Tag Archives: camhs

Should charities be propping up statutory services?

In the past few days, the closure of Kids Company has dominated the news. To an outsider, their rapid demise has come out of the blue. There were undoubtedly financial issues as Kids Company struggled to keep up with the volume of self-referrals from young people, operating an open door policy. I have a lot of sympathy for all those affected. Kids Company was a life line for an incredible amount of children and young people, many of whom had been failed by statutory services. The staff, who were paramount in delivering the services and support that these young people so desperately needed, are equally as dismayed.

The situation has made me reflect on the role of charities as opposed to statutory services. As someone who receives support from both CAMHS and a charity it raised some questions for me. Are charities picking up the slack? We know that there is a real issue when it comes to funding health and social care services. I was horrified to read an article in the Guardian which mentioned that only 1 in 9 children in need can be supported by social services. That isn’t right. It’s imperative to look out for the most vulnerable young people in order to give them the best chance of getting on in life. How much of that is the job of charities and how much of that is a job for statutory agencies? In an ideal world, I’d say that it’s a job for both. When agencies such as CAMHS and social services have the capacity to work with young people in need, the voluntary sector can compliment the work. However, when the burden of care falls almost entirely on a charity as local agencies cannot cope, it’s a risky position. Many of the young people who turned to Kids Company did so as they were not able to receive help from anywhere else. Now who will they turn to? If statutory services were unable to pick them up initially, will they be able to now?

The voluntary sector is amazing. I am a firm believer in the brilliant change that charities can bring about. If the government will not commit to spending what is needed for statutory services to do their job, then they would do well in not reducing their contracts and grants to charities. Is it any surprise then, that that’s exactly what they’re doing? Between 2010-2013 government funding for all charities fell by 11%, but funding for children and young people’s charities fell by 18%. When you couple that with the gaps in statutory agencies, it doesn’t paint a picture of a society run by those who particularly care whether or not the most vulnerable are protected.

Camila Batmanghelidjh has said that she feels silenced by the government as they felt she was too outspoken and raised issues around child protection which they’d rather keep quiet. I wouldn’t be surprised. The reality is though, that thousands of young people who desperately need support will be left without. Those who never reached Kids Company’s doors, who have never reached the case load of social services and most likely never will, are still in need. The issues that young people face are still just as prominent, the only difference being that we have now lost one thread of hope. I sincerely hope that the government finds a shred of humanity and starts to look out for those who need it.

“Future in mind” report and the promise of £££?!

Today marks the launch of the “Future in mind” report, setting out recommendations in the hope of improving children and young people’s mental health and wellbeing. 

Now, I do a lot of campaigning. I am also a CAMHS service user and so getting CYP mental health up the agenda makes me a very happy person! However my issue comes when I perceive what others see as concern and positive change as tokenism. Unfortunately, this is how I saw the launch of the taskforce report and Clegg’s recent ‘pledge’ to allocate £1.25bn of the Budget to mental health services.

I’m sure that many politicians do care about improving mental health services, Norman Lamb being one, but there is a “too little, too late” vibe around the entire thing. We could have put our energy into attempting to secure decent CAMHS services for our young people 5 years ago. Instead, our funding has been cut (in 2008/09 £758m spent was on CAMHS in real terms, compared to the £717m in 2012/13, the last year for which figures are available) resulting in a shortage of beds, resources and staff. 

“But, Stella!! We know this! It’s better late than never!” I hear you say. That’s very true, but – call me cynical – I fail to see how the money will make a substantial impact. It will make an impact, yes, and it is better than nothing, yes. But once it’s broken down over 5 years and into CCGs (of which there are 211) and further than that, into the CAMHS services that each individual CCG provides, it doesn’t leave a lot. I fear that a large chunk of the money will be used to replenish services and get them back to the levels that they were at before the majority of the cuts were made, before we can see any real improvement. 

As for the report, I have read it and I agree with the majority of recommendations made, but I’m sure that all the suggestions are ideas that staff and service users have been requesting since the beginning. Should all of the changes be implemented, CAMHS would be getting a pretty major facelift! Even in fairly ‘structural’ terms, with a recommendation for scrapping the tiered model and introducing another such as the Thrive model, on which I have reservations. 

As the pressure of the election rises – along with my cynicism(!) – so do the election promises. Politicians need to cover all bases and make as many people as they can willing to vote for them. Making CYP mental health an interest serves well, as not often has it been an issue of much concern. Without meaning to sound condescending, it almost seems like a niche issue to cover.

What roles do schools play in promoting and looking after young people’s mental health?

“Teachers are not mental health professionals” is a phrase I have heard often, both in and out of school. Most recently I heard Nicky Morgan, Secretary of State for Education say this on Wednesday in the Houses of Parliament during a discussion on mental health in schools. A group of young people, including myself, were invited to speak to Nicky Morgan and Sam Gyimah to see what schools are already doing what more we think should be happening.

