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.

[erinaceus]

at this age parents are still advocating for their children/young people.

Not all parents advocate for their children/young person. This is true regardless the age of the child. Further, parents do not get to decide what is and is not confidential in the context of their child's medical care. To my knowledge - and I am happy to be corrected - this is also true regardless the age of the child.

RipeningApples you come across as both angry and exhausted. You might feel more supported on the Child Mental Health board. Your post is not about your mental health, but the mental health of your DD. In the main, MNers on this board post about their or another adult's mental health; MNers posting about the mental health of their children post on the Child MH board.

[RipeningApples]

It isn't true up to the age of 16.

Yes, of course I'm angry. What would you expect - a caring parent to accept it?

[RipeningApples]

But where do I fit? My daughter is an adult when it suits the NHS and a child when it suits them.. At all times to provide the minimum service possible.

[KittiesInsane]

It's pretty shit, isn't it, RipeApples?

DD has been referred to a counselling charity. They can't see her till September.

DS had a two-year wait as a younger child with severe anxiety and OCD, for someone with the right expertise.

He had a 9-month wait in the middle of his A-levels. We were told that by the time he got to the top of the children's waiting list, he would be over 18 and have to start again at the bottom of the adult waiting list.

Grab your private counsellor and start ASAP, if you can. I couldn't find one who was willing to take DS on without talking to him instead of me (and DS doesn't do talking to strangers).

Then try to put some of it out of your head and breathe. I think you're funnelling your anger at what's hitting your DD into being furious with the system (I speak as someone who's just got irrationally angry about DSA forms).

I wish you the best of luck with it all.

[KittiesInsane]

Should have said that the two-year wait eventually came up with the best NHS help we could have wished for - but it was a long two years till she was free.

[RipeningApples]

I am furious with the system. I cannot believe that a CAMHS nurse practitioner sat and told dd that an urgent referral to the counselling charity would result in counselling during the summer holidays only to find out that means it might start in 8 weeks, at the beginning of next term. Why be so cruel and dishonest, or possibly just totally incompetent. I haven't told dd yet. I think I'll let the CAMHS nurse do that on Monday. I could have sorted this out if the truth had been told four weeks ago - ah but four weeks ago our local hospital was trying to pretend they could keep her overnight against her will. For what? For a CAHMS assessment [needs a laughing hysterical emoticon]. A CAHMS assessment that would have resulted in nada.

I am going to cause the biggest shit storm I possibly can over this. I am so angry I can barely breathe. Tomorrow I may be calm enough to start drafting one heck if a formal complaint.

[SealSong]

I don't know why your directing your anger at CAMHS so much. Presumably the CAMHS practitioner was of the understanding that the counselling could be offered in four weeks or they wouldn't have said that. You state that the counselling was provided by a separate organisation not CAMHS - therefore if there was a delay in it being provided then that was outside the CAMHS practitioner's control.

Sounds like it would be more helpful all round for you to take a calmer approach to things.

[RipeningApples]

I'm really sorry sealsong but the CAMHS practitioner should know the time frames. No? If not, why not? Is that not their job. Why state x, when the truth is y. Why waste people's time. Who should I direct my anger and frustration at instead? I can't think of anyone else who should have known this information. The CCG have just pumped another couple of million into CAMHS here. Not seeing an improvement. This is far more about mismanagement than about lack of resources.

Anyway must get some sleep because I only sleep until 1.30-2am nowadays due to abject worry.

[SealSong]

Perhaps the four week time frame was what the practitioner had been told by the counselling organisation. Things change, however...maybe the counselling organisation had experienced a surge in demand. Maybe the CAMHS practitioner had made an urgent (four week) referral to the counselling organisation and maybe the counselling organisation did not agree it was urgent hence longer wait. Not CAMHS fault.

Anyway, I wish you and your DD well.

[OnceThereWasThisGirlWho]

surely the cahms person could have explained that there was a misunderstanding about the waiting list? Why just refuse to answer/fob off? And why is op expected to be calm about them being underhand in this way? If thy dont want people pissed off they should be hinest and make things as clear as possible, not hide behind cliches and half truths and misdirection.

