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Teenagers

Parenting teenagers has its ups and downs. Get advice from Mumsnetters here.

Why are CAMHS so fucking shit?

48 replies

Minifingers · 02/05/2015 20:48

Apologies for the length of this. Long history of posting here about my difficult dd, now 15 and in year 11.

DD was referred back to CAMHS recently (we had had a pointless 12 weeks of family therapy which achieved nothing a couple of years ago) after telling her counsellor/mentor at school at the end of last term that she was suicidal. School promptly banned her from the premises as they felt they couldn't safeguard her there. This means she couldn't attend any revision sessions over the Easter holidays or the revision residential for children at risk of failing maths and English.

I have been anticipating and predicting this deepening of her problems - I told DH six months ago that she would have a mental health crises as her exams approached, as she had to face up to the mess she's made of her education, and experience the horror of sitting lots of exams she's not studied for at all.

I know she's very unhappy. How could she not be, after 4 years of doggedly oppositional behaviour towards us and her teachers she's got used to adults being exasperated and pissed off with her, and her self-esteem is very low. She is massively cheesed off with having to get up and go to school when she doesn't feel like it. Sometimes she won't go. Sometimes she goes but then buggers off somewhere. Conversely she certainly seems to have a lot of laughs with her friends, is out happily socialising every day and has been most days since telling her counsellor she was incredibly unhappy, so I'm a bit confused about her mood.

She is out at friends' houses every evening after school pretty much and every weekend. When she's at home she is horizontal in bed on her lap-top, coming out of her room only to demand food or money, or both. We've recently told her we won't give her money. She also does no school work and won't lift a finger at home to help. We have offered to pay her to study. She has said 'no' firmly to this and instead threatened to shop lift or beg if we won't give her cash for doing nothing. She feels that we have an obligation to give her money because she needs to buy cigarettes, and feels we should give her the money for these because she's 'stressed'. I'm anxious about what she'll do if we carry on not giving her money as a few weeks ago she stole my bank card for the first time and went to get her nails done, because I wouldn't give her cash. I did get it back off her, but she hasn't returned the money, and I've now lost all trust in her. Incidentally, neither DH nor myself smoke and we are very unhappy about dd smoking, but recognise that other than not giving her money for cigarettes we can't stop her doing it when she's not at home.

The psychologist at CAMHS has said that she is experiencing a lot of anxiety in relation to school and GCSE's. My response: no shit sherlock - DD has spent the last 4 years being chucked out of lessons, disrupting lessons, in internal exclusion, not doing homework, truanting, doing her coursework at the very very very very last minute and handing it in late, if at all, it's inevitable that the chickens which are now coming home to roost are going to make her feel severely anxious as she faces up to the reality that she has to do these important exams and she's probably going to fail.

When I pointed out that anxiety might actually be an understandable and rational response to dd's situation, the psychologist implied that the anxiety goes back much further than what dd is talking about now. I'm at a loss with this as neither I, nor DH, nor any of dd's wider family (who she's close to) or her teachers (many of whom like her, despite her bad behaviour, because she's confident and amenable and bright when she's in a mood to be) would have described her as an anxious child. In fact, we all would have said the opposite - that she has always been an unusually confident and self-assured child, even in the last few years of bad behaviour, she's still not ever had any problem communicating her needs to adults, and has had good friendships.

CAMHS view seems to be that her behaviour is the result of anxiety and that it's also 'relational' - ie, that it's because we (me in particular) have a poor relationship with her. Pointing out to them that our relationship was absolutely fine until dd became hugely difficult and oppositional, and that it's deteriorated because of her behaviour, seems to be water off a duck's back. They just won't acknowledge that the very difficult behaviour preceded the conflict in family, and that the conflict in the family grew from it. I feel that unless they acknowledge this, and also acknowledge that her lifestyle (constantly eating junk food, no exercise, spending prolonged periods of time in bed but staying up half the night texting and using the computer, having no hobbies or any activities which don't involve staring at a screen) may also be hugely compounding her problems.

Anyway, since she's been back attending sessions at CAMHS her behaviour has deteriorated - she's going out more and more, spending less and less time at school, and doing less and less school work (well, nothing at all actually). They've put her on antidepressants. Bizarrely, after having made a really big issue about how important it was for us to take charge of her medication (to the point of the head psychologist phoning me at home telling me that I needed to take the week's worth of fluoxetine they'd given her on her first appoint) they then gave her a prescription for a month's worth of antidepressants at her appointment, and phoned me to tell me to get the tablets off her. I pointed out that I'd told them that she was profoundly oppositional - hadn't they taken that on board, and that it would be very difficult for me to get the tablets off her if she didn't want to hand them over. Predictably, neither DH nor myself has been able to persuade them to hand them over, therefore we now have a situation where a depressed 15 year old is walking around with enough medication in her handbag to properly overdose - given to her by CAMHS, despite their own concerns about the risk.

