Teen dd took overdose, cahms are useless

[umbrellasusie]

14 year old dd took a paracetamol overdose today. Her mental health has been bad since starting high school. We strongly suspect she has adhd. We have paid out our arses for private assessments, it's looking likely she has it (waiting on report) but the dr can't prescribe meds until she is seen on the nhs. We can't afford private meds.
Today, cahms came to assess her. They said she doesn't meet the criteria for a referal because dd regrets the overdose and they don't think she will do it again. They said they could put in a referral but most likely be rejected. Dd also refused a referal as she thinks she's fine.

Dd is far from fine. She has no impulse control and acts out first, thinks later.
One negative comment, or bad day can send her spiralling. She's not doing well in school and needs constant hand holding because of anxiety.
Cahms told us that the gp won't medicate dd for anxiety, only put in a referal.
Dd will not open up and finds talking about problems a real issue. She hates talking and refuses all talking therapies.
I have no idea where to turn or what to do.

Keep her talking as far as possible, keep letting her know you are there , is there an adult at school that she trusts ? Do you keep regular communication with them?
Be kind to yourself, this is very hard on you too x

Could you consider keeping her at home if school is having such a bad impact on her MH? I know is much easier said than done

I'd contact mind's infoline when they open tomorrow (9-6 Monday to Friday, the number is 0300 123 3393). They can advise on the best help options near you, what do to next, what services to get in touch with etc.

Does she have friends at school? Would moving schools to a specialist mental health school be an option at all? We were in an almost identical position with my eldest, and I wish that we'd moved her to one. I know that this is not a quick process but it might be worth looking into. Are the school aware of what is going on with DD? (I assume so if she's getting support with her anxiety). Where are you located?

Please make sure to take care of yourself too, it's very tough 💐

@fruitypancake yes, she clings on to a teacher at school who she sees everyday to check in, but after speaking with her today, she won't open up to her or anyone either. She just keeps saying she's fine. She dances around the issues without getting into it.
She is a total avoidant when it comes to closeness, and opening up.
The teacher and I talk often, so we both know what's what.
Dd likes to tell me regularly that I don't understand, and throws it in my face. But I can't understand if she doesn't tell me anything.
Her home life is pretty solid, happy. But she struggles to cope with everyday tasks, and not coping at school what so ever.

Stop sending her to school

@xmasdealhunter yes she has friends at school
But she has now fell out with two of them and any negative comment or negative interaction can send her into a dark place, very anxious, and out of control. I cannot get through to her when she's like that. Nothing anyone says or does helps her. She completely disengages.

She is in complete denial about everything. Sat telling drs today that she's fine and isn't thinking about harming herself, yet she did.
I can't home school her as I have to work and also have a toddler at home.

@Nollybolly6 and do what with her?

I'm sorry OP. I went through this with my brother (he was living with me at the time) and it was so hard.

From personal experience, she may keep trying until she gets the support she needs. Keep a close eye on her - move any painkillers/knives/razors. Keep pushing for support, and when/if anything else happens shout from the absolute rooftops that you need more support/aren't happy with what they'd recommended. With DB it got to the point I needed to refuse to take him home, and they had to find him a bed in a mental ward (which is what everyone knew he needed but no one would sign off on until he had nowhere else to go!)

Do you live near any Cambian School site? They are specialist mental health/ADHD schools. Asperger, Autism and SEMH Schools near me | Cambian Education It might be worth giving them a ring as well as mind to discuss options, to see if it's a potential route worth looking into?

Work with her to make a crisis kit. Which is a box of things that will help her to regulate when she is distressed/overwhelmed. She can keep that at home.

Have a mini version, that she keeps with her. I'll find a link which explains what it is and what to put in it.

Get a safe for the house, and keep all medication in there. If she's impulsive, you need to be able to prevent the impulsive behaviour. Going to a shop/finding paracetamol puts time between the impulsive decision and the action - time to change your mind.

Have a look at the neurodiverse DBT book, or the anxiety gremlin books. I'll look for the links.

The medication isn't that expensive, and made a huge difference for my daughter. So it may be worth looking at that option. And looking at a clain for Disability Living Allowance - which can pay towards the medication.

Get her on the waiting lists for the NHS now, if she isn't already.

My daughter had quite a few months out of school, at various times over the years. She's at Uni now. She's still up and down, but things are mostly better than they were.

Removing access to phone/Internet overnight to aid sleep/stop the drama at bedtime.