FWIw op I undestand. I've cost the state thousands, hundreds of thousands probably and rising. Even 5 yrs of therapy would have been cheaper if applied at the right time over a decade ago.

[SealSong]

The CAMHS person might not have KNOWN that there was a misunderstanding about the waiting list though, if they just saw OP's DD for assessment and onward referral that would have been the end of their involvement...it's over to the counselling organisation then.

I'm not expecting OP to be calm, actually I understand her dissatisfaction, but her level of anger struck me as a bit unhelpful.

However if the OP does feel that she has been deliberately misled then I suggest she looks at the formal complaints procedure if she wants to go down that route.

Anyway I'm done here.

[OnceThereWasThisGirlWho]

Altho tbh Op I wish someone had given me a heads up on what the system was like. I'd advise ignoring the batteles in order to win the war, as it were. get everything you can in writing and keep a timeline of dates, appointments, names of who you/dd see. Just in case you later need to make a specific complaint (both areas I lived in you have to complain about specific incidents, a catalog of errors or more general issues don't fit their rigid complaints procedur). As the other person, ie. not the patient you are in a unique position to stay calm and be the organised one - as the patient it can be overwhelming and feel like you're bashing your head againt a brick wall.

[erinaceus]

It isn't true up to the age of 16.

I believe that both the points I made are true:

Regardless the age of the patient, not all parents are advocates for their children.

A patient's has the right to confidentiality regardless their age, unless it is in the best interests of the child to break confidentiality, in which case this will be explained to them.

Yes, of course I'm angry. What would you expect - a caring parent to accept it?

I expect you to be angry. However, not all parents respond in the way that you are responding. This is why I suggested that you may find more support on a board for parents of children with mental health problems such as the Child MH board here on MN. There, you might find suggestions for different ways that you could support your daughter.

But where do I fit? My daughter is an adult when it suits the NHS and a child when it suits them.. At all times to provide the minimum service possible.

Such as there is a role for you, it is a supporting one. Whether your daughter receives treatment from CAMHS or AMHS is not quite to do with what suits the NHS. It is more to do with what the NHS provide or are able to provide in the area in which you live, and the care and treatment that is deemed in the best interests of your DD. I do empathise. The NHS can appear capricious. Mental healthcare in the UK is notoriously among patients for being both in short supply and for treatment being challenging to access, whether the patient is in a crisis or not. The specific issue of your daughter being simultaneously a child and an adult is the issue described and explained in the Transitions link that I linked to.

[OnceThereWasThisGirlWho]

SealSong Why does it need to go down the complaints route though? Why not just be honest? Why do they act suspicious and like they're hiding stuff? They could even say "I don't know". When I was in hospital for an op, I was given a time to arrive but it was made clear that they couldn't gurantee when op would happen as emergenies would take precedence. Fair enough. Why don't MH services act in the same transparent way? Presumably the way different services are being run by different organisations [glares at politicians] will only make this worse.

Also, if OP is expected to have to go through the complaints procedure constantly rather than just being given clear information and explanations, it is she who will be fobbed off as difficult and not believed for constantly complaining!

Does anyone know if it's possible to have care overseen by a CPN or someone, whilst having private therapy? That would seem to be the best solution in this case. I'd always recommend going private for therapy if possible, but potential need for hospital or more support outside therapy would be very costly.

[OnceThereWasThisGirlWho]

Just to make it clear Seal I'm not trying to be argumentative or put down your personal pratice, but the way MH services operate seems utterly bizarre, counter-intuitive, and illogical, when you have not experieced it before (I'm sure some of it seems bizarre, counter-intuitive, and illogical from inside too!). Especially when one has had good experience with the physical health side of the NHS. It's just a completely different ball game and seems utterly baffling until you know a bit more about how it works.

[RipeningApples]

Ah well, sorry for having been angry. Although I think most people would be.

The nurse will call me tomorrow I think to confirm dd is being offers diddly squat by them for three months after the attempted overdose. Am playing out a frosty "thank you for letting me know, I believe you have dd's number and suggest you call her to tell her this yourself". Any umming and arring and I think I'm justified in telling her to do her own dirty work directly.

