CAMHS waiting lists - clinician's perspective

[ifeellikechickentonight]

CAMHS waiting lists are really long at the moment in some areas. I assessed a child today who definitely needs our intervention. He will be seen in 3-5 months - this is nothing like as bad as in some areas but still a really long time for a child and family to have to wait given the circumstances.

The mother hit the roof - you don't care about us, CAMHS are shit, you only care about getting paid, nobody cares about my son, you are trying to bat us from pillar to post, if you gave a shit about him you'd see him now, etc - this is not the first time I have had this directed at me.

Now I understand that she is at the end of her tether, understandably so because of the stress of the son's mental distress on the family, so I took all of that on the chin, apologised for the delay and we talked about what to do if things get worse in the meantime.

But I was thinking about it afterwards - does she actually think I don't care?? Seriously?

I know there are a lot of CAMHS parents on here so I wanted to say what I couldn't say to her and what I can't say with my NHS lanyard on, which is this:

• I HATE the waiting lists
• I came into this job to help children who are suffering, and making that child wait months for treatment is horrendous
• not to mention that many children deteriorate while waiting (although some improve)
• I genuinely want your son or daughter to get better
• funding has been cut dramatically to services, we are expected to do a lot more with a lot less
• it's harder to get staff- with 1% pay caps across the public sector half of our psychologists have left to go private so even when we have money we struggle to recruit, it's hard to get nurses, OTs and social workers too and will be even worse once we feel the impact of the bursary cuts in a few years
• other resources that used to provide early intervention so kids didn't get so severe that they needed camhs have had their resources slashed- school counselling waiting lists are well over year in some schools, HVs have caseloads in the hundreds so can't support younger children, lots of schools don't have their own nurse any more, the vol sector has been decimated and don't get me started on autism provision
• demand is sky high at the moment, the number of referrals per month to my borough has doubled in the time I've been a clinician but the number of staff has nearly halved
• I have no control over any of the above
• please don't blame me - blame austerity, blame Jeremy Hunt, but please know that if I could change it, I would.

Thanks for listening.

As an ex-CAMHS clinician myself, I understand the pressures you are under. However, it is nothing like the pressure of having an unwell child day in and day out who you feel powerless to support in getting the help they desperately need.

It is unfair of you to come onto a board full of parents struggling with this and vent. Get yourself some clinical supervision before you burn out.

I'm under adult mental healthcare, and all I expect of those that support me is honesty. Tell parents what you have told us!

I have a great nurse at the moment who I'm seeing whilst I wait for a more specialist referral, and she's quite straight about the fact that the wait is so long because demand far outstrips supply. Their managers keep changing systems to make them more efficient, but that's not going to change a thing if there are no more staff. Conversely I've had clinicians trying to bullshit reasons not to refer me, shifting me between lists so the official wait times are less. They're the arseholes that help absolutely no one but get praised for meeting their targets.

I hear you @chicken, and I know it's incredibly frustrating for the parents too. I'm not sure there will be anything left by the time we get a govt that will make change happen.

Ds camhs nurse was so apologietic about the wait for assessment (12 months in our case) it was obvious that it was just as frustrating for the staff as it is for the parents.

Getting angry with the front line staff would very much be a case of shooting the messenger

Actually rainybo, I'm glad op had said this. My son is under Camhs care and we waited such a long time for it that he DID get worse. It's very very obvious to me that the people we see there want to do their best by him but are being constrained by lack of money and resources. This is a disaster waiting to happen, across the board, but o don't blame the workers at all, I blame the fuckers who made these cuts in the first place. Op, please know that the mum you saw today was probably at the end of her tether. I've never known hopelessness and despair like it before, dealing with a child who need so much extra support is a very lonely thing. She took it out on you as she sees you as the 'system'. She's just as frustrated as you are. Thank you for doing what you do x

I think that's a bit unfair Rainybo

In my opinion many parents appreciate knowing that NHS staff do care and seeing the human frustration that people in healthcare feel can help them understand that this is not shit staff or inefficiency causing the problems

With Bombardier I'm under adult mental healthcare, and all I expect of those that support me is honesty. Tell parents what you have told us! That. Why can't you say it with your NHS lanyard on?
It is desperate to have an ill child getting worse and yes, it feels like services don't care.
Rainy has a point about supervision - not a criticism of you, everyone in this type of job needs supervision, venting about the cuts and consequent desperate parents venting at you is a great use of it.

