'Overstretched, underfunded and disorganised' - we reveal the problems facing the St Albans mental health service which is supposed to be supporting our children

PUBLISHED: 12:00 29 July 2017

"Overstretched, underfunded and disorganised" - youth mental health services in crisis.

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Parents are regularly reporting dissatisfaction with the NHS service that's supposed to help children with mental illness.

Is CAMHS doing enough to support our young people?Is CAMHS doing enough to support our young people?

The local Child and Adolescent Mental Health Service (CAMHS) has a similar reputation in St Albans to that of the national picture – substandard overstretched services leave families desperate, often begging for support but receiving none or little.

Some of the worst cases describe suicidal teenagers abandoned by the professionals who are supposed to assist them - distressed and alone with nowhere to turn.

A gap in autism provision sees those with autism spectrum diagnoses also unassisted by mental health doctors and nurses: they do not meet the criteria for mental health help as autism is a neurological disorder yet there is nothing else suitable in place.

The NHS refuses to discuss individual cases with journalists and because of the nature of mental health still very unfortunately being linked to stigma, shame and even blame, parents are often not forthcoming in identifying their vulnerable children and describing their mental health in print.

Parents have contacted the Herts Advertiser to complain about CAMHS.Parents have contacted the Herts Advertiser to complain about CAMHS.

The result is that ongoing hugely stressful battles - between worried overwrought parents and the overworked professionals at under-resourced facilities that are supposed to ease child mental health problems - go largely unpublished and parents silently struggle.

Problems with CAMHS are not isolated to a handful of cases, as the Herts Advertiser can reveal.

One mum reports being told by a CAMHS family support worker “You can ask me until you’re blue in the face, I will not advise or support you”.

She describes her seven year old as being “in a worse state than ever”, after he was diagnosed with severe anxiety and a young emotional age, and only attending school for an hour and a half a day.

Harley TobiasHarley Tobias

Her biggest gripe is that there is no coordination or joint thinking and she feels she has had no guidance or advice on how to handle his anxiety, what to expect with his therapy and no communication between CAMHS and school or CAMHS and parents.

Another family reports being told they needed family therapy after their son was diagnosed with anxiety and depression, but they had to wait almost nine months for the counselling, which delayed any healing according to his mother.

After five sessions, he was told his therapist was going on leave and that there would be a replacement – and then CAMHS staff said due to lack of resources there would not be a replacement and to try a local charity.

Cancelled psychiatry appointments and a change in school were followed by the child being arrested. His mum reports that “things had got very bad at home and his medication made him aggressive, oppositional, risk-taking and angry”.

St Albans teenager Harley Tobias, who sadly died in October 2015St Albans teenager Harley Tobias, who sadly died in October 2015

She added: “CAMHS are overstretched, underfunded, disorganised and hard to access and contact – at terrible cost to so many families in the area.”

We raised many of these complaints with the executive director for strategy and integration and lead director of CAMHS, Karen Taylor.

She said: “We are sorry that some families feel they have not been able to access support for their children when they have needed it.

“We aim to provide high quality services to support young people’s emotional and mental wellbeing and we take all complaints very seriously.”

She urged parents to raise their concerns directly with CAMHS, in order that they may be resolved.

We also contacted a spokeswoman for the Hertfordshire Partnership NHS Foundation Trust, who explained that there is a recognised shortage of space for young people suffering with mental health conditions, with 16 beds available in an adolescent unit in Hertfordshire and when they are filled, children are sent further afield for in-patient psychiatric care. She said they are working with NHS England to develop new approaches aimed at reducing the number of young people who need in-patient treatment and providing it closer to home, for those who do require a bed.

Case study

The mother of a suicidal St Albans teen has spoken of her heartache as her daughter was placed in a mental health unit in a different county – a four-hour round trip away.

The 13-year-old was recently blue-lighted to a Herts hospital and treated for a toxic paracetamol overdose, before being sent to Kent, where she was admitted as an in-patient and received treatment for psychosis.

A week later, she was sent home for a visit but suffered a severe psychotic episode, during which she attacked her family and attending police officers. For three hours police and ambulance crews talked to her, as she “battled with the alters [characters she feels are in her head and talking to her] who had taken control”, according to her worried mother.

