DD has CAMHS appointment—what to expect?

[Ineedcoffeenow]

DD is 15, almost 16. She was placed on the CAMHS waiting list for both neurodivergence and mental health (they’re two separate lists where we are). She has got an appointment for the mental health side of things this week. I don’t know what to expect.

I think she is depressed. She doesn’t eat much, lies in bed, no longer sees/has friends. She’s made detailed plans to kill herself—to the point that she left the house but then came back. I’m worried sick that she will hurt herself. She’s really struggling to get to school.

what can I expect on Friday? Might they take the suspicion of ND into account? Or do nothing at all? As a family and her school both believe there is some form of ND. I’m worried they will only treat her MH, when I believe this stems from ND.

if it’s your first appointment expect very little, a twenty minute conversation if that and then you’ll be put on another waiting list for actually therapy or help. It’ll be very frustrating.

Many thanks for the reply. Is there anything we should/shouldn’t say? Anything that might help?

Lots of judgemental questions about family background and some questionnaires to fill out.

They should consider neurodiversity but that can be a double edged sword, because they may decide not to do therapy until her assessment is complete.

I’d go with being very clear about your safety concerns, what was happening when she had a plan for suicide, how did you find out - eg did she speak to you or did you discover by other means - what has led up to her refusing school, what do you see as the stressors in her life and how do you address them at the moment. Push back against any idea that all she needs is consistent parenting, yes she absolutely does need that but she also needs some professional support. Have a look online at different types of therapy so you have an idea of what you’re looking for - CBT can be helpful but there are lots of different approaches that can really be helpful for teenagers. Try to think about what you and she want the outcome of any therapy to be eg her mood more to be more stable, better coping strategies, her back in school. Parents often bring their kids to therapy to “fix” behavioural issues, which therapy won’t really do, so really consider what you think she needs and why. That will help you advocate for her with clinicians who don’t know her or her needs.

Also consider whether your daughter actually wants therapy and will engage because if she doesn’t, all the therapy appointments in the world won’t help.

Ive had some crackers of initial appointments, they can be hard going so equip yourself with as much knowledge as possible and stand your ground.

In our case it was an extensive history taking with me and DS (who wouldn’t speak much), some discussion of appropriate first steps, and a follow-up appointment. They suspect DD has severe anxiety with underlying autism, and they are treating the anxiety through school-based provision in the first instance and putting him on the years long list for assessment for the ND.

You’ll see a range of answers on here. As a therapist that has worked for CAMHS, a first appt would be:

Overview of symptoms
History taking (including family history)
Risk assessment and safety planning

this is a brief summary, but would take 60-90 mins for me to complete with a family. I’d also like to see the yp and sometimes the parents alone, depending on what’s been said.

This.
Things vary by region, but basically it'll be this.

DD3 was seen for OCD and anxiety. She was already on the waiting list for ASD. The therapist confirmed that she thought she had OCD and needed medication, but couldn't get her that. She said that she would be put on a group therapy waiting list, even though they knew it wouldn't work for DD3. Then she'd be put on an individual list, even though they knew it wouldn't work. Then, when that didn't work, she'd be put on a psychiatry waiting list, then when she got to the top of that list, she would be offered medication. She estimated 2 years. She also said that had DD3 not already been on the ASD waiting list, she would have added her.

We waited a few months, by which point she was out of school completely. Someone kindly gave us some money for private assessment and she was seen, diagnosed and treated. She was diagnosed with ASD (NHS), and the ASD assessment team said that ADHD was likely. The psychiatrist treating her for OCD agreed and assessed her for ADHD and treated her for that. It was enough to get her into her new special school. Her NHS ADHD assessment confirmed her private assessment about 9 months later.