wait so long that what started out as a straightforward, routine referral ends up as an emergency. It's not right. We know it's not right. Management know it's not right. When you say we should " make our voices heard" I'm not sure what you expect us to do. My colleagues and I have complained to anyone and everyone in a position of authority (our MP's, Nursing Unions, the Commissioners, senior management) until we're blue in the face. The bottom line is that this is about money. We need more staff. Demand has gone up, the cases have become more complex and there are less of us. Much less. To address this will cost money and our funding is determined by a Government driven by an obsession with cutting costs, regardless of the human cost. Please don't think we don't care because we really, really do.

My dd is currently on a 'therapy holiday', an euphemism for 'your therapy time at CAMHS has run out'. She is no longer the acute case that she was a few months ago (touch wood) but she is by no means 'better'. She is still profoundly anxious and this impacts on her daily life.

At our signing off meeting, I repeatedly asked the lead clinician to give me some pointers to where I can continue to seek appropriate help in the private sector. I am realistic that there are probably many more young people in our area that need NHS support than my dd in her current state, but there was no advice forthcoming from them about where we go from here post-CAMHS.

I can pay for some treatment if necessary, I would prefer my dd to continue her treatment in the NHS but needs must.

Normally I am totally NHS or nothing but surely in this crisis there needs to be a more joined up system between NHS and private? My dd turns 18 next birthday and I am dreading the transition.

PS You mention the tier system - dd was never assessed so categorically. Would she have been? If so surely we should have been told?

The "Tiers" that you're referring to are simply the names given to different types of CAMHS services. Tier 2 CAMHS also known as PCAMHS provide short term interventions for young people with mild/moderate anxiety and depression or low level self-harm who don't meet the threshold for generic CAMHS. The focus is on early intervention and preventative mental health care. We don't have Tier 2 in my area now as it's been cut. Tier 3 CAMHS is generic CAMHS services in the community. When people refer to "CAMHS" in general terms they are usually talking about Tier 3 services. and Tier 4 is inpatient CAMHS. Some areas also have a Tier 3.5 or Tier 3+ service for young people who are in crisis and usually on the cusp of hospital admission.

yorkshapudding, thanks for clarification, useful to know.

Almost forgot, if you're still looking for a private therapist, the BACP (British Association of Counsellors and Psychotherapists) have a useful "find a therapist" tool on their website. BACP accreditation doesn't guarantee that someone is a good therapist but it does mean they have genuine qualifications. Unfortunately, there are quite a few charlatans out there so you can't be too careful. I would enquire specifically about their experience working with children and young people. A lot of private practitioners will say on their websites etc that they can work with children, adults, couples etc. I am always wary of this. I have worked in both Adult and Children's mental health and there is a world of difference, personally I would want someone who specialises in and is passionate about working with children. NHS are not allowed to recommend specific private therapists (for many legal and ethical reasons) but your CAMHS clinician should have been able to give you info for some local voluntary sector organisations/local authority funded services I would have thought. Have you looked into IAPT for your DD? They only offer short term CBT but if she's no longer acutely unwell this may just provide her with a useful refresher of the coping skills she's learnt in therapy with CAMHS.

Sorry that should have been "NHS staff are not allowed" not just NHS.

Yorkshapudding, thank you so much. This is just the kind of information that I was hoping our CAMHS team would give me. I will follow this up.

If you are looking at private adolescent therapists, as a parent I suggest looking at practitioners/therapists working in the local private adolescent units, like the Priory. These units work with NHS teens as well as private patients, so if they agree to see you privately, they are usually closely linked with camhs. I have experience of them via the NHS and as anywhere, some are great, and some less so, but to work with NHS and private adolescents, usually means they have a lot of CAMHS experience and qualifications and have links with local Camhs.

Sorry Yorkshapudding, I cant imagine how hard it is in your position and I think your voice is invaluable to parents on these boards . Despite our nightmare situation of tier 4 and no adult therapy, I believe camhs needs the investment as the chance of some success with treatment seems higher the earlier it is.