Can I, as a FC block them giving my LAC anti-d's?

[Gymbob]

My 14 year old LAC, has been told by CAMHS she has 'a low mood'. She hasn't being diagnosed with depression. CAMHS are likely to prescribe my fd anti-d's this week. I have asked if we can try other avenues first, like CBT, or even a placebo if they must prescribe. I do not believe she is depressed, and I'm not on my own, school doesn't think so either. Trouble is, CAMHS have asked her if she would like to start on them, and she is delighted and looking forward to it.

I am not totally against the idea for the right reasons, but I don't feel that they should prescribe anti-d's without exploring elsewhere first.

As a fc, what powers do I have, does anyone know. I mean, do I have the power to prevent them doing this or will I just be overruled?

thanks in advance for any advice or opinions

FC foster carer? LAC?

sorry FC foster carer. LAC looked after child x

Oh right

Have they actually said they will prescribe anti d's?

Low mood over a period of time is usually depression, isn't it?

Why would you want to stop something that would help her? Or do you want to explore all options first?

I imagine as she's only 14 they think she's pretty seriously depressed.

Don't the LA have PR, but you don't, so they get to decide?

Drama Queen CAMHS have said it's likely that the psychologist will prescribe them this week.

I'm not an expert, but I wouldn't agree that low mood over a period of time is depression - it's low mood. I don't think she's depressed.

Of course I wouldn't want to stop something that would help her - I said that in my original post, but nothing, I mean nothing else has been offered, no counselling, no placebo, no therapy of any kind. Surely that can't be right? If I didn't care, wouldn't I just let them put her on the anti d's, at least I might get some respite from the moodiness! What about the potential side effects, and besides there is evidence that talking therapy can be just as effective in some cases as medication.

George I think you might be right actually thinking about it

George - or don't the LA and me have joint PR?

I'm pretty sure you don't. Wasn't it covered in training or an info pack?

No you don't have PR. So you can't decide for her.

And unless you're a mental health professional it's best to let them prescribe them for her, they will very likely not do any harm. The waiting list for Cahms appts for therapy is ridiculous - can you access other services? Nspcc? School counsellor? Pay privately out of fostering allowance?

I'm also a fc who doesn't think anti-d's are the obvious answer but if they're not offering anything else it is something. And they're very unlikely to do harm.

PR is with the LA and parents on a care order. LA can trump parents if needed.

OP, what do you think depression is?

Drama this is straight from the dictionary:

'severe, typically prolonged, feelings of despondency and dejection.'

She does not have those symptoms. Why are you being so condescending?

Laurie I have accessed other help for her, and she thinks it's helping, but she's hanging out for the anti d's.

I'm not I asked you what you thought depression is.

Bowing out, good luck with everything.

Ok, she wants them then she should have them - that's simple.

I'm struggling to understand - are you really anti them?

If she wants them then they are likely to have an even greater effect as she will believe in them.

YABU. ADs and talking therapies are very rarely 'stand-alone' treatments. The most therapeutic results are most often achieved with a combination of both. As well as this, results from ADs are never instantaneous - nor are therapy appointments. Starting on an AD may mean that your LAC (how impersonal, I hate acronyms and labels) is much more receptive to therapy once it becomes available - CYPS services are stretched to the limit more or less nationwide.
With all due respect, it's not your place to over-ride experienced professionals, not to mention the wishes of a fourteen year old who, I assume, has capacity and Gillick competence.

OP I don't know anything about your position as FC but the charity Mind has a very helpful website and helpline - I wonder if that might be useful?

Here's what they have to say about depression

I am a carer and I don't know why you would want to deny her the help the professionals say she would benefit from. They don't just go to a dictionary like you have, they do a proper assessment and treat as indicated (where resources permit). The LA would not view interference from you on that level at all positively. Any other help you can get for her would be more effective alongside the medication they recommend. I do not intend to be rude but the fact is you are not the expert here, if this child were your own you could stop them, but not as a foster carer.

You can't give people a placebo in the UK. It's effectively lying to your patients. How could she have any trust in her treating team if she found out they gave her fake tablets?

The definition of depression as a mental illness is not that found in the dictionary, it's medically defined and low mood over a prolonged period of time would easily qualify.

CAMHS would not recommend an anti-depressant to a teenager lightly and presumably are offering other support as well (or know she is getting it elsewhere). Is she seeing a psychiatrist or psychologist or both? You mention a psychologist prescribing which would be unusual as if she is seeing a psychologist they would be offering talking therapies.

Is there a reason you are so against anti-depressants? Proposing she is lied to with fake tablets instead is very concerning.