Seven page complaint letter now drafted noting every interaction in the last twelve months. 40 appointments, engagements, to try to support dd, notwithstanding the phone calls and research. Dd's still at school, still achieving but hits crises when stressed or something upsets her. Not hitting CAMHS thresholds after four overdoses although the three of no greater severity before this one didn't come to the attention of a&e. All managed by me and GP but this time, when dd presented at a&e, nope doesn't merit CAMHS urgent support still even though we were promised it would. If dd has overdosed in spite of two interventions of private counselling, a consultant psych and anti-depressants, you'd think she merited a bit of support after the local hospital tried to admit her involuntarily. But no, the best we are offered is charity counselling three months after the O/D.

Practising my calmest, iciest response tomorrow. Will certainly say that if dd escalates again and something serious happens that I will hold CAMHS responsible in the absence of any timely intervention. Literally steeling myself.

[dangermouseisace]

ripening applies I wouldn't be so dismissive of 'charity counselling'. As someone who has been in and out of MH services since I was a teenager, the help I received that wasn't on the NHS e.g. was through charity/university was the most useful. It is unfortunate that DD has to wait, but 3 months is actually a fairly short wait compared to many, especially in current times.

Does your daughter see you get angry about services/counselling etc or do you manage to keep this away from her?

[RipeningApples]

No, she doesn't see. My angry outlet is on here. The CAMHS nurse has actually said this morning she never indicated counselling would be provided quickly over the summer holidays. DD does, like me remember her saying that.

I don't really dismiss charity counselling but I would not have wasted time with the assessment for it if I'd been told in the first half of June that it wouldn't be available before September. That I not what we were told.

[dangermouseisace]

that's good you keep it under wraps- well done as it clearly frustrates you. I remember my parents being dismissive of CAMHS when I was a teenager which made me feel pretty hopeless- if they couldn't help me who could?

It might be an idea to agree with the next practitioner you speak to an 'actions list' to make sure that you are all agreed on what is going to happen next, and have it written down at the actual meeting/phonecall rather than wait for them to write their own version later. When I worked for social services I used to do this for my service users/carers just before I left to clarify exactly what I was going to do now, and the timescales (e.g. I will refer you to X organisation. I will send the referral this week; I will telephone you by X date with an update etc etc). It sounds basic but discussing these points meant that any discrepancies about what I'd said/what the service user thought I said/what I thought they wanted and what they really wanted were clarified and we both had something written to refer to. It don't think it is standard practise but I had in mind what it was like to be a service user, not knowing what to expect or when things to happen, or whether I remembered things right or not. And it meant I could be rightly held to account if I didn't do what I said I would!

[erinaceus]

I am not the parent of a child with a mental health problem, nor am I a mental health professional. Nonetheless, I have cared for and about friends and relatives who have been admitted to hospital following an overdose or other self-harm or suicidal behaviour. I remember how utterly powerless and desperate I felt. I cannot imagine the extent to which such feelings might be magnified when the patient is one's child, however much I try.

My angry outlet is on here.

As a constructive suggestion, one option is that you request that MN move this thread to the child MH board. You can do this by clicking on "Report" on your opening post and requesting that the thread be moved. You do not have to do this. I suggest it both because the MH board has helped me in at least one difficult situation lately, which leads me to feel somewhat protective of this valuable community, and because other posters have explained that they are finding your posts difficult or upsetting. In essence, you are expressing your anger and your expression of your anger is having an effect on this community. I personally value this community, hence the suggestion that you move your post, an effort to protect the community from distress.

It's a small-scale freedom-of-expression vs responsibility-of-expression type argument. The talk guidelines remind us "how difficult this parenting business can be, and if there's one thing all of us could do with, it's some moral support." I am suggesting that you might feel more supported on the child MH board.

[RipeningApples]

Sadly dd is neither a child nor an adult at 17.

Point taken. I won't post again. Waves a cheery goodbye.

[OnceThereWasThisGirlWho]

Don't disappear RipeningApples. Despite DD potentially being under adult services, the child MH forum may be better from the point of view of speaking to other parents in a similar position.