Referral to CAMHS - what to expect?

[TheHorrorOfIt]

My 14yo is being referred by the GP to CAMHS, for an anxiety-related potential eating disorder; she is very underweight so the GP says she is considering it an urgent referral and will speak to them today.

I keep hearing how CAMHS and related services are very over-stretched and under-resourced; can anyone in this situation advise on what to expect, in reality? How long does it take to get any input; is there a sort of gate-keeping service that you have to go through before any specific help is available; that sort of thing. The GP didn’t actually know, and couldn’t advise on how they actually communicate, so we are a bit in the dark.

Obviously I’m doing my best to reassure but any advice or experience would be helpful! Thanks

We got help on our 3rd referral to them for anxiety because DC hit crisis point and stopped eating and drinking so was admitted to hospital. The first 2 we got knocked back.

As DC was very underweight they were very quickly assessed for an eating disorder. It was quickly established it wasn't an ED but anxiety and we got initial emergency sessions after a few weeks - then a cbt course for dd a few months later.

So eventually it was a positive hrlp but it was the 3rd attempt to refer and things hit rock bottom first with her- which I think is eventually why they helped. Anxiety basically ruined their childhood between 7 - 13/14 but they are much better now.

Also DC would not eat or drink at school for ages. I just fed them loads before and after and they survived somehow.

@BeethovenNinth If you think your child is on the verge, do everything you possibly can to keep her from losing any more weight. You still have control while she is a child and will lose it when she grows up - speaking from experience as a now mostly recovered anorexic with many, many anorexic friends (some recovered, some not). The faster you can get on top of it, the better for her, even if she's giving you a narrative of needing to have some control.

As someone who works in CAMHS it's sad hearing peoples experiences as we work so hard under a lot of pressure with very little resource. We wouldn't be in the job if we didn't actually care, we are health professionals after all.

OP, in answer to your question, it depends on the quality of the GP's referral and what information they include, ie. level of risk and acute mental health as to how soon your child will be seen. A lot of GP's don't include enough or relevant information which makes triaging that much harder and time consuming.

If I were you, I would write an additional supporting letter that the GP can attach to their referral. Include everything ie. what the risk and mental health concerns are from a parental point of view, and what you have tried to date and how successful they have been.

I would assume GP has done some baseline tests ie. checking height and weight, blood pressure, pulse, bloods and ECG if required. If your child is physically compromised I would take them to A&E to have these tests done as physical health is priority at the moment given they are so underweight.

Even if the referral does get accepted, there will be a wait for assessment and then further and possibly longer wait for treatment if required. If anxiety is the primary concern then that is where the work/ treatment will be. What support have school offered? What self help resources have you/ your child accessed?

You can Google your local CAMHS service and see if you can contact the referral centre yourself, 1. to check the progress of the GP referral and 2. to seek a telephone consultation with a professional whilst waiting for the referral to be processed. Most places if not all should offer this to parents/ carers as well as to referring professionals such as GP's.

Unfortunately terrible experience here too, made DS’s (14) anxiety actually worse as he hated taking about his inner most feelings to a total stranger (actually 3 different strangers as he had one person for his initial assessment (online) a first counsellor and then a replacement when she left, so had to repeat ‘his story’ 3 times) and they couldn’t provide an alternative solution. We signed ourselves off it and have tried to help him ourselves

I honestly believe that teenage mental health in the UK would be improved if CAHMS was shut down altogether. It is actively damaging to young people to pretend to offer them support, make them jump all the hoops and bare their souls, and then refuse them help on the grounds that they aren't ill enough. I don't know anyone - anyone at all, absolutely nobody - who has had a good experience with CAHMS, and I know kids who have been turned away suicidal, self-harming, severely underweight with ED, other MH problems, and various combinations of the above. The damage that this causes will last well into their adult lives, and damages long term their ability to ask for help.

I will be absolutely furious with CAHMS until the day I die.