What does the child's social worker think about the proposed medication? I'd be calling a meeting with both my social worker and the child's social worker if I had doubts about any medical treatment that I was uncomfortable with. Historically with all of the foster children who have been in my care, I've acted strictly as part of a team with the other professionals, and my views have always been taken into account with the other professionals in the team. This certainly isn't a time to strike out on a limb in my opinion.

Gymbob I understand exactly what you're thinking.

I would resist my DCs having Anti-D's too and want to explore other options properly. I don't claim to be any kind of expert but I have had prolonged periods of low mood in my life and there has always been a reason for it - something that could and should be resolved to make me feel better. Drugs may well have helped lift my mood but they woudln't have resolved the issues. If one of my Dc was feeling like that I would want to know we had done absolutely everything to get to the bottom of any problem before resorting to medication.

I know that in some cases depression doesn't have a "cause" as such but I do thing that in most there has at least been a trigger. I imagine a teenager in FC has more reason than most to be suffering from low mood.

I would also like the idea of a placebo and don't understand the outrage, It's a prove scientific fact and can help with all sorts of things. The treatment would be very real.

Psychologists don't (ordinarily) prescribe anti-ds, usually the psychiatrist as they have a medical degree.

I think the OP is getting a hard time unnecessarily on this thread, as she is merely showing concern for the girl in her care. Can I just say PR is with the LA on a Care Order, though they are meant to keep parents informed and take into account the wishes and feeling of the child or young person.

I can't understand why CAMHS are talking of ADs as only a GP can prescribe or a psychiatrist, but in a case like this a GP would not normally refer the patient t a psychiatrist. I think the way forward is for the GP to make an assessment of whether in fact ADs are an option, and if so, then they should be talking with the LA who hold the PR on the girl.

FatherTed and *MarathanFan - completely agree with you both.

CAMHS would involve a multi-disciplinary team including a psychiatrist.

I don't know any GPs who would prescribe anti-depressants to a 14 year old as it is a specialist area which is why she is seeing CAMHS.

Laurie I do not believe that if she wants them she should have them. In fact I think that is outrageous to even suggest it. My fd is a complicated case, and I don't believe that at 14 she is mature or wise enough to make these kind of decisions - much as she thinks she is. She has already mentioned to people on Facebook that she is going to be getting them, and she will no doubt announce that she has been prescribed them.

I have already said I am not anti AD, but I am horrified that CAMHS appear to be going to prescribe them because she wants them. They haven't even done a proper assessment. And even if they had I still think that resorting to medication - particularly for a vulnerable 14 year old - should be a last resort after all other avenues have been exhausted.

Kundry Placebo's are regularly used in the UK, they are not illegal, although the GMC do state it is against GMC guidance. I would hope that she would not find out if she had been given a placebo. I did take her to the GP at her request, as she didn't believe me when I told her that the GP couldn't prescribe AD's.

Fatherted I won't be striking out on a limb, don't worry, but I have made, and will continue to make my displeasure known. Unfortunately, we are between social workers atm, which is really bad timing.

MarathonFan Your support is greatly appreciated here. thank you

JoeDolan She is seeing a psychiatrist not a psychologist, the latter can't prescribe.

NanaNina Thank you for your support

Roshbegosh I don't want to deny my fd help - why would I. I am wanting the very best for her actually, which is why I am putting so much time and effort into this. I want to be satisfied that if she does get AD's, it the best option for her, and at the moment I'm not.

Shoewhore thanks for the link, it's very interesting.

Mrssmith I understand what you are saying about treatments, it makes sense to me, but I disagree that I should have to allow a 14 year old AD's just because she wants them. Yes, she has capacity but that still shouldn't mean she can have them because she wants them.

Drama apologies for being short [embarrassed]

Am trying to think of a time in 20 years of medical practice I've seen someone intentionally prescribe a placebo - it's never.

GMC guidance isn't something doctors muck about with, it's not guidelines that you can follow if you like but you don't have to, you HAVE to follow it.

And I doubt the psychiatrist's assessment was 'you can have them if you want them'.

Nowhere have you said in your post that she is not competent to make that decision though

Just because you don't think she is mature and wise enough to make that decision has nothing to do with it unless she's actually determined as not competent.

I have a fc that age who is competent to make decisions I personally don't agree with - multiple piercings, horrible hair dyes and make up - if she wanted to take anti d (and I've already told you I wouldn't be keen my job would still be to support her)

I think you're having trouble seeing what's your decision and what's hers (in concert with her medical professionals)

I've already been supportive of you on this thread and said I agree with you - but me agreeing with what you want is irrelevant. You don't get to make those decisions for her, you don't have PR and if she's able to make medical decisions then she gets to decide whether to take the anti depressants.

I'm very, very surprised you think what I said is outrageous

Feel free to come back and say actually she has extensive learning difficulties and isn't competent to make medical decisions

Because I would like to be able to support your position