Autistic teenager multiple suicide attempts, what to do

[RyanLondon]

Hi, I am a father of a 16-year-old teenage daughter. She is officially supposed to be in year 11, but she has barely been attending school for the last 3 years. She is an only child, and she has had, in relative terms, a fairly comfortable life. Before the age of 12/13, she did not show any autistic symptoms that we, as parents, teachers, her cousins or anyone else, noticed. She always struggled with friends.

She is the quiet type of autistic child, but at home, she is not quiet. She is not violent, and she does not swear, so most adults, and even professionals, struggle to pinpoint her issues as he comes across as a very polite, well-mannered teenager. And this is part of the problem; her issues are very deceptive, and as she wants people to like her, she presents as someone very together.

During the lockdown time, she started having issues concentrating. From there on, it has been a 0 to 100mph in less than 3 years. She has been in hospital at least 5 times, on two occasions for 2 weeks at a time. She was officially diagnosed as autistic about 6 months ago - so very late, which I believe is more common with girls. However, they suspected she was autistic for at least 1-2 years now. She has been seeing CAMHS on an almost weekly basis for about a year or more. She has been in a mental health facility, initially as a day patient, since October 2023. For the last 2-weeks, she has been a residential patient there because she cut her wrist, and she is adamant about ending her life. In short, since engaging with mental health services, her issues have been escalating.

She is our only child. She was at the top of her class, very academic and had high ambitions - which was all her, not us. She has now completely given up on life. Before you ask, no major trauma has happened in our family or her life that we can think of. We have thought of every possibility, from boys to sexual abuse and anything in between. Unless she tells us something or we see some evidence of something, we are lost. I have installed cameras inside my home in the communal areas for safety reasons. It is just the 3 of us at home, mum, daughter and me.

We live in London, and we are considering moving somewhere rural - for her as she likes the countryside. We have even considered moving abroad, somewhere like Portugal. However, we know that living with her is draining. Plus, there are limited mental health facilities in rural areas. You have to consider everything in situations like this. We also have to hide everything when she is home, from handwashing liquid to floss, because she can use almost anything to do self-harm. For me, the mental health services have been shockingly bad. At the same time, I accept that it's not easy to solve these things.

However, I will have a decision to make in the next 6-12 months, which makes me feel like a terrible parent. If she is not stable enough and her attempts don't stop, it will drain me and my wife - further. If we are not well and stable, then we cannot be there for her. We are already severely depressed. It is highly unlikely the NHS will consider a residential home for her - that is the feeling I get because she has supportive parents. So, what are we to do next? Because she is being released home next week. We took her out to a restaurant last night, and she made it fairly clear that she wants to end her life whenever she gets an opportunity. I am going to relay this message, but I am sure it won't change the plans set by the mental health team.

I would welcome any advice from parents with any knowledge or experience with mental health issues. Thank you.

[divingworldchampion]

I am so sorry you are all going through this it is horrendous. I have a very similar story to you so I have every sympathy in the world. Our daughter is now almost 18 and things are so much better. I want you to have hope.
Our daughter too was very suicidal and did overdose and run off from school, we found her on the railway line. These things never leave you they are so traumatic.
We were desperate and so took her to see a private clinical psychiatric who prescribed her anti depressants (sertraline). Camhs were totally reluctant to do this but we felt at that point we had zero other options left.
The combination of this and leaving school had had a massively positive effect on her. I would definitely consider antidepressants if I were you. I wish you nothing but good luck.

[lavenderlou]

Sorry to hear this. Severe anxiety and mental health struggles are sadly common in autistic girls. If you join the Autistic Girls network Facebook group there are people on there who may have had similar experience and can offer advice.

[BeethovenNinth]

We have been through hell with our daughter since lockdown. We have had self harm and anorexia. No help as we are in Scotland and cahms is broken.

christ, I feel for you. I know how you feel. It’s utterly horrific

can I suggest some left field stuff at this stage? In utter desperation, I used the ketogenic diet with my daughter to get her over a non eating depression hump. She agreed to it. It worked amazingly. (She did it two weeks and her mood picked up). Have a look at some of the studies on keto for brain health and MH issues and discuss with her psychiatrist - you have nothing to lose.