Maybe you should have told the parent what you said in your post. It's shit working in the NHS I can't imagine what's it like in mental health ( one of the least funded areas! ) but if I'm honest I don't know a single person who has had a good experience of Cahms ( sorry ) the trouble is by the time they have made it to you people are at the end of their rope. It would be nice if users of the service didn't take it out on frontline workers it's just so draining. I literally start swearing as soon as I see Jeremy CHunt on the tv. Where they get all the hospital staff shaking his hands when he visits hospitals ( must be actors recorded at Elstree! 💐

IME NHS clinicians and other staff are telling me something similar every time I see one, and that includes CAMHS as I wait for help for ds - they've accepted the referral this time at least and hope the wait will only be a couple months. I was expecting a year or so, so I hope to be pleasantly surprised, but may well not be.

The last 3 GPs I've seen looked about to cry because of their inability to make appropriate referrals any more because clinics aren't accepting them. There aren't nearly enough staff - I wouldn't be surprised if there weren't enough supervisors.

As long as no-one tells me what 'should' happen rather than what will happen, I can cope. If anyone has bright ideas of how to stop the NHS being starved to death, do let me know.

Great post, OP. Really well written and a great explanation from the other side.

Should we even start on the so called "crisis team". it's hard not to be angry with them but I do realise it's down to complete lack of staff.

In general it seems contracts are slowly being given to virgin too....

We had our first assessment in December with our 15yr old. I think I've been in denial all his life and major issues were identified straight away. We were seen again in April. Since then we've had a few more meetings and assessments.

The Doctor we see has now given us a diagnosis... AND identified and referred us to another department for a possible cardiology issue which may be serious. So in all honesty she may have saved his life.

I've nothing but praise for camhs.. yes you wait a bit and yes it might take a few days for someone to get back to you but I still always leave believing we are being heard and my son finally has a voice.

I also have nothing but praise for camhs.
It took 3 turned down referrals (due to funding) before they saw her but once she got in the system they have been amazing.
The support we have been given over the past year has been great. I can't fault them.

I can only speak from personal experience.

My dd was only referred to CAMHS because GP refused to help with a private referral. It was better to tell us to get help off the internet than recommend. This was because they didn't k ow outcomes although the private sector is peppered with part-time NHS employees whose outcomes are known. Bit of lateral thinking and we'd have been off the NHS doorstep.

Having chased down an apt, we got one at 9.30. Arrived at 9.10. The building was locked up. First person to arrive wandered along at 9.20. Therapies work 9-5 with zero flexibility. Regularly phones weren't answered before 9.15 after 4.45. 30 minutes a day x 10 staff = 5 hours, 2t hours a week. That's 25 assessments or therapy sessions.

After a ten week wait they offered dd group therapy in the middle of the day. Inaccessible and the twit who assessed actually noted that starting a new school would be stressful in the short term and her issues were focussed on achievement. But still offered something that would be detrimental and then refused an alternative because i"d inquires about a private referral they and my GP had refused to help with.

Totally disorganised. Don't work contracted hours.

Sorry I'm low on sympathy but very glad we had several thousand pounds to support dd privately.

When CAMHS are HONEST, apolitical, caring, competent, flexible and organised you might garner my sympathy op.

MY services for children are dire. When the staff complain due to the impact on the children and young people rather than on themselves they just might begin to start earning a little respect

This issue is not all about money by a long chalk. We saw CAMHS twice. Neither clinician was fit for purpose.

Last point. The role of schools is to educate. The role of the NHS is to provide healthcare support. Get on with your own job and stop shagging it to others.

If resources are limited start helping those not dependent on the NHS to access private services rather than telling people to look up on the internet. If it ain't safe for CAMHS to recommend due to lack of knowledge about outcomes it ain't safe for parents to find support off the internet
Put a toolkit together in the 25 hours or so a week hour fandabby overworked teams turn in late and leave early.

Fab service here in leafy Surrey. NOT. It's a disgrace about which it's employees make excuses.

As you were.

What have you done to change it op? Have you written to your MP? Have you written to the Department of Health? Have you written to the CQC?

I work in the quasi public sector. I regularly work 50+ hours a week. I'm awfully sorry but "therapies have always only worked 9-5" doesn't cut it.

Where I live £2.3m has been pumped into an additional layer of bureaucracy which is a zillion times more helpful and responsive than the local CAMHS units. Nothing however has been done to deal with appalling CAMHS units that are carrying on in their same old idle, incompetent and uncaring ways.

