Private Psychiatrist refusing to see DC

[cowzen]

Don't know if anyone else has dealt with this but teenage DD was diagnosed (privately) with ASD and ADHD last year. School has been supportive and we had been continuing to see the private psychiatrist who offered anti-anxiety medication which I declined thinking we could manage without.
Fast forward and last week DD was admitted to hospital following an attempted overdose. The CAMHS Crisis team got involved - and as a result the private psychiatrist has said they can no longer be involved in DD's care.
Now I understand why they have taken that position, but I feel as though we have now fallen between the cracks - stuck waiting for a referral, unable to access medication as DD is under-18, and unable to access the private alternative.
Is it worth trying other private practitioners to see if they will take DD on?

What's the wait time now she's reached crisis point? Is she going to be visited by the community team?

The problem with going private for mental heath treatment is she really needs to get on with that person and you're putting all your eggs in one basket. It's great if you can find someone she trusts who is reliable but you're out on your own again if it doesn't work out. I would push for NHS care and supplement with occasional private second opinions as and when you need it.

It must be incredibly worrying for you 💐

And the reason the private psychiatrist has washed their haves of you

Hands

The OP hasn't asked for judgement, the OP has asked if it's worth trying to go private again. Medication isn't an instant fix, it's only part of the solution and there is absolutely nothing to say that her DD wouldn't be in exactly this place even with medication. The child mental health board isn't a place to try and make a parent feel shit about past decisions.

Stay under CAMHS as long as you can. They can prescribe medication at any age, unfortunately my DC was prescribed an antipsychotic drug age 9, off label, it was fantastic. We are still with them and I'm dreading when my DC is too old for CAMHS.

My DC, if it helps at all had risperdone for years to help with asd and possible ADHD. It was brilliant. Unfortunately after nearly 10 years they couldn't tolerate it any more so we have been doing our best with Sertraline and Aripiprazole ever since. Fluoextine is the antidepressant they normally start teens on, run a very long mile, it can, and does, cause very sudden suicidal thoughts, normally a couple of weeks in when as mum you are starting to let your guard down if everything seems calm

This is child mental health board, not AIBU. Contribute something supportive or go away.

OP if your daughter is under the crisis team they may be able to fast track her into the system. I'm an adult with ADHD and I was suicidal before Christmas, the ADHD medication has made a huge difference so don't give up hope.

If the private psychiatrist can't get involved due to CAMHS input, wouldn't that apply to all psychiatrists who practise privately?

Or am I missing something?

My other DC was admitted to hospital with anorexia, in between lockdowns, and we were in touch with the CAMHS crisis team for ages.

You need to be the squeaky wheel making a lot of noise. Or in my case be completely honest and say I have an autistic child and an anorexic child and I can't cope without a bit of help.

So sorry you and your DD are going through this.
If she is under CAMHS crisis team will she see a psychiatrist quickly?
We saw a private psychiatrist as CAMHS told us, after a long waiting list, that DD wasn't ready to engage with therapy and when I asked about a psychiatrist they fobbed me off. So we went private, but when eventually she was offered a psychiatrist appointment with CAMHS we had to choose as she can't be seen by 2 different psychiatrist at the same time.
We choose CAMHS but still bit worried CAMHS will leave us in the lurch.
So only being seen by one psychiatrist is the usual practice, if she's in crisis perhaps CAMHS will be better as should be a multi disciplinary team. I hope she gets the support she's needs but if CAMHS don't respond rapidly chase them, I've heard complaining to PALS and your local MP can help access services.
Regarding medication my daughter started off with sertaline, and it helped somewhat shecseitched to flurexotine and its worked much better for her.
I think getting the right medication and right dose takes time, everyone responds differently. It's nit a quick fix as takes up to 2months to start to work and their are side effects as medication settles, headache, nausea and it can sometimes make them initially more depressed.
However the right medication is life changing so it's worth preserving with.
Good luck

A cahms psychiatrist can prescribe meds, I would try getting back in touch and seeing if they can do that. Not sure if GP can, could try. Otherwise another private psychiatrist may take on.

