What should I expect from the school for dd who has been having mental health issues?

[Sara2000]

Dd has had a significant time off already following a mental health crisis. We were seen by tier 3 CAMHs last week who suggested I ask for a meeting with the school to discuss what support they can put in place.

I know they have mentioned a "safety plan" which would allow dd to leave the class as long as she stays in sight of the teacher and have assigned 2 teachers for her to go to if she is struggling. Is there anything else I should be expecting from them? At the end of the day they are a large secondary school , not a mental health team but I wondered if there are some standard pastoral care supports they might have available. School is a massive trigger for DDs anxiety but we are trying to get her back in if we can.

Does the school have a "quiet room" or somesuch? This kind of option is extremely helpful, particularly if your DD gets overwhelmed at times and I would ask that she be able to use that whenever she needs to - my DD found it hugely reassuring, even if she didn't use it a lot, she knew that the option was there, iykwim. I would definitely ask about that.

Also, if possible, could the CAHMS team liaise with the school? CAHMS can offer advice to the school, and it's good to have a conduit of information. Also, CAHMS can back you up if, say, you request her hours or courses reduced.

Why does she need to be "in sight of the teacher"? She's not in primary school. Could I ask what year your DD is in?

OP, I really feel for you. Been there with my own DD, who has made an almost full recovery. Solidarity.

Thank you. Shes 15 and in year 10 . I think she has to be in sight as she has expressed suicidal thoughts. I will ask about the room and also CAMHs getting involved in the meeting.

Do you mind me asking what helped your child and does she have ASD? I have this feeling my dd does.

No, I don't mind at all. My DD doesn't have ASD. We were very lucky to have been assigned an excellent therapist, who met with DD once a week. There was quite a bit of stuff that still weighed on her from primary school (bullying) and she needed to work through that. The therapist also met with us separately to support us, and help us through this. I thought this was unnecessary at first, but it turned out to be incredibly helpful. I know very well the intense worry you live with, every hour of every day, and sometimes you need to have someone asking how YOU are doing.

Music helped - she plays two instruments, and also listens to a lot of music. The school was really supportive and took the pressure off her by allowing her to drop a course, and allowed her the option (not always taken up) of coming in late one day a week so she could catch up on sleep (she was constantly tired). She was in Y8/Y9 though, so that might be more difficult in Y10.

Mostly though, it was time. With time, she got better. She began to have "good days", and those came a bit more frequently, until the good days happened more than the bad.

It's really alarming, as a parent, to see your child so distressed - you want to make it all better. You can't. You can only be there for her as a calm and loving mother, sometimes listening to DD, sometimes just silently holding her and stroking her hair (I did that a lot). Have faith that this will pass, and she'll come out on the other side.

And please feel free to DM me if I can offer any support.

Thank you so much. It is horrendous. I feel like I'm fighting an invisible enemy and have no idea where to start. CAMHs were ok , but it all felt too vague. I want concrete answers. I think she has anxiety and depression but I dont know. Did your DD have CBT?

Oh God, I know! It is horrendous. But it won't last forever, and you will get her through this.

Did CAHMS not give a diagnosis? You should have that and a treatment plan at the very least. If you're unhappy with what's on offer, then you're going to have to advocate on your DD's behalf for something better.

Again, we were fortunate with our therapist. She didn't do CBT but psychotherapy. We considered medication, but on balance decided against.

Sara sorry you are going through this. 💐.

My Ds is 16 and was diagnosed with ASD last year. This late diagnosis and lack of support in education has caused significant mental health difficulties. He tells me he is traumatised by his school experiences. He's just moved schools and things are awful at the moment.

He was rejected by Camhs at the start of the year but after a re-referral they have now agreed to see him.

They did a phone assessment this week and he was unable to talk so I gave them an overview of what is going on. Within a couple of hours of me talking to him the mental health nurse had phoned Ds's school and told them he expects them to work in conjunction with him to support Ds.

He mentioned to me about CBT to help Ds come to terms with his autism diagnosis. He has already talked to the practitioner at Camhs but she feels that Ds could not cope with it at the moment as he is severely underweight.

I completely understand how you are feeling. It's been almost impossible for us to get support for Ds's autism and mental health difficulties.

On sight of teacher because suicide risk

I thought that. What a horrible thought.

I had similar and we just went private. Expensive but faster and better.

