What is the point of cahms, who can help my son with his terrible anxiety

[Hadenough91625]

We think my son has adhd/asd (traits of both), been through hell his whole life. Went though cahms age 7 at request of the school for an adhs referral. Cahms only gave 6 weeks of counselling with younger minds and discharged us.
We continued to plod on with great difficulty. He's 15 now and along side his difficulty to concentrate/focus etc he also now has sever anxiety, health anxiety, ocd.

We went to the GP 18 months ago to refer back in to cahms , finally saw them yesterday initial assessment appointment (2nd one he's had)
We were in there for 2 hours , gave huge amount of detail. They were very nice , nodded at the right place , were sympathetic and said he ticks all the boxes and definitely needs help.
Then tell me that other than counselling again that we don't want they won't offer anything else. Can put on adhd pathway which takes years to see anyone and nothing in the meantime. He desperately needs to see a psychiatrist and be put on medications.

I said to them anyone over the age of 18 can go to their GP, tell them they are anxious and be prescribed something there and then. They will also be referred to a mental health team to be assessed by a psychiatrist if needed. Why can my son not receive anything when he suffers from extremely debilitating physical symptoms from the anxiety. Every day he gets worse and there will be untold damage by the time he gets to 18.
It is so frustrating .

6 weeks of ‘counselling’ with a trainee therapist (and they often are) is worth Jack shit. No one who's squeezed through this pitiful sausage factory of a system is refusing anthing - 6 weeks and then put back on yhd waiting list for another six weeks 18 months of so down the line - that’s a woefully inadequate seevice. Oarents aren’t to blame for this.

Anti anxiety meds for children can only be prescribed by a child psychiatrist I believe - that’s what we were told.
We had to go private for an ADHD and autism assessment for our 15 year old who was suffering from crippling anxiety, OCD, panic attacks constantly and just about out of school - they also suffered at times during primary school. It’s terrible and I feel for you.
Camhs were very little help and it’s such an awful situation. It is expensive but if you can get a private assessment and treatment for the anxiety it will help so much, it’s shocking that mental health services for children and teens are so poor.
Medication for anxiety and ADHD (it turned out they had rampant adhd and many autistic traits but not autistic) were transformative and fast acting, and the school were able to make adjustments like having extra time in exams and a quiet room for them etc but this can only happen after diagnosis with a care plan..
I have no doubt my child would have ended up out of school and isolated. However at age 20 they are happily settled at university having a blast.

It might help some children but sadly did nothing for ours - the anxiety was too ingrained. Mildly anxious kids maybe but not full on horrific panic attacks causing vomiting and OCD that made them have to count their every breath. The only thing that stopped it completely was meds. Nobody wants to give their 15 year old drugs like Sertraline, but the alternative was worse and counselling did nothing but increase the anxiety and OCD because they had believed the counselling would help them get better and then when it didn’t there seemed to be no hope!

This has changed. NHS England has advised GPs not to take on shared care from private providers.

@Hadenough91625 if you use Right to Choose, then the GP will be able to take over prescribing because it will be an NHS commissioned assessment despite being from a private provider.

I agree sadly it can make things worse and this was more or less our experience with camhs.

Some kids need meds alongside counselling - they have a mental illness.

As awful as the prospect of being on these drugs is, and they often have to take it for years it can actually be life saving.

We did go private. I then was able, after a lot of nagging, to get CAMHS to accept the assessment. Then they said the medication waiting list was 54 weeks (DD3 was already medicated). After a massive amount of nagging, they took DD3 on and are now prescribing. It hasn't been easy at all.

Have you eliminated all screen time?

According to the ADHDUK Reddit sub, GP’s are now not picking up right to choose prescribing anymore.

Just on your thing that any 18 year old can get meds from the GP @Hadenough91625 There is very little evidence for meds for anxiety and depression in that age and the risks can outweigh the benefits. I've been a GP for 20 years and off the top of my head I can't think of any 18 year old for whom I've prescribed for anxiety

I don't work with under 18's but I have colleagues who do. Happy to give you details if you'd like.