I would also see a really decent nutritionist who can help with some basic like in depth blood tests, check some micronutrients, help with DHA levels etc. even checking her vitamin D level and supplementing.

my daughter is doing well just now. It’s been incredibly tough but there is light - I promise

[Pugdays]

I was diagnosed autistic age 50 ,as a teenager I had 2 fairy significant suicide attempts, resulting in a hospital stay both times .
Mine was down to bullying at school ,and my parents being selfish nasty people.
Once I got to college and studying the course of my choice ,I didn't have to try to kill myself,I was busy ,I got a part time job ,I made friends..so my life was full.
My advice,is get her doing her education on line ..
School is horrendous when your autistic,every fucker bullies you .
If you haven't got a core group your fair game all round .
I'd not attempt to get her back in school ,if she's under 16 ,home educate her or look at on line learning, apply for EHCP for on line learning to be paid for .
Look at alternative provisions,horse therapy ,or animal therapy
Go to your local LEA web site and look up alternative provisions,then try to get funding
She needs to be busy ,she needs friends,she needs hobbies ,
She needs a life away from being a residential patient,she needs to be busy
She needs something to want to get up for each day ..untill she has a normal life again.

A puppy ,or rabbit or kitten, something she could look forward to choosing when she gets home , something that needs her to care for it ,and look after it ,walk it for exercise... something that is hers to love and be loved by .
And that pet becomes the focus of the family to talk about ,not her mental health...that's your first step back to normal ...then education,home ed or on line ,look at college courses ..look to her future,talk about ,when you get to uni ,when you get to college,what course could she do ..
Keep focusing on the future,
Good luck

[Hellenbach]

Is here any kind of pattern to the behaviour? I ask because I work with teenage girls, some with ASD, who do experience worse symptoms when in the middle of their menstrual cycle.
It's worth thinking about PMDD.

www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/about-pmdd/

[FloofCloud]

Oh goodness, your child is mate severely affected but our DD has been to hell and back too. We found the suicide attempts were affected by her hormones so GP thankfully put her on the pill so she only has periods now 2-3 times a year. She's also on sertraline which really helps. She's not self harmed for nearly 2 months now (cutting for my DD) but I worry every day about it starting again.
Unfortunately our younger DS is starting to show signs of sensory processing issues (same as DD) and it's likely he's ADHD so feels like we're going through it again albeit DD was masking for a long time e, he doesn't mask he's literally 0-head banging and self strangulation in a micro second
Can your DD be tutored from home via your school? School should be doing their utmost to get her an education, my DD has 3 tutors one for maths, English and art, plus does online learning for double science, she's year 10.
I wish you all the best but in all honesty for us the drugs helped a lot
Good luck

[TheChosenTwo]

I’m so sorry to read this, it’s heartbreaking and leaves parents (well it certainly has for us) utterly traumatised.
Our dc2 has made several suicide attempts and landed themself in hospital for a week each time, once pre Covid so it’s not Covid which was the start of it all. I know it can be a catalyst for many.
CAMHS were a waste of time to the point of negligence (I can’t even go into it again for fear of winding myself up) but we have found them a private counsellor that they finally feel comfortable with, a doctor to prescribe antidepressants, and they are almost a year in to that now. Dh and I live in constant fear of the next time. In a way it’s no way to live and in another we are just grateful for the good days.
Really sorry, I have no advice to give. Just a lot of heartfelt empathy. I have 3 dc and this one seems hellbent on not being here sometimes.
Raise the alert with whoever you need to about your dds comments, it’s alarming and just so frightening.

[UsefulChocReindeer]

Sorry to that you all are in this position. Is your daughter on any medication? Anti-depressants?

My daughter was diagnosed ASD at 16, like yours she was very keen to please and follow rules (because the world didn't really make sense for her) in primary school. No one ever picked up anything atypical, until the anorexia and depression hit in her teens.

She saw CAMHS but found them unhelpful, but it did give her access to a psychiatrist who started prescribing her anti-depressants. She has been on anti-depressants for the last 5 years, with varying degrees of success.

What is currently helping my daughter most is seeing a private therapist who specialises in ASD. Daughter has in person or online appointments and says the therapist is very understanding and helpful - I couldn't tell you exactly how, but she is not currently threatening suicide, so for me that's success.

Like private therapy, NHS therapists are also hit and miss - but if you can afford it, you can hopefully choose someone who your daughter will click with and find helpful. Good luck.