The funniest thing is that when dd took a tiny od and went to the local hospital to make sure she hadn't harmed herself they then wanted to disproportionately keep her in overnight with a 1:1 nurse to fa imitate a camhs refeŕral the next day. That was shocking too. We went home and CAMHS saw her as an emergency the next Tuesday. The CAMHS woman said she's get counselling urgently within three to four weeks. So the next day I advised her private psych that camhs had come up trumps and we bad accepted.

Three weeks later we were advised counselling would be at least 6-8 weeks. The private counsellors were then booked. CAMHS said I'd misunderstood and the practitioner wouldn't know the lead times. Why didn't she say that then? I deal with complicated strategic issues every day. I don't usually misunderstand what people tell me or misinterpret complex information.

WHEN CAMHS CEASE TO BE UNHELPFUL AND DISORGANISED OP I MIGHT SPEAK AND THINK WELL OF THEM

Very much looking forward to your response.

From "mum" aka Mrs Roses when not dealing with HCPs.

Had similar shambolic service from CAMHS here. Ds's paed referred him direct to consultant psych because "ds doesn't need to experience what would come before he actually saw someone who could help"
Consultant psych was tbf very helpful,knowledgeable and understanding but then tried to arrange therapy with PMHW. She was a joke,hadn't read ds's notes, had no idea of the history, no idea of his needs and blew it the minute we walked through the door by grabbing at ds's hand (which if she had read ds's notes she would have known physical contact was a definite no)
Sent ds to his Dad spoke to PMHW told her I wasn't prepared to allow ds to suffer her incompetence and we went private instead.
Wonder tbh whether that is a ploy to clear names from the lists tbh?
Not heard any positive reports about our CAMHS service, dd's school and ds's paed have both said that their experience has been they cause more harm than good so would definitely not hesitate to go private again if needed.

Ive just had a phonecall drom CAMHS asking me to call back to make an appointment for my dc that was rwferred last November.
My dc has been up and down but her eating disorder has tipped from occassional/ incident linked to constant in that time. I actually enquired a few times as i thought our referral had been lost.

Oh thanks for being so honest and providing some important stats from the inside.

It's literally a nightmare to have to wait so long for treatment. I've just joined mum's net and found so much positive help and information. The bottom line is that I am on a mission to sort something out for my daughter and hopefully other children/teenagers and parents who are stranded at the end of a very long queue, and for whom "going private" is not an option.
I think there needs to be an immediate go-to service that offers an action plan of positive steps, useful advice, contact numbers and short term support for families. Could some of the government's new £300m budget be spent on this, which may ultimately reduce the pressure on long term treatment needed? I know that there is no quick fix, but an initial one-off counselling / cup of tea service might go a long way to letting the children know that there is help out there. This could also lead to community support, unfunded by the gov.

All the time children, teenagers and parents become so isolated in their situation and it would help if there was someone else to offer support and general holistic advice, instead of Mum saying "why don't you join a club", Teenage Daughter replying " Do you honestly want me to become a f*ing cheerleader"!?....
I know it's not funny but there does need to be a solution to this CAHMS situation asap.
Thank You to all the practitioners and professionals who are stuck at the end of the line and doing everything they can to help xxx

Our CAMHS clinician sat on my son's ASD diagnosis for 7 months as we couldn't get an appointment. She could have phoned or fitted me in, it was only 10 minutes. She then wanted to 'wait' until ADHD test, which was in July.
She then went off sick for six or eight weeks.
Yes, I understand that she is human.
Yes, I understand that she has been sick.
No, I don't understand how a draft report can sit in someone's file waiting for her to come back in.
My son is now unable to access school AT ALL because we haven't had this report and the EHCP, and the support this brings.
I can't work because school won't take him.

Could someone else not have finished her report? The system is inhumane.

So she knew he was ASD nine months ago and we've had NOTHING.

I know she's a person and works hard but I am so angry.

Thanks OP for confirming what I thought. My kids have had some OK support from CAMHS. But the situation re support for mental health is appalling. I lost my brother in law to suicide last week. He'd never been deemed ill enough to see a psychiatrist despite years of illness and extensive family history.

But fundamentally need is rising and funding has fallen in real terms. Tell your friends how bad it is. Write to your MP. Support someone like MIND, sign the petitions, vote (). And be kind to yourselves. (Climbs off soapbox)