dd again

[RipeningApples]

Counselling hasn't been very helpful but she'd like some now. She had a crisis after taking a small self harming overdose a month ago. Since then she's been assessed by:

A MH liaison nurse specialist NHS in hospital - CAMHS and counselling recommended.

Her psychiatrist - private counselling recommended (holding off in the hope that some,NHS counselling might be provided)

CAMHS nurse practitioner assessment - referred to counselling charity.

Now assessed by counselling charity who think she'll be a good candidate for counselling.

The NHS has now paid for three assessments which have recommended counselling. Does anybody else think it would be a good idea if the NHS spent a bit less of its money on assessments and a bit more on the actual counselling.

One month in from a low point still no idea when NHS,counselling might be provided. Could have had two/three sessions by now but dd has now answered the same or very similar questions at four assessments. And we wonder why the NHS has no money!!!!

It is ABSURD quite apart from extremely wasteful. In fact I could have told all four people that she needs someone to help her with anxiety, depression, self esteem, etc.

[dangermouseisace]

ah well at least they are all in agreement!

If the counselling charity have now assessed dd- does that mean that they will provide the counselling?

[RipeningApples]

Yes, in eight weeks as assessed as low risk. This is after a&e tried to insist she had a 1:1 nurse overnight to facilitate a CAMHS assessment the following morning (Saturday). Have now been advised CAMHS wouldn't have turned up the following day anyway. The od was 26 hours previously and minor and she was fine. A&E were completely disproportionate. Almost a month later after three assessments she's been offered counselling in six to eight weeks. CAMHS indicated three weeks ag this would start during the school holidays. Mislead again by this dismal organisation and a lead in of 11 weeks from the CAMHS assessment.

The NHS has money to spend unnecessarily on a 1:1 overnight stay plus nurse (agency), on a MH liaison assessment, on a CAMHS nurse assessment, on a charity assessment. If they have money to spend on that, can somebody tell me why they can't provide counselling more quickly and efficiently to prevent further escalation. To support young people to get well.

It is just not good enough. Are there any CAMHS people about who would care to explain the logic. I am so cross I could explode. Such a waste of time and resources. Do these people get their kicks out of messing vulnerable teenagers around?

[erinaceus]

RipeningApples

If you have specific questions about NHS care, you might find Patient Advice and Liaison Service (PALS) are able to help you with some of your questions.

Do these people get their kicks out of messing vulnerable teenagers around?

I do not know. I do not work in child mental health. However, I very much doubt it, for all that it can feel that way to both the patient and their carers.

[RipeningApples]

What is all the more ludicrous is that parents don't get answers vis a vis confidentiality for 16-18 year olds unless they involve their young people in the complaint when the young people need no more added stress. Hence this group is particularly ill served.

[cheezy]

Is there any way you could afford private counselling while you wait for NHS? There are some low cost counselling services around if you Google and some counsellors offer concessionary rates. Mental health services for young people are dreadfully stretched at the moment. Good luck

[erinaceus]

...this group is particularly ill served.

Yes. This is a known problem. For example, the challenge is discussed here at YoungMinds.

[mylovegoesdown]

I thought you said a month ago that you were having nothing more to do with CAMHS and we're going to pay privately?.

I'm not saying you should have to but wonder why you'd changed your mind.

[Waitingfordolly]

My DD is having private counselling that's subsidised through a youth centre by the district council here. We were told by the GP that it would be v unlikely we'd get anything through CAMHS. I don't understand why when they are making it easier for adults to get support around mental health (though I have thoughts about the quality and appropriateness of that) that it's practically impossible for young people, who will then grow up to be adults with mental health conditions and need more support. Hope you get help for your DD.

[RipeningApples]

To answer you mylove because the hospital admission involved a ss referral I went along with the CAMHS assessment and was informed at that assessment that they would refer for counselling to start quickly in the summer holidays. This has turned out not to be the case.

I can afford private counselling but wasn't aware the NHS was means tested yet and think it would be better if perhaps it was formally fir things like this,so lay people weren't left to find their own care.

What has annoyed me is that the NHS has now funded three assessments each duplicating the other and wanted to fund an overnight hospital stay with 1:1 nurse but claims it doesn't have resources to roll out the preventative therapy that is required. It's ridiculously wasteful and ill thought out.

