Hannah Barnes did a beautiful explainer and Anna Castle was excellent. I was so very impressed by Will Smyth. Such important points made at such a young age and absolutely all credit to that young person and their family.
Thank god for Victoria Derbyshire keeping Chay on the point, what a relief to see normal journalism applied on this crucial topic.
Chay’s advocacy for it being fine to treat these distressed kids the same as adults was embarrassing. Also oddly immature thinking for an adult. Chay really didn’t have any points to make beyond saying that adult and child patients aren’t cared for together on wards. OK duh-that’s basic safeguarding, but we also look after the vulnerable adults on adult wards, Chay. We don’t (or shouldn’t) pretend all adults have the same needs, if we actually want to help them.
And then Chay’s big point is claiming it is ‘infantilising’ for anyone to question whether a highly vulnerable cohort of children and young people should not be put straight in to an adult transition service. There aren’t enough eyerolls for that.
Adult services were originally designed for the needs of much older mid-life adults, usually male transsexuals, with years of adult independent living behind them. Those older adults will have had a chance to live their lives, get jobs, move locations, have romantic and sexual relationships, find housing, find their adult tribe, reflect on how their families and education and their sexuality and beliefs have shaped their life, perhaps have had their own children. They will have seen how their own age group peers are living their lives. Crucially they will have met loads of different adult people living their lives in different ways. Many will have had the chance to have had years of professional psychological involvement before they ever got to adult GIDs.
In total all those years give adults an unhurried chance to really think in a realistic adult way about what they want as adults going forward for the rest of their lives. They will have a much clearer sense of who they are and think in an informed way about what will make them happy.
If this judicial review fails, the difference between a young person of 19 or 20 coming fresh off the street into adult services after being referred age 16) and a 16 year old getting the full benefit of the Cass-informed holistic approach of the future and then going into adult services or not, as a 20 year old, is going to be extremely stark.
I don’t want for us to have to wait to see the inevitable difference in statistics of irreversible transition between the holistic care and non holistic groups, before the NHS rethinks this policy as being an actually very leading and funneling way to provide a service. These are very young people with often complex vulnerabilities that adult services will soon be seeing in an inappropriately narrow way.
There should be children and young peoples services in GIDS until 25, (or until you get to the top of the list in that service even if you were referred just before your 25 birthday, so that a non-rushed holistic assessment can be made by them ). Then if you’re initially referred to GIDS as a 26 year old or over, then these adult services should begin to provide a lighter touch holistic approach for a minimum amount of time to try to identify and support the many vulnerable adults who will be finding their way straight to adult GIDS.
And as a final point we should not be relying on massive waiting lists to build in thinking time for children and young people. The system of care should do that with the appropriate professional support. If numbers of referrals go down over time or if the introduction of holistic care in children’s services means that more patients don’t reach adult GIDs, then what happens to these patients who aren’t going to be waiting for years to be seen any more?