Feel like I am in a deadlock with CAHMS

[ahatintub]

These last few months have been distressing, with my younger brother (teenager) seemingly developing poor anger management issues and can't seem to concentrate on any task. The lack of house work done by him and him not going to school while issues, what is more problematic is that he is aggressive and physically harms mum and dad and since he now sleeps much later than others, they can't have any proper sleep since if they aren't awake he might harm them.

He was referred to CAMHS several months ago and one would expect them to act more decisively since he is already diagnosed with autism but it seems they are keen on making this into what feels like a pointless endeavour since they referred him back to the GP who referred him back to CAMHS.

Has anyone else been able to escape deadlock like this?

Does your local trust have a separate service for autistic children/teenagers? Some do and if they do then the CAMHS services will automatically reject à GP referral for an autistic child/teenager.. Obviously they should transfer the referral to the correct service but many jusr send it back to the GP.

autism.org.uk only shows the local CAMHS and the child development service
Also, by local trust do you mean the local NHS trust?

Realistically, there is not a lot anyone can do. I expect that is the issue

Does DB have an EHCP? If so, he needs an early review. An EHCP can include provision that DC wouldn’t otherwise get a the NHS. If he doesn’t, an EHCNA needs to be requested - IPSEA has a model letter you can use.

Has DB and your parents had social care assessments? A carer’s assessment from DM &/or DF and an assessment via the disabled children’s team for DS.

Depending on DB’s needs, have your parents looked at children’s continuing care funding?

Of course there is more that can be done.

such as what?

To name a few ways further support can be given:
-SEP and a more appropriate placement (or EOTAS) via an EHCP - needs an early review or an EHCNA requesting if an EHCP isn’t already in place.
-If CSA, provision under section 19 of the Education Act 1996 whilst an EHCP is finalised/improved.
-Therapies (e.g. OT, SALT, MH therapies) and other therapeutic provision - via EHCP or otherwise.
-Home OT assessment to ensure the home meets DB’s needs the best it can and improve safety.
-Social care support - carer’s assessment and assessment by the CwD team.
-Medication to help with sleep. A referral to a sleep clinic if necessary.
-In a minority of cases other medications are used (e.g. small doses of risperidone or similar are sometimes used in extreme violence in autistic DC)
-Depending on needs looking at continuing care funding.

half of these are nothing other than ways to put in place various mitigations which in all probability don't even exist, and the other half are likely to be useless.

People expect miracles, but often there are not answers

Every single one exists. No one expects miracles. No-one has asked for a magic wand. But everything on my list can help.

maybe, a bit, to some people, but this is a violent and destructive teen, no, I don't think anything on your list is going to make any difference. You are talking about an EHCP, for example, that is not anything in itself, it is just a list of other things, and those other things might or might not be completely useless - all those therapies, for example - have you ever known any of them change a single violent teen? I have not. I have come to the conclusion it is just the modern equivalent of witch doctoring. And care funding? Just moving the problem onto someone else, who has to agree to take it on voluntarily, and why should they?

I don't think any of this helps. Sure, it generates many hours of busiwork, but nothing constructive.

Everything on my list, including SEP in an EHCP, can help a violent teen. Yes. Of course it can help. Continuing care funding is not about moving the problem to someone else. It is about providing the care and support a child needs and supporting the family so a child’s needs are better met.

Do you think DC with other disabilities shouldn’t receive the care, SEP etc. they require or is it only certain disabilities you discriminate against?

Having seen your posts on other threads, it is abundantly clear you have very little knowledge of SEN despite claiming to be a SENCO, so I will take your posts with a pinch of salt.

Have you checked your local CAMHS criteria?

If the GP sent in a referral and they sent it back, it sounds like they rejected the referral.

I think you are very naïve, and unrealistic. I am sure you very much want to believe these things work, but in my experience, they simply generate paperwork

I’m not naive. I support other parents with these type of difficulties day in, day out. My posts are entirely realistic. I also have disabled DC in receipt of such provision.

If your posts on other threads is anything to go by your experience and knowledge is extremely limited.

Alternatively, I have had a lot more experience and am a lot more realistic than you. I deal with people like you every day. They learn the reality of the situation, eventually, and stop giving false hope, and chasing imaginary cures, and get down to what can really be done, in real life, which is very little, once you have reached this stage. Many children grow up eventually.