[RipeningApples]

Interesting link by the way but not really applicable as dd hasn't had any care from CAMHS. She needs counselling and we are four weeks in from a crisis and have been advised there is a 6-8 week from now. I'll ask my GP for an NHS,referral for counselling for me - I bet it will be quicker and easier!

[AndNowItsSeven]

If you can afford the private counselling pay for it don't make your daughter wait to because of principles.

[RipeningApples]

I will, don't worry. That doesn't however alter the fact that the NHS has now spent money unnecessarily on three duplicative assessments whilst providing zilch that is helpful. It's a shame the NHS doesn't consider it helpful to prevent escalation.

[mylovegoesdown]

An NHS counselling referral for you might be quicker (though I doubt it) but would likely be a 'phone or group based intervention that wouldn't be appropriate for your DD. 1:1 counselling on the NHS is in short supply, particularly so for adolescents which requires different levels of experience and expertise.

The NHS is under-funded and has been for years. MH services even more so. The system is failing but not because over-worked and under-paid professionals 'get kicks out of letting vulnerable people down'. That's ridiculous and offensive.

I've assessed people who have previously been recommended for counselling or therapy and are waiting for it and I've agreed that's what they need. They might lurch from crisis to crisis but that doesn't mean there is an appropriate therapy service they can get what they need from quickly. Of course the NHS consider that helpful to prevent escalation but if it isn't available or there is a waiting list, what do you expect them to do?.

They're working within what is possible and available. I guarantee that professionals are just as frustrated and annoyed as you are but they can't magic up something which isn't there.

It's shit I agree but it's not that the NHS doesn't care or don't know what happens if people can't get the help that they need.

A 6-8 week wait is short in many areas. I've known people needing more intensive and complex therapy wait months. No it's not good enough but it's all we have.

Write to your MP or the government about lack of appropriate provision. And challenge all the people you know who think people with MH problems should just get on with it or pull their socks up.

[RipeningApples]

That doesn't address why what's available can be used wastefully on three assessments which duplicate each other and recommend the same thing. Nor on the proposal to book a,1:1 nurse overnight to await a CAMHS referral when the consultant paediatrician felt dd was ok and was better for her to go home,but the protocol said x. The paed was unaware that at 17 she could be assessed by the MH Liaison nurse and didn't have to wait overnight for CAMHS.

There seems a huge amount of money to waste nut none to spend on care.

Not least CAMHS told me dd would get care in the holidays, locally this way. I find out four weeks on that this isn't available until after the holidays. I don't understand why they don't provide accurate information. If they had done that I could have sourced care starting next week but have now lost four weeks because of this,assurance. Surely they have to take some responsibility for that? This is,what camhs have now offered - I had a feeling it would come to this which I why there was no earthly pint waiting overnight in a hospital waiting for us to grace is with their presence. If I had gad any concern at all that at that point dd was a danger to herself, of course I'd have stayed. How many counselling sessions,could be funded instead of an overnight 1:1 hospital stay and what ave turned out to be three duplicated assessments.

It seems to me that the,people in MH just like to push paper around and contemplate their navels justifying their inaction rather than doing anything remotely helpful or constructive.

I don't especially mind them wasting heir time but I mind the wasting mine and dd's,very much.

If they don't provide what they said they'd provide by close of business on Monday I will be writing to my MP and the CCG.

[RipeningApples]

And I haven't had the heart to tell dd that CAMHS have let her down again yet. Just trying to get something sorted out. Will tell her over the weekend. Better still the nurse practitioner can tell her - I'll get her on the phone and she can do her own dirty work.

[mylovegoesdown]

Yes, that's exactly right. People who have dedicated their adult careers to MH care sit around contemplating their navels and justifying their inaction. They wanted professional qualifications in a hugely stressful job with crap pay just to arse around in an office not caring for the people they went into the profession to care for.

If you can't see that an assessment (no matter how many) is completely different and a completely different department/organisation to offering extended counselling then you don't really understand the NHS. Nor do you understand they can't magically provide something that isn't there.

Which is okay. And yes you've been let down but you posted about your contempt for the NHS last time so yes, we get it and understand your frustration but carry on slagging off the system when you said a month ago you'd pay for private care.

Do it. You shouldn't have to but it is what it is. Don't abuse professionals working in a shit and inadequate system.

[RipeningApples]

I do see it's different from counselling but I don't see why the same thing needs to be done three times to result in zilch. Once to result in zilch would have been enough - even better if we'd been advised of zilch more quickly wasting less of their time and dd's. Why can't you see the pointless wastefulness of this?