CAHMS were a total let down, just stuck my son in a group, zero one to one, didn' t tell me anything that l didn' t already know.
My advice would be do the work yourself l spent months online, reading books researching school anxiety/ refusal and panic disorder, as well as home education. It took over every aspect of my life literally, because there was abso!utely no help to be found by way of GP or CAHMS.
I dont know why they just can' t admit they have no idea on how to treat anxiety, the success rate is very low.

Thanks innocenta. I really appreciate it and hearing from people who have recovered gives me optimism

i am meant to he getting 3000 calories daily into her. We are nowhere near that. We are now eating vaguely normally but she has developed an odd aversion to textures. Smoothie are ok. Lumps of chicken not.

she doesn’t have ASD.

apparently even if I get urgent referral to CAHMS it’s not much use as so over stretched so I am rapidly learning elsewhere.

im sorry so many are in the same boat

@BeethovenNinth Is she having a high calorie drink with every meal?

You're doing well in getting her to eat. A lot of these aversions come from the disordered mind and disappear later on in recovery. (I don't mean anything I say as medical advice, of course - just speaking from experience of my own/friends' illnesses.)

Getting her to eat is good. We started out on 3 meals and 3 snacks a day and a glass of milk or smoothie with each meal. Remember you are the adult and take control. She can't go to school, see friends, go on her phone, etc. until she has finished it all. She stays at the table until it is finished, even if it takes an hour. If you get to snack time and the meal hasn't been eaten, the snack is added. If it;s that bad, it's very disruptive and difficult, but it's the only way.

If it is something she would have eaten before anorexia it is something she can eat now.

This Facebook group is very helpful www.facebook.com/groups/430874960395142

Thanks

I find dinners horrific and she only eats because I say I will drive her to hospital if she doesn’t. My other children are suffering anxiety from it all and I am having panicky feelings every day from 1600 about dinner.

I need to toughen up but it’s still new and I can’t believe it.

I think she looks much better now but I’m not weighing her at home.

she doesn’t want people to know so I haven’t reached out to friends. Who do you rely on for support? The stress is immense

@BeethovenNinth You could consider feeding her separately from the other children so that their mealtime feels more normal and is less stressful. I know some families who have done this. (Obviously if you've been told you must all eat together, ignore me.)

You should tell your friends, at least one or two. Keep it quite private and don't discuss it where she will be aware, but you need and deserve support. EDs thrive in darkness.

Thanks innocenta. That’s helpful. I have stated to feed the others separately and last night it was two hours of hell getting dinner done so they watched a film on their own too

i am two weeks into this and we have good days and bad days. The bad days are horrific.

how do people manage all this around work? She is more settled when I walk her part way to school. I am frantically fitting in appointments around by part time hours but with three kids and a job it’s a massive juggle already

To be honest @BeethovenNinth my DH took sick leave from his work to be the primary carer once we realised it was going to be a long journey. I had not long changed jobs and so he had the better terms and conditions hence strategically he took the leave.

Do tell your work what is going on - and point them in the direction of sites like BEAT if they need more information - it may help them get an understanding without pestering you for information all the time.

Seconding Myrtle that, unfortunately, often one parent has to become a full time or near full time carer for the eating disordered child.

Not ED related but since January, I've seen two older teenagers have their CAMHS referrals picked up reasonably quickly. The first was after the teen had been admitted to hospital. After discharge it took about a month before regular appointments were set up but that was sooner than the parents had been warned to expect. The second is a teen who - based on my own experience of referring younger children - I wouldn't have expected to meet any threshold so was pleasantly surprised when I learned their case was being picked up and direct work offered. In that case, it seems as though an astute parent/carer had provided extra information by email to give context to the GP referral and to spell out the impact that being on the periphery of friends' mental health crises was having on the teen.

On the basis of the second teen - and referrals I've made myself - I would definitely encourage you to provide additional information in writing. In an ideal world, you would be able to find the local CAMHS referral information so you can be sure you are providing details of the sort that will be useful.