Sertraline was prescribed by a child psychiatrist for my 15 year old. The panic attacks were constant, every night hanging over the toilet vomiting or hyperventilating but the OCD was dreadful- it made them have to count every breath and repeat phrases and words in their head which was debilitating to say the least and sadly not helped at all by counselling.

Within a few weeks of taking the meds and fine tuning the dose the OCD was gone - completely. And the panic attacks subsided massively and 5 years later are no more. This child was in a terrible state. Now 20 and living their best life at university.

Yes it seems to be the case now. Only the well off can afford to get treatment that really does work for many. We could and can afford it but I feel for those who can’t. It’s just not fair and it’s failing young people.

There are some supplements which might help management of symptoms like Omega 3, B Complex and magnesium. Getting a good sleep routine (magnesium may help with that), good diet and exercise can all help and might be worth trying while you wait for referrals.
I’ve been trying all this with my Dd and have seen a lot of improvement but she’s also getting good support at school and counselling.

Camhs first refused to assess my DD for ASD. After that we went private as discovered health insurance covered it (I think they've tightened the criteria now), got the diagnosis but that didn't bring any help for her anxiety. Went back to camhs who refused to see her as her anxiety was a result of the ASD (that they said she didn't have!). I gave up at that point as my friend said the help they gave was useless anyway.

DD2 was on ADs from CAMHS but with long follow up times. The GP happily changed her ADs at 17¾.

DD3 is on sertraline for OCD and low mood, prescribed when 15, and it was radical.

Absolutely no blame here and I agree that 6 weeks of counselling probably isn’t sufficient so parents will need to push for something else if it’s not being offered.

Yes, but a child psychiatrist. Not by her GP. That's the point I was trying to make, as the OP thought that anyone aged 18 could access meds via the GP. I'm glad they helped.

Again, that was after a psychiatry assessment, not just rock up at the GP at 18 and access meds.

No idea. the only way you get to our CAMHS is be suicidal and unless you're actively trying to kill yourself you still wait months and months.

What do young people do then, if they can't access CAMHS (I had to make 4 referrals, alongside 2 referrals from school and a referral from a speech and language therapist and throw my toys out of the pram after a 'single session family therapy' session before DD2 was accepted on to the psychiatry waiting list)? If you as a GP won't prescribe at 18, when CAMHS wouldn't see them when they were under 18, what can they do? Because I've already been told that DD2 is unlikely to meet the criteria for CMHT as an adult because her depression is well managed on meds. But if she didn't have the meds she'd be in a terrible state. Do they have to wait until they're in a terrible state??

In this case though there’s potential neurodiversity which would impact the treatment plan. SSRIs may not be appropriate if the child doesn’t have OCD and the issues are in the context of autism.

CBT could be offered with adaptations for neurodiversity.

DD3 was diagnosed with OCD by CAMHS. They told her that she would have to go on a waiting list for group therapy, which they knew she couldn't attend (OCD) and then when that failed, she would go on a waiting list for individual therapy. But they knew she needed medication, so when that failed, she would go on the waiting list for a psychiatry appointment, then be put on a waiting list for medication.

We saw a private psychiatrist who is actually a CAMHS psychiatrist in another area. He assessed and diagnosed her OCD, then started medication. Within weeks she was allowing school staff into the house rather than standing on the door step. After a few months she started visiting her new special school. Then she built up to full time.

Who tells you that?? All 3 of my children have ASD. All need antidepressants to help them cope with the challenges of neurodiversity, alongside any therapy. A great analogy is the person at the bottom of the well. Therapy is giving them a ladder to climb out of the hole. Antidepressants are giving them the stool to reach the ladder.

I said may not be appropriate. Not ‘never appropriate’ or ‘shouldn’t be prescribed’.

My dd has ND. Lots of anxiety but no ocd.

Sertaline has transformed her.

Totally appropriate.