All schools should have at least one mental health first aider if not many. Their PHSE program will include MH provision and the push in schools presently is MH support. They will be paying into external support already if they have little in-house provision. Either way speak to SENDCO about what support you think would be helpful. In sight of teacher or someone is normal safeguarding procedure.

Sorry you're going through this. It sounds really hard.

In non-covid times my school would typically have any of the following available, depending on the child's situation:
Time out card
Nominated members of staff
Appointments with a mentor or counsellor (we have our own team of support staff, usually for those who can't get in with CAMHS)
Access to a quiet room in the learning support base
Some flexibility with homework and deadlines where possible

However, with Coronavirus measures that's much more difficult to do because:

1. Year groups are in bubbles so we can't have students from different year groups mixing in the quiet rooms
2. Rooms have to be cleaned between use so that's an issue for some of the areas in the support base
3. Social distancing means that some of the counselling rooms (really small offices) can't have more than 1 person in them so they are off limits
4. There's staff isolating and off with health issues so we're struggling to cover the children with EHCPs, with no staff spare to staff other areas

There's no easy solution at the moment I'm afraid.

MH is the top priority in schools at the moment. There has never been a better time to be requesting help.

Thank you all.thats given me lots of food for thought. I am so sorry to hear about your DS @Punxsutawney. That must be so difficult.

I feel we've been quite lucky as we were seen by CAMHs within a week of being referred, but it was just an assessment. I think that was because she was making threats of suicide and actively self harming. The psychologist said they would contact me next week with a treatment plan but hinted it would be CBT. I have found someone privately who can do that.

Dd had an ADOS assessment last year but didnt meet the diagnosis threshold. However , I am sure its ASD. The bit where they tested her came out over the diagnosis threshold, But the bit where they asked us how she was as a baby and 4 year old bought the score down, as I dont recall her missing any milestones, playing in an unusual way etc. Althiugh her primary school commented on her playing alone when she was in reception but it seemed to be a one off comment. I'm.not sure if all this is because we gave the wrong answers as we aren't remembering it clearly or because girls dont always show those early developmental markers. However , CAMHs said she could be seen by the psychiatrist if the CBT didnt work so maybe we can talk about it again then.in some ways I think it would be best not to know at the moment as I dont think DD would cope with that diagnosis.

I got some more information out of her today and it seems the triggers at school are noise and crowds. I dont think the school will be able to do much with CV19 other than the plan they already have. I am sure this is the last thing they need and I don't want to be a PITA.

The psychologist suggested we should apply for an EHCP as her processing speed is only 2% but I'm not sure about that. She does well at school despite it. Well, she did when she was there.

Sara Ds is going throw the EHC assessment process at the moment ( well he would be if the LA bothered to contact us). He does well academically too despite everything else going on. He's struggles to communicate and is completely overwhelmed with school though. So it maybe worth you applying for a EHCNA.
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I think many young people with a late autism diagnosis have masked and coped for so long they just get to the stage when they can't cope any longer.

Yes I think you're right. I might give it until half term and the raise that with the school.

If you feel there is a missed ASD diagnosis then I'd strongly recommend you ask for a second opinion - from a neighbouring health authority, if necessary (they usually have reciprocal arrangements). Is this the same branch of camhs that assess for ASD? If not insist on a referral back to the neurodevelopmental team.
The underlying reason for your DD's anxiety needs to understood and supported.
School may have access to an educational psychologist or autism/ social communication team who can also support them. Diagnosis isn't usually necessary to access this
CBT can be effective for people with ASD if this has been offered but really needs to be done by a therapist skilled and experienced in working with autistic clients

Thank you. Yes it was the same Borough, but this time it was tier 3 instead of tier 2. I felt the psychologist we saw this time also thought ASD jusy because he said "what happened with the ADOS assessment last year?" I told him I knew it was our scores that had bought the overall scores down to below the diagnosis threshold. So he have me a social communication questionnaire to co0mplete as a test to see if tier 3 team would assess her. It was asking questions about when she was 4/5 such as did she have eye contact , have to and fro conversations or about when she was a baby did she point at things. I answered as best I could given it was 10-15 years ago and he said her score was no where near the threshold to be seen by the hospital team. I just look at her now and this k she is the stereotype girl with ASD. Deep thinkers, analyses everything, sensory issues, avoids social interaction other than a carefully cultivated group of friends online, long history of struggling to make friends at school from around year 3 , totally socially isolated in year 6, she will only go out now if she knows where we are going first.The list goes on.