Anyway, sorry for the rant, but I'm so fecked off with CAMHS - what they're doing with dd is like pissing in the wind. I feel like we're in a chicken and egg stand off - they see dd's oppositional behaviour as growing out of anxiety and problematic family relationships, we see dd's oppositional behaviour as having come out of the blue in adolescence (she was an exceptionally happy, confident and easy child up to this point) and that all the other things - low self esteem, anxiety about school, unhappy relationships with us, as having grown out of her being so doggedly confrontational and uncooperative, particularly her refusal to behave reasonably at school. I want them to explore why dd is so oppositional and see what can be done to help her help herself, rather than just medicating her, and pathologising her totally understandable and normal anxiety, which any child would feel when facing sitting important exams they've done no work for.

Incidentally, please no one suggest we should have home schooled. I'm very pro home schooling. But we tried it for a term when we were in the process of changing dd's school, and it consisted of dd lying in bed with the duvet over her head every day telling me to fuck off because she wanted to watch tv.

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unweavedrainbow · 02/05/2015 21:04

This is hugely tricky. The thing is, and this is why CAMHS is behaving the way they are, anxiety to the point of not being able to function and suicidal feelings don't normally come out of nowhere, unless there is an emerging mental health condition, undiagnosed developmental/neurological condition or compounding environmental factors (bullying, poor relationships etc). At 15, CAMHS will be reluctant to diagnose a major mental illness and will presume that any developmental condition will have been diagnosed in childhood, so they will want to work on the relationships first before they start digging. Do you believe the issue is psychiatric? What about ASD/ODD? Children with ASD can "mask" in childhood and then break down in adolescence as life becomes more complicated.

SouthWestmom · 02/05/2015 21:12

Why would they be reluctant to diagnose a mental illness? We came across this and it was harder for the dc not to have a reason

BringBackCabinPressure · 02/05/2015 21:13

My parents would have labelled me as having high self esteem, confident, outgoing etc until I massively imploded at university and dropped out for the next 15 years. Yes years.

Actually I had huge anxiety which I'm only just facing up to now in my 40s, I just masked it.

I do remember being scared to sleep though because of the thoughts/worries and staying up watching tv and reading then not being able to function. And causing huge arguments when my parents found out. But I couldn't verbalise the anxiety because I didn't know that wasn't how everyone felt.

Not sure if this helps, and may well not be applicable or relevant, but maybe?

Levismum · 02/05/2015 21:15

I don't normally reply to posts but when I read your post it made me think of a condition called PDA. Explains her oppositional behaviour & the anxiety.

I deal with Camhs due to my son's difficulties so i fully appreciate how invasive & absolutely infuriating it is to be involved with Camhs.

PeaceOfWildThings · 02/05/2015 21:24

Thecschool banned her from the premesis because they could not provide her with adequate access to education for her illness? That is descrimination. It is very much their problem to deal with. Sue the fucking lot of them. Angry

unweavedrainbow · 02/05/2015 21:31

They are reluctant to diagnose major mental illness, especially mood disorder, in teenagers, as the milder (or sometimes less mild!) end of mood disorder can overlap with what they consider to be "normal" teenage behaviour and mood swings. Teenage apathy and prodromal schizophrenia can also mirror each other. Tbh, there is still a lot of "stigma" attached to mh diagnoses and they are trying (however misguidedly) prevent a child from being "saddled" with a difficult diagnosis that could lead to extensive services involvement (and potentially prevent them from doing what they want) when there isn't really a need for it. Add to that that many of the drugs used to treat major mental illness are somewhat heavy duty and not licensed for young people and it can all end up rather difficult.

SouthWestmom · 02/05/2015 21:34

Thank you for the explanation. In our case it's ocd and dc was left more stressed as they'd rather have had something 'external' if that makes sense - like , you have a broken toe.
Minifingers I have read lots of your threads feeling incredibly sorry for you. I'm assuming you've tried places like Young Minds for you to talk ?

Goldmandra · 02/05/2015 21:36

Definitely look into Aspergers in girls. Lots of girls mask and work very hard to fit in socially in earlier childhood but the social demands of being a teenager plus the requirement to organise and drive your own learning as you approach exams can become overwhelming resulting in overwhelming anxiety and panic and a total inability to cope or ask for help.

The average age for diagnosis of AS in girls is somewhere in their teens so it really is not unusual for parents not to have suspected a thing when their DDs were younger.

Minifingers · 02/05/2015 21:44

Her mood improves or declines according to what she's doing. If she can go out or have friends around she appears to be in very high spirits - laughing, mucking around, very chatty. If she has to go to school or do school work she's morose and angry.

I'm not sure whether she is truly suicidal or whether she's in a total state of crises about her exams and telling her mentor at school that she is suicidal is a way of throwing a bomb into the whole mess and stopping everyone putting pressure on her to study.

I have thought of PDA but would it come entirely out of the blue in early adolescence with not a hint of any problems prior to this? She has been seen by some very senior doctors at CAMHS and the only diagnosis has been depression (since being re referred) and anxiety (ditto), and TBH I don't see how a child could be anything other than depressed and anxious given the situation she now finds herself in.