[CalmAfterTheStorms]

Anxiety and panic disorders can rear their ugly head around age 13. It's usually the reason why so many young people have such enormous issues attending school.
Anxiety and high intelligence go hand in hand.
My son was a high achiever, in all the top sets, excellent attendance. Suddenly around age 13 he started having real difficulties getting into school.
The lack of understanding and support made him very depressed, it's like they punish and shame children for being afflicted with these terrible symptons, and he also became suicidal. He felt a failure and that life wasn't worth living.
He has been self taught at home the last several years and things have really turned around.
Would your daughter consider home education, starting afresh at college or maybe trying to get part time job, even if delivering leaflets or dog walking for now?
I also agree pets can and do make the world of difference.
CAHMS, told me young people are often better equipped to handle MH issues such as panic and anxiety as they get older, late teens.
I feel for you and your wife, l know the toll it took on myself, it's unbearable at times.
Try not to lose hope.
Have you looked at the Not Fine At School website, so many others struggling with similar issues

[CadyEastman]

I just wanted to offer some hope. We haven't experienced the suicide attempts but do have a DD who is an academic year ahead. This time last year we were at a real crisis point.

Things aren't perfect now but she has held down a PT job, is doing a college course and has a BF.

This time last year I wouldn't have believed that any of that would be possible.

[Oblomov23]

Sorry to hear this. My closest friends dd has had similar in the last year. It destroys you and is wearing. Even paying for all private counselling and adhd and also asd healthcare professionals hasn't helped much. Take care of yourself in all this.

[Pugdays]

Obviously,just to add to my post ..
I honestly didn't think I would make it to my 20s
Back in my day ,there was no camhs ,no counselling, my self harm and bullima were out of control..I was regularly climbing out of windows , running away and hitch hicking in lorries,I really didn't care about myself.
What saved me ,was a focus ..college ,uni .. boyfriend..job..then babies ..once I'd had a child I would never of caused them any harm by trying to kill myself..
In a residential facility,her only focus is her mental health,so it comes a spiral staircase..she needs a focus away from that ..
I'm 50 and still here ,and I would never of thought that I would be when I was younger

[RyanLondon]

@divingworldchampion

I am so sorry you are all going through this it is horrendous. I have a very similar story to you so I have every sympathy in the world. Our daughter is now almost 18 and things are so much better. I want you to have hope.
Our daughter too was very suicidal and did overdose and run off from school, we found her on the railway line. These things never leave you they are so traumatic.
We were desperate and so took her to see a private clinical psychiatric who prescribed her anti depressants (sertraline). Camhs were totally reluctant to do this but we felt at that point we had zero other options left.
The combination of this and leaving school had had a massively positive effect on her. I would definitely consider antidepressants if I were you. I wish you nothing but good luck.

Hi, Thank you for sharing the positive place you are with your daughter. It does give me some hope. She has been on Fluoxetine for almost a year. CAMHS was reluctant to prescribe anything. It was our constant push that made them consider prescribing it. I know with anti-depressants, the average person goes through several before they find the right fit, the one that works for them. However, CAMHS and the mental health team have been shockingly slow. If left to them, they would probably try two medicines in the space of 5 years. Anyway, at present, she is being tapered off Fluoxetine. She was on 30ml and is currently on 20ml. We want to see how she is without medication for a few weeks before we try something else. However, I have noted Sertraline, which I have heard mentioned somewhere before, so will look into it and consider trying it at some point.
One more thing: I would agree with you; taking my daughter out of school was a huge help for a while, as she hated (and that's not an exaggeration), genuinely hated school as she did not fit in at all. And every one of her suicide attempts was a result of "an event or interaction with someone or something with the system." What do I mean by that? I mean, when I took her out of school for a while, although she wasn't happy in the general sense, she wasn't suicidal. Her first genuine suicide attempt was because one of the heads of the department told her she had to sit her exams, even though we, as parents, told her she did not need to sit a single exam if she did not want to. I even okayed it with the head. So, it was a communication issue. The second attempt happened because the mental health facility was discharging her, and the third attempt happened because she did not like the outcome of a meeting to discuss her treatment.
Now, we are in a situation, which happened over the last 3-5 months, where we have regular suicide attempts, she says she is getting messages from god - end of the world and all of that. None of these things were present even 6-months ago. Yes, she was autistic and down and depressed, but she wasn't talking about ending her life at every opportunity and message or signal from god. BTW, in case you are wondering, I don't follow any religion, my wife does, but I don't.
I have been trying to persuade my wife to abandon the system and for us to manage care ourselves as I feel we will have a degree of control. My wife is too afraid. So, we are at a crossroads. The last few years have affected us every day, from our mental health to work and income.
Could you share the clinic you took your daughter to? I want to look into it. Thank you.

