CAMHS case worker

[Jaq2]

My 15yo ASD son has anxiety and depression with suicidal ideation. He was due to meet a case/support worker today but the appointment was cancelled this morning (she was ill). We will be sent a new appointment but depends when she will be back at work. We have had months of waiting lists and more recently assessments (which he has found harrowing) but no treatment from NHS, just advice to "be creative" in keeping him safe and lots of crisis phone numbers. We would go private but we're not really sure of what he needs - psychiatrist, CBT practitioner, etc. He did see a private counsellor for a few weeks but that didn't seem to help. And we keep being "almost there" with promises of help with CAMHS. Have others found the case workers helpful? Or should we just find someone privately who can see him very soon?

Has he had a CAMHS assessment and what was the formulation and recommendations from that? What was the reason for having a CAMHS case worker involved? Was it to coordinate support or to provide an actual therapy intervention? If you don't know the answers to these questions then I guess he needs an assessment of his needs in the first instance.

He had a CAMHS assessment where we were given advice on risk management and safety plan (was the same set of crisis phone numbers and websites we already had and the removing medications, knives, door keys, etc which we had already implemented following a visit to A&E, the involvement of his school and support of the Rapid response team). The lady at the assessment said he would be put on a waiting list to be allocated a Camhs worker to do some interventions and help him better understand his ASD; if that was not helping the worker could put him forward for treatment such as CBT. I asked for more information but it all seems very vague (eg she will work to support your son). Also I'm sure I was told she would see him weekly but when this appointment was cancelled they said the worker maintains her own diary and we didn't have an appointment for the following week. I'd just like to know whether to keep on with CAMHS or if we should go private now (or should have done back in January when he was first assessed for counselling which we're still waiting for!). If we go private does that cut all support from CAMHS in the future?

If you do go private, then CAMHS will discharge as having two lots of therapies going on at the same time can be contradictory.

It depends what you want to do. Going private may also mean a wait, and you've waited this long so why not just pursue CAMHS?

If he needs support to better understand his ASD, why not look at ASD resources such as National Autistic Society. Equally, there's are tons of CBT resources online to start looking through such as moodjuice.

Thanks Littleguggi - I can understand not having two sets of treatment on the go and I wouldn't want to overwhelm my son. I think we are just worried that if we stick with CAMHS he might not get any therapy to address his depression and anxiety for many weeks to come and since we don't really know what sort of private care/treatment would be best for him we have been trying to get some information on this while we wait. When you said we would need an assessment of his needs, who would we see to get that, a psychiatrist? We have looked at loads of online resources, including the National Autistic Society but I'd not come across moodjuice - I'll check that out, thank you.

A psychiatrist will be able to diagnose and prescribe medication if required, but they will be more expensive if going private. They probably wouldn't want to medicate if he is suicidal though.

A psychologist may also be able to diagnose and will have an overview of therapies, so if you son is keen to access therapies as opposed to medication go for this. Equally a counsellor or mental health practitioner will be able to do this also.

Maybe look for a practitioner with an expertise in ASD so they take this into account. His anxiety and depression may be in the context of ASD as opposed to a separate mental health condition. If this is the case, they can work more creatively, saying that, lots of kids with ASD respond really well to CBT as it's quite literal and structured.

Good luck!

Thank you. Had really bad night with him saying it's too late for help - hope we can make it through this.

We had copious amounts of CAMHS intervention but very little seemed to help.
Unfortunately my dd would not engage with them, which is apparently common for children with ASD, she was 13/14 at the time.
She is now coming up 16 and still struggling with anxiety and low moods. CAMHS discharged her when she wouldn't accept any more therapies from them. She had CBT and she used to meet somebody weekly for a "chat", which to be fair, offered little in the way of boosting her mood or helping her understand herself.

Apart from gaining a diagnosis from them, they weren't great overall.

If I thought my dd would be more accepting of private help, I would go that route but she is expecting a magic pill to make everything better and I suspect such a thing doesn't exist.

If your son is receptive to help, I would hold on for CAMHS.

@Jaq2 you can take him to a&e if things get too bad.
We have had to do that one night when she was suicidal 😭

Thanks NiceTwin, we've been to A&E twice, last time horrendously busy and as he is severely squeamish about blood, vomit, etc a packed childrens waiting room was not helpful - they did get us into a quiet room after a couple of hours but not sure I'd manage to get him there again (unless we call the police to help as I was advised we could do).
When he is not feeling too bad he says he wants to engage and get help but the longer it goes on the less he wants to talk to anyone. I wish there was a magic pill too! Love to you and your daughter.

Just go private if you are able to comfortably afford it. CAMHS is notoriously shit. I’m so sorry you’re going through all of this. I’m sure there’s some sort of emergency therapy you could book without effecting your son’s status as a CAMHS patient?