Moving from CAMHS to adult services?

[blinkybell]

DD had a mental health breakdown a few years ago and has been seeing CAMHS for therapy weekly for a couple of years - they also prescribe medication, etc.

She turned 18 last year and she moved on to a transitional therapist who works between CAMHS and adult services (whilst CAMHS continued prescribing her medication) and then recently she was moved fully over to adult services and all support from CAMHS has stopped, including prescribing her medication.

We had an appointment with adult services a couple of weeks ago. Yesterday she received a letter confirming she had been put on their waiting list - the wait is 12 - 18 months.

Our GP doesn’t want to take over prescribing her current medication as they have ‘concerns’ about it, but nor do they want to prescribe anything else until she is seeing the adult services therapist in 12-18 months. Their only suggestion is for DD to start withdrawing from the medication so she doesn’t suddenly run out.

CAMHS have been great and prescribed 2 months to tide us over until we get this sorted, and as a last resort will prescribe next time if we’re desperate but we really need the GP to take it over.

Is this palaver normal?

It’s a bit frustrating that she has to stop the therapy that is helping for 18 months but I can always find her a private therapist if she needs it, but I don’t know what to do about the medication.

Adult care can be quite different. Is she guaranteed weekly therapy under adult services? Of not, finding private now seems sensible rather than in 6months time etc.

Can the adult psychiatrist prescribe the medication, or is that a year’s wait t be seen.

I have waited two years to be seen by adult services due a previous psychiatrist waiting and no provision for those deemed stable but needing meds.

OP I am so sorry this is happening to your daughter.

My daughter was diagnosed with juvenile bi-polar at 15 after an in patient stay at an adolescent unit. CAMHS and adult services worked together for a smooth transition over a 6 month period leading up to her 18th birthday. I have to say adult services has been a whole lot better even though it was something she was dreading.

Adult services are of the opinion her poor mental health was down to her learning disability. She has been stable for nearly 2 years and came off her last medication 2 months ago. If she continues to remain in good mental health she will be discharged in September.

Thanks!

I’ve spoken with adult services about prescribing and they’ve bounced me back to the GP.

DD is autistic and has really severe social anxiety which CAMHS were working on with her and we’d seen quite a lot of progress. Adult services has signed her up for specific social anxiety CBT and will then go from there.

She’s finding the transition quite tough, plus she’s got exams at college going on and some other stuff going on so is really struggling right now.

I’ve spoken to DD about speaking to a private therapist in the meantime, we found a really lovely psychologist while she was on the waiting list for CAMHS, but she’s very anti the idea at the moment, but we’ll keep working on it.

Thanks!

Sorry, x-posted

We have a specific team who works between adult services and CAMHS. The transition from CAMHS to the transitional team was perfect and nothing changed, she just saw a different psychologist/psychiatrist, and, stupidly, I had assumed that adult services would just take over and everything would continue with no real changes.

You need to ask the GP to make a psychiatry referral, though whether they accept it or not is a different matter.

Mental health services have always been lacking, but the system is barely functional at this moment.

I'm curious what the medication is that the GP won't prescribe? Even in adult services they would expect the GP to take over prescribing, even ADHD meds, anti-psychotics and lithium etc.

I'm an adult psychiatrist and unless we're actively changing medication we would expect the GPs to manage the actual prescriptions once things are stable - they are funded to do this.

We got the gp to continue prescribing as my son went to Uni. This seemed to work.

I wouldn't advise CBT for someone with ASD, from my experience. In my area there is no autism specific mental health support available on the NHS so the trust has to fund the cost of another provider, across county lines, as it has to be autism specific.

Thank you!

@Annabel28 Pregabalin.

The GP say they have ‘concerns’ as it can sometimes be mis-used.

It was prescribed by a CAMHS psychiatrist and it works so it would be a shame to have to stop it. The GP’s only advice was to start lowering the dose now as it is dangerous to stop suddenly.

The CAMHS psychiatrist has spoken to both adult services and our GP to try and resolve it, or even start on something else that they are happy to prescribe but they just won’t do it. CAMHS will prescribe again if we get desperate, but they can’t do it for 12-18 months

@BehemothWatermelon No, I’m not convinced, she's done CBT twice and got nothing from it. Adult services say that a more specific social anxiety targeted CBT should be more helpful.