She said: “When police called for a psychiatric assessment nurse, they were told – as we were told last year – that there is no mental health assessment team for under 18s. The police were going to remove her safely to an adult unit where she could be sedated and transported back to Kent but eventually she tired and we were able to return her to Kent relatively calmly by police car.”

The family complained to CAMHS, but as emails went back and forth between NHS bosses and the aggrieved mum, the girl’s condition worsened and she tried to take her own life - for the second time.

The mother-of-two, a primary school teaching assistant, wishes to remain anonymous for fear it will affect any help they receive in future: “I have worked in schools for more than a decade. I’m a sensible grown-up who has seen how systems work and I have been involved with many professionals from the education, welfare and health services. I see how hard we all work to make it right for every child; how caring, compassionate and practical we are, backed up by processes and support systems. And then there is CAMHS.

“Lives are being ruined. CAMHS is like an ulcerating wound that won’t heal. Their responses to my complaints have been insulting and dismissive. I do not want apologies. I want a service that works.

“My daughter attempted to take her life for the second time last week and is now an in-patient in Kent. Were it not for quick thinking and medical intervention, we may well be arranging her funeral.”

In 2015 the girl was referred for mental health help for obsessional behaviour, offered calming techniques and the case was closed. She began self-harming, seeing ‘people’ and hearing voices and was eventually assessed by CAMHS last December.

Earlier symptoms included episodes where she curled up and went rigid, reporting she felt she must repeat sounds she heard in her head, unable to move until the episode passed. She explained that faces “sometimes go weird” when she talks to others and how she sees “shadowy figures nobody else can see”. The youth also reportedly heard voices, which developed into ‘alters’ and became increasingly more controlling.

In the space of months, she ran away late at night and the police were involved, she required several trips to A&E and took multiple overdoses. Her first therapy meeting was in January.

Her mum says delays in arranging suitable appointments meant her health declined, and after a few appointments with CAMHS therapists and social workers, the child refused to attend as she found the sessions unhelpful. Gaps existed, despite them being described as ‘immediate referrals’ and ‘emergency meetings’ and ‘urgent GP requests’, and when they were held, they resulted in the patient fleeing meetings, finding them unhelpful or refusing to attend.

Her mother added: “We are terrified that we are losing our beloved precious child and furiously angry and frustrated that we are not being helped by the one service that should be comforting, supporting and working to get the best outcome for our family.

“She is an amazing, clever, funny, kind compassionate beautiful person with so much potential and we may well lose her.

“It terrifies me to think she may only be able to function as a mindless sedated zombie or forever locked up going slowly insane.

“She is carrying such a heavy load and CAMHS should have eased that not contributed to it. It’s unbearable. I feel like she’s dying. Somewhere in my head I am planning a funeral.”

Support services

Youth Talk is a well-established charity, which provides talking treatment to young people between 13 and 25 years in and around St Albans.

Charities are helping fill the gap in many areas of health and social care, and this was the reason Youth Talk was set up by a local GP in 1997 who recognised a growing need.

Following a major review in 2015, funding was secured to improve CAMHS between 2015 and 2020 to help the one child in 10 who suffers with a diagnosable mental health problem in Hertfordshire.

Conservative MP Anne Main regularly receives correspondence from distraught caregivers: “Problems with CAMHS is something I have been dealing with quite a lot recently. I understand the frustration parents have when dealing with CAMHS.

“When they’ve contacted me and I’ve looked at their personal cases, it’s clear that communication between schools, parents and the health support team aren’t good enough.

“We need to get rid of this silo mentality and stop this revolving door of form-filling and bureaucracy that often gets in the way of providing a good service.”

Case study

Eve Tobias, whose 16-year-old son Harley died in 2015, is among those unimpressed with CAMHS.

She feels he was not given enough support by them, in the lead up to the fatal incident where the car he was driving smashed into a parked campervan in Marshals Drive, St Albans. She is in contact with CAMHS over her grievances and stated: “I just know they failed us and let Harley down by not doing their job properly.

“For him, it was a case of he was seen and diagnosed but they failed to let me know and follow it up.

“They didn’t return any of my calls after initial assessment, so he didn’t get the medication he needed when he was 14.

“Then his behaviour spiralled out of control. If the doctor had done her job two years earlier, he would have been on medication and things could have been different. CAMHS are useless and so many people say the same.”

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