The key for children heading down this road is prevention, rather than pinning hopes on a non existent "cure"

Given your posts, I highly doubt you have a lot more experience than me. My posts are reality. I am not giving false hope or imaginary cures - did you ignore the part where I said no one had asked for a magic wand? Can you quote exactly where I said I wanted a ‘cure’. As anyone with an ounce of knowledge knows you can cure autism.

I've been at the forefront of research, training and delivery for 40 years, and raised umpteen children with SEND. How about you?

And yet, you don’t know how the avenues of support can help DC and families or how executive dysfunction, motor planning difficulties, anxiety, demand avoidance, overwhelm can be relevant to someone with ASD and dyspraxia or why DC ...

I have supported thousands of parents on MN and IRL navigate the system and secure exactly the provision and support detailed in my pp. I also have disabled DC myself who has the provision and support in my pp.

OP - I’m sorry sounds a tricky situation.

Are your parents receiving dla / caters if you’re in the uk?

maybe your brother is in burnout and needs to rest. This can take up to a yr or more. Maybe all demands from your parents need to be removed and him just to drink / eat / go to the toilet and then he will heal. I could never make my ASD tidy up takes too much energy for him - not worth it imo. Maybe the aggression is because he can’t cope - let him relax for a long time. Yes it’s unfortunate for the other people in the house but he needs rest for his mental health.

Also, school that can wait. Mental health more important. Although the LA are responsible to provide the education if he’s been out of school for 15 days. Maybe it was the pressure of school that tipped him? Was he in a mainstream school? Special school?
Or maybe hormones are playing up too.

I think the only way to get help is paying privately, unfortunately too many children need help now within cahms…. is that an option? Can be expensive but can be worth it. (Yes you shouldn’t have to but maybe it’s worth paying for it - who knows)

adhd meds / like other meds have their ups / downs whilst trying to get the perfect dose so that could take some time.

Hopefully your mum and dad can play tag team so at least one person gets some sleep. They need to remove all demands for your brother to gain energy. Does he like game?Or what is his passion?

viv Dawes ASD burnout on Amazon is a good book

There is some helplines to call if he is really getting out of control / an and e if he will go …. Everything is just too slow unless you’re at crisis point.

which county you in?

Good luck

I think posting this type of extreme negativity is unhelpful. If you are not deliberately trying to spread unhappiness, this style of posting should be reconsidered.

There are many things that can be tried. No one is discussing miracles.

@OvertakenByLego and @Sidslaw
Take your argument elsewhere! The OP is asking for help, she sounds pretty desperate. Your bickering over who known the most about SEN is frankly pathetic and extremely unhelpful! @OvertakenByLego list she posted is very useful, but it’s full of acronyms and jargon that the average person in the street has no idea about. The OP would find it more useful if you explained your suggestions more clearly, and signposted her to where she can find out more.

This ^ our gp referred DS2 to camhs as he was struggling, they rejected the referral, they were only accepting referrals for young people at risk of suicide. We paid for private counselling. This was a decade ago, I expect the service is even more stretched now. Wishing you all the best OP, I hope he gets the help he needs.

And I am warning the OP of the truth, none of this stuff is going to make much difference, it is all busiwork, and paper work, nothing is particularly effective at this stage, but a lot of children simply grow out of it.

By all means, try anything you want, but if you pin your hopes on any of this, you are likely to be disappointed - better be prepared for that.

I think we/you need more information. What else has changed for him, at the point this behaviour stated? Was it just age, has he always had a tendency to aggression? What triggers the behaviour, look at what is happening just before and what is the response to the behaviour. Is autism the driver ( is he genuinely losing it out of fear/frustration/demand avoidance?) Or is he too powerful in the home and too much in control? It sounds like you think he needs therapy but what? Is it family therapy or do you think he needs to share his feelings- things like psychotherapy are very very difficult for autistic teens to use well and is unlikely to be the answer here. If you think medication is the answer, at his age he'd have to want to take it, and then you are back to issues of control and demand. I recommend you think of these answers and then speak with your local SEND parents group for more advice.

last time I checked, no one grew out of being autistic.