I was reading her last primary school reports the other day and grieving for the child she used to be. The words they used - mature, happy, hard working, confident, high achieving, popular.... Where has that child gone?

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BringBackCabinPressure · 02/05/2015 21:47

Could there be a bit of fear of failure in there? High expectations on her, pressure to succeed (internal or externally imposed) leading to absolute self sabotage? Better to fail when you haven't tried, than try and fail?

Well that was my thinking with my Uni exams anyway Hmm

Minifingers · 02/05/2015 21:50

But Gold - I wouldn't just have said that dd 'coped' in social situations as a child, I would have said that she excelled - she had amazing social skills. Still does when she chooses to. She can talk to anyone. Engages in the warmest and most direct way I've ever seen in a child or teenager.

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Goldmandra · 02/05/2015 21:56

The words they used - mature, happy, hard working, confident, high achieving, popular.... Where has that child gone?

If she has AS, she worked very hard to maintain that outward persona and she's in crisis now because she doesn't have the resources to keep it up as well as keep up with the demands of school work and life in general. This is a very common scenario in girls with AS.

Better to fail when you haven't tried, than try and fail?

My DD2 has AS and this is a perfect description of how she responds to demands on her. It is the PDA aspect of her AS and it makes rewards useless as motivation.

Minifingers · 02/05/2015 21:59

"High expectations on her, pressure to succeed (internal or externally imposed) leading to absolute self sabotage"

We have never pushed her at anything. Ever. We were absolutely hands off in primary in the sense that we didn't interfere with her homework, do any extra work with her, tutor her, nothing. Ignored the SATS - no preparation at home for spelling or times tables tests nothing. She is musical but we let her give up piano and choir without making a big deal out of it.

Really we have never asked anything of her other that she attends school and behaves reasonably there.

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BringBackCabinPressure · 02/05/2015 22:01

Could still be internally imposed though ie by her not you

BringBackCabinPressure · 02/05/2015 22:02

Although my parents were hands off to extent I don't actually remember them even attending a parents evening - the only approval or notice I got was being top top and 100% in exams, and even that was grudgingly.

unweavedrainbow · 02/05/2015 22:11

It's unusual, but not unheard of, for high achieving, popular girls to drop out and do nothing. They're self destructing or attempting to regain control over their lives, like girls with anorexia or similar conditions. Normally there is fairly considerable expectation to succeed though, either from school or home. Internally imposed perfectionism generally has to come from somewhere, even if she just picked it up from society (ie "nice girls do well at school" or something).

Minifingers · 02/05/2015 22:12

We've always been interested and proud of dd's work. We've not been disengaged, just not controlling.

So many people have suggested ASD because of the oppositional behaviour, but I have read quite a bit about ASD in girls and except in relation to this it doesn't fit as a diagnosis. I have a ds with HFA and have done a bit of reading and learning about autism generally - it just doesn't work for dd.

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BringBackCabinPressure · 02/05/2015 22:14

It was only a thought Smile

ashtrayheart · 02/05/2015 22:20

You have my utter sympathy, I have 2 teenagers who have been thorough the Camhs system. They are actually being very good with my son who has severe OCD but no 'bad behaviour' but my dd was a different matter! I felt constantly blamed for her issues. I totally understand your feelings of the issues being caused by her behaviour not the other way round. Plenty of teenagers from loving supportive backgrounds have turbulent teenage years. I hope yours comes out the other end ok Thanks

ashtrayheart · 02/05/2015 22:21

My dd was incorrectly diagnosed with asd and I never felt it fit! It was later withdrawn.

duplodon · 02/05/2015 22:28

You can have biological and genetic propensities towards anxiety and perfectionism too. My ds1 says things that mirror my childhood OCD which I always believed were a reaction to my father's alcoholism when I grew up in utter chaos with minimal responsiveness to my feelings and he is living in an entirely different context, with structure, routine and open loving communication.

We know so little about these things.

You may not have ever intended to control or invalidate her, but sometimes parents and children are just poor fits for one another and intentions are .misread. One way or another, there will have been a trigger for this...it doesn't just come from nowhere. It's no one's choice or fault, but oppositional behaviour arises when your learning history provides you with evidence it works to get you what you want. I don't mean materially necessarily.

duplodon · 02/05/2015 22:33

Sorry posted too soon. The timing to me suggests peer influence, a traumatic event you don't know about or some undiagnosed neurocognitive deficit. As her ds has HFA I would want assessment of language and cognition,screening for subtle communication deficits, dyspraxia, dyslexia etc

Parietal · 02/05/2015 22:33

have you seen this in todays guardian
www.theguardian.com/society/2015/may/02/crisis-in-childrens-mental-health-nhs-insider-speaks

CAMHS just don't have the money & people needed to support children who badly need help.

Goldmandra · 02/05/2015 22:45

OK. You're clearly in a good place to make this judgement. I hope you get some answers soon.

Minifingers · 02/05/2015 22:47

Duplodon, there is definitely peer influence. None of her friends are hard working or ambitious. They have all truanted, and been disruptive at school.

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