Go back to the gp, they might at least have some further ideas of where to refer.
She might benefit from some cbt?

https://cahs.health.wa.gov.au/For-families-and-carers/Resources/Library/Emotional-first-aid-kit#:~:text=Every%20person%20is%20unique%20and,fidget%20toy%20or%20a%20game.

https://www.amazon.co.uk/Starving-Anxiety-Gremlin-Behavioural-Management/dp/1849053413/ref=asc_df_1849053413?mcid=0eec92bde70e3996ada9f1d846377600&th=1&psc=1&tag=googshopuk-21&linkCode=df0&hvadid=697181752995&hvpos=&hvnetw=g&hvrand=7287889713471931707&hvpone=&hvptwo=&hvqmt=&hvdev=m&hvdvcmdl=&hvlocint=&hvlocphy=9045402&hvtargid=pla-641864455112&psc=1&gad_source=1

https://www.amazon.co.uk/Neurodivergent-Friendly-Workbook-DBT-Skills/dp/B09S9JBS8G/ref=mp_s_a_1_1?crid=18PZWCGH7513Z&dib=eyJ2IjoiMSJ9.pfFZKebwc1WJFNsCHdGWrYNr857f3SXrw0qg-VmxwSxbQCxP3rmiqH0ksTgt-Alp_Z4CWcy4wnnkwId_wNPmJan014GYwQ2Jt2IqqcUrTtRsqrB1_m7lI6sIGSCj2ui0hdwCGujiw4w3WwQM4EDy9whtE8Q_XdqD4WASblPAFSao_PVSsHstf6enUv8w-Vw5R8HwgrbnGf84T8gjTCG_Hw.q0RVDVidp6cXyJdxmsNzDIPpCxRWQtoBrVlkpo-ajdY&dib_tag=se&keywords=neurodivergent+dbt+workbook&nsdOptOutParam=true&qid=1736377999&sprefix=%2Caps%2C146&sr=8-1

Sorry for the shit links

OP, I've been in your shoes. It's a long path so big hugs.

Ask GP for a referral to any other services, or re-refer to CAMHS if harming means lower tier services won't accept. Although even when you do eventually get help, it's a few sessions of CBT which a lot of ND young people simply can't engage with.

Get a lock box for the medication. If she's determined, she'll buy more, but it reduces the impulse option which tends to be strong in ADHD.

Let her stay home from school. Contact safeguarding lead at school. Ask for alternative provision on medical grounds. Don't off-roll her. You want appropriate education to be the LAs problem not yours. The current school is damaging your child's health and is not suitable.

Her overdose is her way of saying she's not being heard. Our daughter now messages the poop emoji if she's feeling scared she might harm herself, and I know to drop everything and take her for a drive - she's safe, the motion calms her and she talks in the car. She also has a sensory first aid kit like a PP mentioned, that tends to work for lower level anxiety not the full blown panic attacks.

Apply for EHCP - it's based on need not diagnosis. You'll likely get rejected first time but keep going. Current school is not appropriate, can't meet need.

Did ADHD assessment rule out autism? There's a big overlap and anxiety tends to be very high in autistic girls especially. The timing of high school is familiar. Can she explain what she struggles with at school? It took my daughter a couple of months to start opening up, but once she could articulate what was hard, it became clear her school would not be able to meet need - look up EBSA as there's a list (or cards) of push and pull factors.

If you can show that you spend a lot of extra time helping her that is not typical for a 14yo, then apply for DLA. It's need not diagnosis, although any assessments help as evidence. It'll take about 4-5 months right now but if approved money is backdated. I took out an interest free credit card, paid for therapy on that, then cleared the balance when the funds came through. I was pretty certain by the time I'd finished the application that she'd qualify at least for lower level if not middle.

Don't panic about education / GCSEs at this point. Her health is more important and there are options (my daughter should be in yr 12, she's instead at a specialist centre taking 5 GCSEs in one year as she couldn't manage to sit anything in yr 11 and had only one term of education in yr 10.)

If you can afford it get some psychological input for the anxiety and self esteem. Doesn’t have to be talking therapies if that’s not her avenue. Highly beneficial at this age.

any creative/artistic/sport outlets for her? Often helps with impulsivities and belonging/opening up.

Firstly put any alcohol, knives, tablets under lock and key. Consider ligature risks

In the event of an overdose (or other serious self harm) take her directly to A&E and refuse to take her home till she has been assessed by a consultant and given medication for adhd/depression. Check the NICE guidelines and ensure they are followed. www.nice.org.uk/guidance/ng225/chapter/Recommendations#initial-aftercare-after-an-episode-of-self-harm

GCSEs ramped up the pressure on my child, who felt completely overwhelmed and then anxious as a result. We found CAHMS useless and realised we need to be the driving force help wise. Look at different types of therapies - Art and drama. Also look at day to day physically grounding activities which help take her mind off things and make her feel good. Cooking, DIY, gardening, crafts, non competitive exercise, walking, animal care, seeing friends and so on.

We got help through the ED clinic. Eventually got a psychiatrist assessment through them after much hoop jumping and now my child is on medication which has been a real game changer. So positive!

Start to apply for an EHCP yourself, don’t wait around for school to do it. Get professional input.

Is she at the right school? Ask your local authority (incision officer?) about alternative provisions for gcse aged children who present as suicidal. Stay away from school behavioural units as a calm less pressurised environment is key. If you can afford it, look at more rounded alternative home school provisions or dyslexic friendly fee paying schools where support and understanding are central. Check if your local college has any 14-16 provision. Try to find a setting which will feed into her interests, whatever they are.

Only off-role her as a last resort, push the LA to provide.