[RyanLondon]

@lavenderlou

Sorry to hear this. Severe anxiety and mental health struggles are sadly common in autistic girls. If you join the Autistic Girls network Facebook group there are people on there who may have had similar experience and can offer advice.

Thank you. I will consider joining this. I even considered starting a group myself which allows autistic kids to meet. I have the know-how, but I don't have the time. I used to do Meetup activities like hiking and used to take my daughter along, and she used to love it. I have tried to find activities for autistic teens/kids, and it's genuinely hard to find.

[SummerFeverVenice]

I am so sorry to hear how devasted your DD is and how deeply it is terrifying you and her mum. Anti-depressants will help calm emotions, but they do not cure depression.

She is going to need one on one therapy with a psychologist she trusts to get to the root of why she is feeling the way she is and to teach her how to ground and cope.

I think too that CAMHS is forgetting that you can be autistic and have a mental illness with psychosis symptoms. Your DD is showing psychosis by receiving messages “from God”. She needs to be urgently assessed for schizophrenia, psychotic depression, EUPD- anything with psychosis as a symptom.

A psychiatrist can put a person on antidepressants and on an anti-psychotic to help block the messages (stop her hallucinations and delusions). The two medication types can be a good combination.

[RyanLondon]

@BeethovenNinth

We have been through hell with our daughter since lockdown. We have had self harm and anorexia. No help as we are in Scotland and cahms is broken.

christ, I feel for you. I know how you feel. It’s utterly horrific

can I suggest some left field stuff at this stage? In utter desperation, I used the ketogenic diet with my daughter to get her over a non eating depression hump. She agreed to it. It worked amazingly. (She did it two weeks and her mood picked up). Have a look at some of the studies on keto for brain health and MH issues and discuss with her psychiatrist - you have nothing to lose.

I would also see a really decent nutritionist who can help with some basic like in depth blood tests, check some micronutrients, help with DHA levels etc. even checking her vitamin D level and supplementing.

my daughter is doing well just now. It’s been incredibly tough but there is light - I promise

Hi, Thank you for your thoughts and advice. There were two girls at my daughter's centre who were being forcibly fed through tubes, and she got close to one of them. Obviously, I don't have direct experience of this, but it feels horrific.
My daughter never had any eating disorders; she doesn't even go on social media, she polices herself, that's not us. But she does something worse: she goes down rabbit holes, which are like conspiracy theories, which can take hours to start believing. So, she goes on websites that are conspiracy theories like that Trump QAnon thing.
Anyway, since she gave up on life, she has been eating like there is no tomorrow; I think she has put on about 2 stones in the last 3-4 months. She used to be very close to me, but now, I am public enemy number one; she said I was part of the Illuminati - you know, the group that you hear about in those Dan Brown-type books.
My main fear is that she is a good-looking young woman/girl; everyone who sees her says so, but she truly hates herself on a very deep level. She took a blade to her face and started cutting her face. It was superficial, and it has healed.
She has a mental age in many ways of a six-year-old, although she is very intelligent in other ways. She has never been into clothes, music, boys or the other stuff most teens are into. She feels too much about people who are suffering on earth. When they see her, most men see a twenty-year-old and not the mind of a six-year-old, and men disgust her, so I feel that could cause us problems soon - it almost caused a situation when she was on holiday abroad a few years ago. BTW, I would be okay if she were gay or something, but she is not interested in anything or anyone.