Anyway my apologies if I've upset you but my principle concern is my daughter and her feelings not those of mh workers and the NHS who have let her down - again! That's the problem really - it's about the patients, in this case my daughter, not you but thanks for turning it round.

[RipeningApples]

Also, I've been paying for private care since October. DD has been assessed as needing counselling, more counselling, than she's already had. Why shouldn't the NHS provide some counselling for her in accordance with the timeframe conveyed? If they can't, why give inaccurate information in the first place? There doesn't seem to me to be a great deal of respect coming from the NHS to the patient in all of this to me so it's hardly surprising relationships become contemptuous.

[Coppinger]

I am also finding your posts very difficult. Your constant complaining is making me very anxious. I have a severe mental health condition, as I imagine several people reading these posts do, and to be honest, you're just aggravating my illness.
Please try to be considerate; I feel for your DD, but if you are lucky enough to be able to afford private health care, then great - go for it! Just remember that many of us can't and your condescending attitude towards the service that we rely on only serves to worry and frighten us.
Sorry to be rude, but that's how it is. I think you're unfeeling and being a bit selfish and I don't know what you expect anyone to say in response to your posts.

[mylovegoesdown]

I understand you're upset and your primary concern is for your daughter. Thank you for saying you weren't meaning me - I know you weren't really, I don't even work in CAMHS but it is upsetting when people levy accusations of not caring on MH professionals when the overwhelming majority do care and are just trying to do their best in a failing system. I (and many of my colleagues) feel responsible for not being able to do what is required when it's not our fault at all and there is nothing we can do to change it.

It is a failing system and is letting people down. I sometimes give inaccurate time-frames for counselling to people because I'm basing it on what I heard last because they're different organisations and it's hard for me to keep up to date. Unless it's crisis assessment, there aren't rigid time frames to (try and often fail) to abide by. I'm not trying to mislead, I'm giving advice to the best of my knowledge that day.

The fact you've been paying for private care for several months seems to me to demonstrate that even privately, there isn't rapid access to counselling as surely your private Consultant would refer you somewhere privately?.

It's awful and it's not good enough. I agree but I guarantee that professionals are going home at the end of the day feeling shit that they can't offer or provide what is needed immediately. There's no need for 'contemptuous' relationships because they're really not the enemy but I understand that's how people feel and I'd probably feel the same if I wasn't seeing the 'other side'.

I'm sorry your DD has been let down by the system supposed to help her. I really am and if I had the power to change it, I would.

[mylovegoesdown]

Coppinger - try not to worry. Yes, the MH system is on it's knees in lots of ways but is still helping lots and lots of people and there are lots of people like me and my colleagues (who are usually my friends too!) who genuinely care about what we do and give 100% in really difficult circumstances.

[RipeningApples]

Coppinger, I am sorry. It didn't occur to me this could impact negatively on other vulnerable people.

[Coppinger]

Thank you for the apology, RipeApples. I hope you and your DD find the help she needs. Best wishes.

[erinaceus]

but not really applicable as dd hasn't had any care from CAMHS.

I am glad you found the link interesting. In terms of how applicable it is to your DD's situation:

Your DD is in the age range (16 - 19 years old) when, as a patient in the NHS, mental health care and treatment explicitly transition from being the responsibility of CAMHS to the responsibility of AMHS. At this juncture, patients can find themselves lost for reasons explained on the page I linked to.

The link I posted links to a document which describes this and addresses parents ("A parents' guide to transition") linked to at the bottom of the page. It is feasible, depending on how long your DD needs treatment, that she will enter "transition" and it could be useful to you as a parent to understand your, her, and the professionals involved in her care's various rights and responsibilities.

That your DD must be involved in any complaint made about her care and treatment is a consequence of the combination of her being the patient and her age. In mental health care and treatment, a 17 year old patient's right to confidentiality is paramount, and takes precedence over a parent's right to complain about their child's care. In my view, this is not a ludicrous setup.

[RipeningApples]

I think it is ludicrous as at this age parents are still advocating for their children/young people. Whilst I don't want the details of what my dd might tell medical staff I do expect on her behalf to be able to ensure the people providing care are doing so effectively. If I ask CAMHS for example why, with dd and I in the room, they told us she would be referred for counselling in the holidays, I think it reasonable for them to explain why that is not happening rather than allow them to hide behind "we can't discuss aspects of your daughter's care with you". DD isn't confident enough to ask those questions.