The truth is that no, teachers are not mental health professionals. But that does not mean that they cannot have an awareness of mental health problems, either in a personal or professional capacity. Given that the statistics are that 1 in 4 people in the UK experience a mental health problem each year, the remaining 3 in 4 will come into contact with someone who is struggling. For those who work in schools, the person they come into contact with may well be a student. A majority of 5-16 year olds are in schools from 9-3:30, Monday-Friday. Spending so much time at school means that staff are in a prime position to notice changes in a young person and intervene. This does not have to fall on the shoulders of one lone teacher, it’s a team effort. Noticing subtle changes in behavior, attendance, concentration and willingness to engage can make huge differences and will most likely be picked up across the board. My mum is a HLTA and came home the other day having received a refresher safeguarding training. She’s never had any training on spotting mental health problems or promoting wellbeing/good mental health. In fact, it is not anywhere in teacher training.

How a child or young person presents with a mental health problem also varies from person to person. A young person ‘acting up’ is not always as simple as that. From the ages of 13-15 I would truant pretty much every day and get sent out of all of my lessons for being disruptive. I spent the majority of my time on report and with my head on the desk. I refused to do PE as I didn’t want people to see that I was self-harming. But I wasn’t a bad kid, I was just struggling with my mental health and not sure what to do about it, yet I knew people who were struggling with similar issues and they isolated themselves instead. There is no ‘one size fits all’ when it comes to trying to spot people who need help, and it requires a great deal of looking beyond the surface.

Everyone is talking about early intervention. Schools are a perfect place for us to help young people. With training staff can feel confident when talking about mental health to students and be able to spot warning signs. I’m in no means saying that we’re expecting teachers to become psychiatrists, the opposite in fact. School staff are school staff. They are not clinical. A teacher does not have the same negative connotations attached to the name as a mental health professional may. They are pretty consistent and there most days. This offers young people a different environment to talk about things that are concerning them, which may feel easier than seeking help from mental health services.

A basic requirement should be for all staff to at the very least know how to signpost to services and make referrals. That way if someone feels unable to help, the young person is able to receive help from an external source. Some young people may not want to talk to a teacher. For some school itself may be the problem! There needs to be a joined up approach between services, schools working alongside CAMHS/social services/YOTs etc in order to best support a young person. It’s by no means rocket science, nor is it impossible. But an attitude shift is required, from “mental health isn’t my problem” to ” mental health is everyone’s problem”. We preach about the importance of looking after your physical health, eating your 5 day, exercising and cutting out rubbish from our diets. But where is the emphasis on keeping mentally well? Where is the impact that lack of sleep can have on your mental health taught? I often go into schools and talk about wellbeing/mental health, and a recurring theme is that initially most young people do not even realize that we all have mental health. For as long as I can remember I have had an awareness of my physical health and have been able to tell if I was unwell or not. So why is it not the same for our emotional health?

We don’t need a massive overhaul in the education system, we just need small yet effective conversations to take place, and the training to make sure that all school staff feel confident in recognizing young people who need help. A lot of the emphasis in schools is towards passing exams, anxiety provoking for most in itself, but for those with underlying mental health problems it can be overwhelming. In order to succeed you need to be relatively healthy in all aspects of life and that’s why it’s so important for schools to play an active role in promoting good mental health and supporting students who are finding things difficult.

The #camhslogic tag

As a warning – this blog post may read as more of a rant than much else. It may also be quite short.

The last post I wrote was on social media and mental health. This is a branch of that – the #camhslogic tag. For years people on Twitter have used it (and lolcamhs) to express their annoyance with CAMHS services. I first became aware of it when I was around 13 in 2011 on Tumblr and I still come across it to this day on various social media platforms.

But the tag seems to deter people from accessing CAMHS services. Countless times I have seen young people asking others about what CAMHS is like, only to get told that they are disastrous and a service to be avoided. I honestly believe that the tag has damaged the reputation CAMHS has, both online and offline. Which is awful! I have been in services since the age of 13 and I have generally had positive experiences. There will always be exceptions but I do think that all staff do the best that they can to care for their patients. This isn’t just in my local mental health trust (SLaM) either, yesterday I found myself in a crisis in Sussex and the staff I came into contact with were brilliant. But the world of social media for a teenager can be convincing and I know that if people slate CAMHS to the extent which they are slated online it does have an effect. When I was first told that a referral had gone through I tried to research it online (although initially spelt it as cammes so didn’t get very far haha!) and if I’d found some of this content, I’m not sure I’d have gone to my assessment.

I only ever hear “CAMHS are rubbish/I hate CAMHS/they don’t know what they are doing” I’m sure that some comments are warranted, I’m not saying that all care is top-notch all the time, but it is unfair. There’s no money. Many staff are over-worked. They have to make difficult decisions day in day out. Depending on who they are seeing they may be constantly managing risk. When do they let someone who is alluding to the possibility that the may harm themselves go? There is 1 free CAMHS bed in the whole of England tonight, who aren’t accepting admissions overnight. So hospital isn’t an option. They’ve got to let them go and manage risk in the community. That’s their call. That’s not an easy call. Even if they aren’t working with high risk patients, it’s not a walk in the park.

I think that young people should cut them some slack. I also think that professionals should also take a look at the tag and see what they make of it! Maybe we should be making more of an effort to involve young people in PPI events and encourage them to make a difference within the service, rather than turn to social media.
(The #crisisteamfail is also a hashtag which is fairly similar that was quite popular a while ago, but more geared toward AMHS/crisis teams.)