[olmp16]

You are not alone. A lot of girls in their mid to late teens have really struggled with their mental health since lock down and I know of girls who have been in terrible situations but a few years on are having almost normal lives. So your daughter's life can be turned around with the right help.
I think you need to book an appointment with a private psychiatrist to have a proper diagnosis (CAHMS are often overstretched) and for her to be put on the correct medication. Sertraline is good for anxiety but you need to check that that is the whole story. I would also arrange regular sessions with a private child psychologist.
As someone suggested having a pet could really help her, particularly a pet that can be hugged.
There is an online school called Kings Inter High if she isn't enjoying mainstream school. Post 16 she might enjoy sixth form college.
Make plans of things for her to look forward to. Encourage hobbies and create a weekly routine so she can do something even like charity work to boost her self confidence. Set small goals that are easily achievable so she can gradually get her life back on track, particularly re: school.
Try and remain outwardly calm. Get support for yourself.

[braggingaboutbrasize]

I'm so so sorry you are going through this. My Ds has ASD and schizophrenia. From your description, your DD is showing signs of psychosis. This isn't something you can deal with on your own. Believe me, I have been there. Go back to CAMHS (or your GP) and tell them her symptoms. They should refer her to a service specifically for psychosis. In my experience, they will take her problems far more seriously. I wish you all good wishes and strength

[RyanLondon]

@Pugdays

I was diagnosed autistic age 50 ,as a teenager I had 2 fairy significant suicide attempts, resulting in a hospital stay both times .
Mine was down to bullying at school ,and my parents being selfish nasty people.
Once I got to college and studying the course of my choice ,I didn't have to try to kill myself,I was busy ,I got a part time job ,I made friends..so my life was full.
My advice,is get her doing her education on line ..
School is horrendous when your autistic,every fucker bullies you .
If you haven't got a core group your fair game all round .
I'd not attempt to get her back in school ,if she's under 16 ,home educate her or look at on line learning, apply for EHCP for on line learning to be paid for .
Look at alternative provisions,horse therapy ,or animal therapy
Go to your local LEA web site and look up alternative provisions,then try to get funding
She needs to be busy ,she needs friends,she needs hobbies ,
She needs a life away from being a residential patient,she needs to be busy
She needs something to want to get up for each day ..untill she has a normal life again.

A puppy ,or rabbit or kitten, something she could look forward to choosing when she gets home , something that needs her to care for it ,and look after it ,walk it for exercise... something that is hers to love and be loved by .
And that pet becomes the focus of the family to talk about ,not her mental health...that's your first step back to normal ...then education,home ed or on line ,look at college courses ..look to her future,talk about ,when you get to uni ,when you get to college,what course could she do ..
Keep focusing on the future,
Good luck

Hi, Thank you for sharing your experience. On a positive note, she is extremely good with young kids. She has a natural gift with kids, and they follow her like the pied-piper. Her mum teaches and works with autistic kids and in the community and used to hold summer holiday kids clubs, etc, and she has been going with her since she was able to walk. As she went into her teens, she used to volunteer at the place where her mum worked so that her mum could keep an eye on her. And when she started displaying autistic traits and mental health issues, we asked her to consider things she liked doing, and she said working with kids and teaching.

So, to cut a long story short, she secured herself a work placement last month with a local nursery. They were very keen to have her. However, we were a bit more cautious because we know she is not entirely stable yet, and we were a bit apprehensive of her being around very young kids. A day before she was about to start, she slit her wrist because of the meeting decisions at her mental health hospital. 

Her autistic traits are both a strength and a weakness at times. When she wants to do something, e.g. work with children, we find it difficult to slow her down because it feels like you are getting in the way of their dreams, and she likes to go 500mph. 

So, I agree with you on most points. The reason I was very close to my daughter is because even though I am a father, I was closer to her than her mother because of some of the traits she displayed when she was younger; I also displayed differently in the opposite way. I had too much energy, and easily made friends, and not always in a good way.

So, I spotted her traits fairly early compared to everyone else, although I did not know at the time that these were minor autistic traits, and I made sure she had my time even when very busy because she lacked friends. However, that was also a negative in one sense because I became, in one way, my daughter's counsellor, which is the last thing you want to be as a father. You want them to have friends their age and get a varied life experience. Not the experience of an older man.

Regarding the pet, we got her a cat about a year ago. It was an adult cat from a cat sanctuary. The cat has been great and is very well-behaved. The cat helped her learn to sleep on her own - again. She has been sleeping with my wife since some of the chaos started because one morning, we woke up to find she cut her face up with something sharp - deep self-hate. However, my daughter is too touchy (anything soft), and she wants to hug and squeeze the cat too much. Cats get scared, and they will scratch if cuddled and kissed too much. The cat gave her some responsibility, something to live for. However, since she has been having her episodes, which involve screaming and crying for several hours most nights, he is a bit uncomfortable around her now. 

