CAHMS-need psychiatrist assessment but social worker instead

[PermaShattered]

Any advice/guidance welcome. We had our CAHMs screening appointment with DD (13) in August. She had been 'struggling' and had started self harming. First appointment for 'Core' work was scheduled for 6 August. She deteriorated with wider range of symptoms/issues and school urged us to bring forward appointment if we could. Now, it's this Friday.

A month ago things got worse and GP said we can't wait a month, but neither he nor we could bring it forward anymore. But she continues to deteriorate. Could give many examples, but she's now speaking about wanting to die, and for two weeks she has been losing a grip on reality (eg 'nothing feels real/i can't work out if what happened at weekend was real or a dream.....' and the like). Sometimes she can be awake until 5am. Uncontrollable rages. could go on.

GP said she needs to be assessed by psychiatrist and when diagnosis given, treatment..... He said she should be seeing a psychologist and, if necessary, a psychiatrist. Yesterday, I phoned CAHMs to find out who she will be seeing - only to be told that it will be a social worker for 'coping strategies'. I was bewildered. I made it clear how much she had deteriorated and she needs a proper psychiatric assessment etc but i was just told that this is their way of doing things. If social worker thinks she needs treatment she'll be referred. But she needs treatment now. Not weeks down the line.

This is all new to us as a family. Does anyone have any experience of this they can share? Any advice?

I feel for you. Have been in a similar situation with my own DD, 14. Have struggled for a year now to get the right help for a child struggling to keep her head above water. Keep pushing. It sounds as if your GP is a strength and a resource. And make sure you're looking after yourself too. The place you are in is frightening and lonely.

CAMHS are pretty terrible for gatekeeping. Our involvement has been for different reasons, namely DS1's ADHD (he already had a diagnosis of ASD with hyperactivity). Most of our contact for the first 6 months, until diagnosis was with a mental health nurse who concluded that because school and I were seeing different problem behaviours, it was down to his ASD only and didn't need further involvement. Thankfully, the psychiatrist wanted to see us, anyhow and we finally got to have a proper conversation about what was and wasn't working and where to go from there (drug treatment, but not following the conventional protocol because the risks were toe, given his current symptoms and behaviour patterns)

Even though we now have a named consultant psychiatrist, getting hold of him in a crisis is pretty darned impossible, as he's now hidden behind a layer of inefficient admin. We can't email him at all. We can't call him and expect to be able to speak to him or even make an emergency appointment. We're lucky if routine appointments even get through to us or if consultation summaries get through to us and the GP and changing an appointment is such a farce we've given up trying, no matter how inconvenient the one we have is.

Sorry your DD is feeling so bad. Obviously this treatment plan is entirely inappropriate. I am quite new to this too, my DD has just been referred to CAMHS for self-harm and anxiety. I am just beginning to understand the inadequacy of the system for children with mental health problems.

So I don't really have the answers but what I would advise is to make a list of everything that is concerning to you, especially: the loss of reality and the suicidal thinking, and the rages (any violence?) And make absolutely sure that the social worker gets all this information. These things are serious so it should result in them referring your DD as a matter of urgency. But there is no way of guaranteeing this. If you are really worried about her seriously being a risk to herself, then you would be justified in taking her to A&E or contacting your local crisis team. That would escalate her treatment I would hope.

There is a thread here about self-harm and about navigating the services, you might find some of that helpful.

toe = too great!

Hi Perma. Psychiatrist's appointments seem to be hard to come by, very unfortunately. My advice is to phone CAMHS every day and ask to speak to the duty clinician. They will phone you back at some point, hopefully the same day. Tell them everything, every symptom, don't hold back. If you're talking ang telling them stuff for half an hour (and I have) you'll be getting the size of the problem over to them. Let them know how worried you are, if you're near tears, don't stop them coming. Tell them about suicidal comments, the disassociation, the insomnia til 5am. All those point to needing psychiatric help rather than a nice chat about hobbies and sleep hygiene. Been there, done that, have the depressing t-shirt. All the best, for you and your DD.

Thanks all, appreciated. Majestic - thanks for link - will have a good browse later. I know they are very underresourced. I have a good friend who has gone/is going through it and has given me some excellent advice. What's very worrying is that it's clear the only way to really get the help when you need it is by turning up at A&E where the child has to be seen by a psychiatrist. There's only been once we could (should?) have done this - but i hope it doesn't get to that. I'm keeping a journal and i'm calling CAHMs again tomorrow to keep up the pressure. Thanks again - and good to know others are in a similar situation (well 'good' isn't the word but you know what i mean... :/)

So CAHMs have taken on board what i've said (by phone). Told them the GP has said DD needs psychiatric assessment, diagnosis treatment - but they say they will start with cognitive therapy (with social worker). And there's a complaints procedure if not happy..... :/

PS Appointment tomorrow ...

Hopefully they'll see for themselves what's needed. I see your appointment was yesterday. How did it go? I found CAMHS reluctant to accept the GP's opinion, they would much rather decide themselves. You would think they would take the word of another doctor though, wouldn't you? I hope the proper help comes soon. It's a hard time. Feel for you all

We were fast tracked to be seen by a psychiatrist when I ended up calling 999 and spending the night in A&E. DD (14) had such a bad 'episode' that I didn't know what else to do. We were visited by Camhs the next morning and seen by psychiatrist within a week, where medication was prescribed. We now have regular sessions with him and medication reviews....would probably still be waiting were it not for the trip to A&E in an ambulance. Don't get me wrong, it was terrifying for all of us, but when your child's mind is in such a state, they need help, and sometimes a parents love alone just isn't enough. We are slowly seeing improvements - certainly not out of the woods yet - but at least the ball is rolling!