Has the private psychiatrist said why? It may be because it is usually considered bad practice for a person to be under the care of more than one practitioner, which does make sense.

The issue that you may face is 'being within Camhs' can mean so many different things and your son unfortunately may not be seen by any professionals.

My son also attended A&E at 14 due to a MH crisis. Camhs had previously refused to be involved as he wasn't 'unwell enough' despite having suicidal ideation and psychosis.

After the A&E visit he was cared for by the Camhs crisis team who visited us at home twice a week for 8 weeks.

They were great, but their focus was supporting him through the tough stuff and keeping him safe rather than any type of diagnosis, meds, talking therapy etc..

We were initially assured he would see a psychiatrist and a psychosis team. Unfortunately, they decided after a few weeks that he didn't meet the criteria for either (which is appalling as he was very poorly), and even if he did the wait time was over 9 months.

His crisis caseworker suggested a private physiatrist who was great and diagnosed adhd driven anxiety. This was a huge turning point for DS.

OP please don't let the psychiatrist assume that another psychiatrist will see your son anytime soon, or anytime at all via Camhs.

Do also bear in mind that a psychiatrist does tend to take a medicine based approach to MH issues, or disabilities like adhd . This most definitely has a place, and DS has found adhd meds transformational. However, talking type therapy can be valuable and is usually not part of a psychiatrists tool kit.

Adhd specific counselling and coaching has also been incredibly helpful for DS. This must be done by someone with lived experience of adhd IMO. This isn't delivered by Camhs in our area unfortunately, but they have been very helpful wrt meds.

Thanks all

For those questioning why we refused medication, we tried fluoxetine and sertraline and my feeling at the time was that it made things worse - but maybe she was becoming suicidal anyway. I am on sertraline myself so I know it takes time.

I will catch up with the more detailed replies later but I guess my real question is how to get the help she needs from CAMHS.

Its really difficult to get help from cahms - very underresourced. Mine is now given a lot of resources but as an inpatient in Tier 4 cahms, and his presentation is autistic catatonia and its very sad that other services did not provide the help he needed in previous 4 years. I also had cancer, chemo etc and that was a factor they did in sectioning. We were not keen on him being sectioned and had quite variable care - some horrific (handcuffed to admit by police and he's really gentle and mute, held down by 4 staff twice a day) and some amazing (world leading experts being brought in), asd diagnosis finally. His was for loss of function. He would not go near a psychiatrist before admission.

@Silkierabbit - I remember you from the cancer support thread. That is also an unwelcome factor for me. Haven't seen you there for a while so I hope things are OK. I still lurk but have been through a few name changes since I last posted.

@freckles20 That is very helpful and also sums up our position. In theory we are under the care of the CAMHS Crisis team and at our last meeting (last week) I was assured that a psychiatrist appointment would be forthcoming. Needless to say I haven't heard anything since.

The private psychiatrist doesn't want to be involved because they assume another practitioner is taking over. So I need to push CAMHS either for an appointment or a private recommendation - someone willing to work with DD in the circumstances.
I am not against medication but I would like to sit down and have an intelligent conversation around what might be best for DD. It is interesting that your son found ADHD meds transformational as I suspect this may be the case for DD also.

Sorry to hear you have cancer too Cowzen My treatment is over now apart from hormone therapy and reconstruction surgery with a huge wait so that's much better. Hope you are OK from the cancer. Do you think that affected your DD? Cahms could not get anything before in hospital but that was multiple referrals going in marked as urgent but mainly me phoning during chemo/radio. Then when they saw him they were all very shocked how bad he is, 4 years of me pointing out things prior to that.🤔Now we have therapies, medication, daily access to psychiatrist, teams from Great Ormond Street, Maudsley, UCL, autism diagnosis. Though an education solution and home based support would have been much better but I think it often does not exist unless you pay £10k for lawyers for education and pay privately for home treatment. We will get 12 weeks home treatment on discharge which they said is normally twice a week but can be 7 days a week. His condition is very specialist that's why they are getting others in. There's a Facebook Group called Parenting Mental Health which is good and has a PMH Inpatient one too. Fine to PM me anytime too.