Cahms appt today, please help me manage DS' expectations, need advice

[freckles20]

I want to start by saying I know Cahms has major issues and that many many young people and parents feel let down and angry with them. I'm feel for anyone needing help and struggling to access it.

DS (14) has been struggling for some time, has been seeing relate counsellor for 6 weeks. Most of this has been confidential other than them sharing with me that he has thoughts of suicide and scored very poorly on the mood scales.

Things have been very very hard, but to keep this thread shortish he came to me on Friday morning and said he'd had disturbing thoughts of suicide all week and in the night they were very strong.

Lots of phone calls later we have an appt with cahms this afternoon. Initially they wouldn't see him as when they spoke to him over the phone he refused to agree to a face to face appointment (but he did tell them how bad he's feeling). Later he changed his mind- hence the appointment.

I admit I did push him to agree to the appointment. I explained it's our best chance of helping him.

It's dawning on me that they are likely to send us away without any help based on what I've heard and read about cahms.

The doctor o spoke to on Friday was very cold, matter of fact and made no effort whatsoever to engage my son in offering and help- I felt like it worked to his advantage if DS didn't agree to seeing them face his face.

I'm really worried about eroding DS' trust in me by over emphasising the need for this appointment just for him to be let down by them. At the time I felt like I had no choice as I'm so worried about him.

Added to the mix is the fact that he is very private. He usually doesn't tell me anything of how he is feeling, despite my best efforts to be open and understanding- so day after day I can see that he's really struggling but I've little idea of how bad he's feeling and how close he is to any drastic actions.

Can anyone offer any thoughts as to how to manage his expectations wrt today's appointment, and what to say if they won't help?

Morning freckles20! I am so sorry your DS is feeling this way. I am a mum of late teens and a school counsellor and I completely understand your feelings about the situation. It is so hard when our children struggle. I can also vouch for the fact that this lockdown has been harder than the others for young people. The families I have been calling (I'm also an asst HOY) have reported a whole range of emotional states for our students - from ecstatic to be returning to school, to angry, to anxious and fearful, to depressed to the point of being in despair, all personal hygiene and routine out of the window.

CAMHS is the go to for kids mental health after the doctor. Yes, they are a massively overstretched service, yes some people have unsatisfactory experiences, but there are many others who have been helped.

If your child has thoughts of suicide suggests they have reached the lowest point. However, whether they have made a plan and have intention to go through with the plan is another matter and does make a difference. That said, things are about to change in terms of school situation which could have a more positive effect on his MH, getting out of lockdown etc but I'm interested as to why your DS has seen a relate counsellor - I presume that on top of lockdown there are relational issues with you and your partner that have affected DS?

With teens, you cannot make them talk or see a specialist. However, the fact he has been to a counsellor and talked to them for 6 weeks is a positive one. Your motivation is love for him - I'm sure he knows that but make sure you tell him this and this is why you are taking him to CAMHS. You have nothing to lose going to this session today. Often the first couple of sessions are the most difficult as there needs to be a relationship built between the practitioner and the child. At this point some kids back away but if they can, I try and encourage them to give 4 sessions a try before deciding they don't want to continue. If this is the first time you are seeing them, chances are this will be an assessment session and information gather - prepare him for this and that it may not be an actual help session. They need to triage his risk and decide on the most appropriate intervention.

If you get nowhere with CAMHS and if the counselling isn't really helping it may be worth finding a psychotherapist for sessions if you are willing to pay privately. I can't make an assessment without knowing the issues. Sometimes it takes 2 or 3 tries with different therapists before you find a good fit.

I hope you get on ok. I have known success stories of children helped through CAMHS where they have been the saving grace for kids who have then got through their bad patches. Remember - DS is on the early road to managing his mental health. I use the analogy of a toolbelt that you try and fill by trial and error trying different tools - we only start filling this tool on average at about age 12 as before that we relied on parents and their tools/reassurances. A lot of counselling in this age group is psycho education - explaining why we have the reactions we do to specific situations. It's normal to have a reaction to an abnormal situation. We have to learn how to manage those reactions and alleviate our levels of distress by building our toolkit. The distress somes when we haven't yet got the tool we need to help us in a given situation.

All the best for today

distress *comes

Have pm'd you.

@januhairyfebruhairy thank you so much for your post it was really helpful.

I really like the tool belt analogy and I'll chat to DS about it. He seems to hate talking to me about any of this, preferring to say he's fine when he clearly isn't. So him telling me about his suicidal thoughts felt massive.

I had been looking at the Papyrus website so I knew to stay calm and try to work out if they were 'just' thoughts or if he also has plans and intention. He said that he did, but he wouldn't share his plans. He said the same to the cahms contact in the phone, and they said that if he couldn't discuss his plans then they would assume he hasn't actually made any- that felt like a dangerous assumption to me.

The reason for using Relate is that in our area they are used to provide in-school counselling, which is separate to the usual relationship advice that they are associated with. I'm so grateful for their help but I feel he maybe needs more that counselling, and that after six weeks things have not improved which is a concern.

Have pm'd you. Hope it went ok today

@januhairyfebruhairy thank you.

I wanted to update in case it helps anyone else.

DS changed his mind about going at the last minute, he was sullen and said he was not going to tell Cahms the truth. We went anyway. It was really hard to make him go and I thought maybe it would be pointless.

I spoke to the professional first alone. He was really nice, he listened and seemed to understand. My concerns were not minimised.

DS then went in alone. I could not hear what was said but I could hear dialogue and even some laughter through the wall. I've no way of knowing how honest and open he was.

Afterwards the professional explained the options available and which he was referring DS to- which is their early intervention service. I think this is level two of four.

I hope it's enough- it sounded like level 3 was for severe MH problems and level 4 was crisis care. He explained that crisis care would be an immediate six weeks of DS seeing whoever was available to ascertain if he was safe and help with coping strategies. He was very honest and said that he though it might be difficult and frustrating for DS to see someone different each week and be asked the same questions over and over.

So I think what he will get is some counselling. He said he thinks DS needs help to correct some of his thinking patterns. I'm unsure of the waiting list but the professional gave me a number to call tomorrow and he said that they should give me some idea.

They definitely discussed suicide in some detail as the professional explained he had tried to explain how drastic that was and see if DS has really thought that through.

I'm wondering if I'd be better looking privately for someone for DS to talk to. I feel so much of it comes down to getting a good therapist who DS 'gels' with, and I'm worried about long waiting lists. I have a friend who works with a adolescents in a different county though and she really rates cahms expertise- but admits they are extremely stretched.