A puppy would be better, something that can grow with her, but we also love the cat, so we would prefer to keep both if we can. The cleaning ends up falling on me. We had a dog for a brief time a number of years ago, and she was so very happy with it. I could be wrong, but I think a puppy may give her something to love beyond herself, and dogs are more affectionate and huggy compared to cats. 

Lastly, I had already crossed mainstream schooling for her and have been considering Open University and other places where she can do her GCSEs and beyond. Almost everyone in my family went through HE, it's not a must, in my opinion. However, I have a feeling it's important to her, and if she wants to do it, I will try and support her in that regard. However, she needs to be stable before even thinking about any of that. 

[RyanLondon]

@Hellenbach

Is here any kind of pattern to the behaviour? I ask because I work with teenage girls, some with ASD, who do experience worse symptoms when in the middle of their menstrual cycle.
It's worth thinking about PMDD.

www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/about-pmdd/

Hi Helen, I have never heard of PMDD before today. Most guys probably don't know about it unless they have someone affected in their life. However, I am open to considering almost anything to find answers and solutions.

In terms of pattern, it's been a gradual progression over the last 3-4 years. It started with not being able to study for 15 minutes, and then her mental health issues started manifesting physically; she was shaking and couldn't walk straight. In case anyone asks, she hates drugs, and she hates anyone who smokes cigarettes. I have tried to get to be more understanding of people's habits as an ex-smoker. So, I know it's not substances because she hardly has any friends. She was in the hospital for over 2 weeks. They scanned and checked everything before they determined it was a mental health issue. Multiple consultants looked at her, including many specialists, and they were all a bit confused by her symptoms.

However, I have found that she has deteriorated since being engaged with mental health services. I have also considered the fact that she may have also deteriorated if she had not engaged with the mental health services. I will never know.

Almost every person I have known and spoken to hasn't had a positive outcome after coming out the other end, which makes me very concerned. I am not saying they are intentionally doing a bad job. I worked in a major hospital a lifetime ago, and based on what I have seen, the system means most people come out the other end worse than they went in. This is only with regard to mental health. I am happy to be wrong; it would benefit me to be proved wrong.

[Tr1skel1on]

Oh my goodness this hits close to home. I have an autistic ADHD teenager that has been psychotic. I've got to be honest, they were on Risperdone from age 11 (antipsychotic) till age 15 when our local CAMHS got a new Dr for the covid period. They prescribed Sertraline after a 10 min appointment and it was a total disaster. It was also awful for my DC to withdraw from. They are now on the maximum dose of Aripiprazole (antipsychotic) and life is relatively calm again. My lived experience is Sertraline is useless at treating serious mental health issues. Look after yourself OP. It's a tough road no one wants to do

[RyanLondon]

To everyone else, I appreciate everyone taking the time to reply. I will read them one by one when I have time hopefully tomorrow. I am sorry if I can't reply to everyone directly. Thank you.

[forcedfun]

For online learning - kings Interhigh worked well for my son.

For the rest, the messages from god is red flag and they need to be considering schizophrenia or similar.

Also agree it's worth considering whether it is PMDD my sister has this and it nearly broke her before she figured out the link

[Tr1skel1on]

OP just read your post about the physical effects. We've had exactly the same here, DC even had to wear heart monitor stuff for 2 weeks to check out. Result, it's definitely happening, but not due to any serious physical problems

[Bluebunnylover]

Hi, I read your initial post but couldn’t read all the the others as it’s a bit triggering for me as I’ve been in a similar situation.

My daughter was diagnosed with adhd and autism at age 14. Had terrible anxiety and bouts of self harming. Struggled getting through high school with a few GCSEs with 50% attendance. 1 year college with about 70% attendance and really struggled with expectations from being at an educational setting.

now is having a year out and have never seen her happier. Looks after a dog couple days a week and has hobbies. We are just going to be led by her. She’s on antidepressants- slowly went from 2.5 to 30. Recommend your daughter goes on them as will really help her.

I would prioritise a break from social expectations of a levels/apprentice/university until she can cope with being in the world.

wishing you and your family all the best during this time as I know how upsetting and stressful it is.