Bridging the Gap in Mental Health Services

BRIDGING THE GAP IN MENTAL HEALTH SERVICES

Why this is urgent right now

The current crisis in mental health services affects all of us. Current figures reveal that one in 10 children now have a diagnosable mental health condition yet waiting lists for an initial appointment with CAMHS in Kent can be up to 18 months and for private mental health services, up to a staggering six months. Who is helping the families and children during this period?

At a time of intense anxiety, many parents are really struggling, trying to manage very challenging behaviours with limited knowledge and skills and the overwhelming sense that no-one is available to help them.

And yet, research shows that parents can successfully support their children during this period if they are given a little practical support. 1

“Good quality parenting programmes can make a real difference…they also potentially contribute to substantial cost savings in the public sector. Despite these opportunities, only a small minority of children and families get the help they need to protect their children’s life chances.”2  

The struggles and failings of CAMHS are frequently in the headlines.  Dr John Goldin, Consultant Child and Adolescent Psychiatrist at Great Ormond Street Hospital in an interview on BBC’s Panorama, September 2018, said “The trouble is the services are very stretched, we’re not meeting the need, so in that sense it’s not fit for purpose.” CAMHS has been accused of “rationing services in favour of those who have attempted suicide”. 3

2017 Figures from Mental Health of Children and Young People in England,4 state that 1 in 8, 5 to 19-year olds had at least one mental disorder when assessed in 2017 and of those Emotional disorders were the most prevalent type of disorder4. Yet figures from CAHMS gained by the Panorama investigation show that one in four children have been rejected from being offered help and a total of 55,800 children did not meet CAMHS criteria.

Before I founded my Family Relationship & Parenting Coaching practice, I worked as Support Worker at a local homeless hostel for vulnerable youth, where I personally witnessed cases of CAHMS “rationing services” because clients were not “in crisis”.

A BBC News report following the BBC’s Panorama programme listed how the service criteria has been rationed, stating reasons for excluding under-18s from service involvement including:

  • Self-harm referrals only accepted if accompanied by another mental health condition
  • Weight loss of less than 15% of an ideal weight for an eating disorder (against NICE recommendations)
  • Must have already engaged with early intervention and waited a specified length of time

NICE Guidelines recommend providing parenting skills support to parents and carers but in my experience here in Kent, this isn’t on offer. Rather, parents are being encouraged to ensure their children fit the criteria for support. One mother I’ve spoken to who wanted to explore alternative treatment options rather than medication for her son, was told that unless he took the recommended medication, she would be discharged from services and would not be offered any support. This advice left her feeling intimidated into accepting medicating her son, and raises the question of where is the person-centred care?

This piece is not written with the intention of undermining CAMHS, which is working with overwhelming demand. CAMHS is working in a context where child mental health referrals have risen by 26% in the last 5 years, and referrals in 2017-2018, for under-18s rose to 198,280, (compared with 157,000 in 2013-14)5.

  • Nearly 19,000 children were admitted to hospital after harming themselves in 2015 – a 14 per cent rise over three years5
  • Between 2013/14 and 2014/15, referral rates increased five times faster than the CAMHS workforce5
  • The average waiting time for children and young people to access mental health services ranges from 14 to 200 days5
  • Once through the referral process and finally able to get specialist support, even young people with life-threatening conditions can wait more than 100 days before receiving any form of treatment.5

This rise in demand may be attributed to more mental health awareness, which can only be a positive. But in a climate where 1.5 million children live in areas with no 24/7 crisis care, and 27 out of 111 local authorities who were consulted, said they had SCRAPPED services3 related to the mental health and wellbeing of children over the last 8 years, it is no wonder that we use the words ‘crisis’, and ‘failing’ because we are failing the families involved and I am advocating that we have an obligation to ‘bridge the gap’, because waiting for children to reach crisis point can have devastating consequences.

Nick Waggett, Chief Executive of the Association of Child Psychotherapists said: ‘We do hear stories of children and young people having to have attempted suicide on a number of occasions actually before they are seen within the service. The problem is that then they’re very ill and it actually becomes increasingly difficult to offer them an effective treatment.’ 6

There are professionals who can help parents understand a diagnosis of a neuro-biological condition, and provide practical implementable tools, strategies and techniques that will make a difference. At The Weller Way, we work with parents and teenagers daily

At a time when negative behaviours can dominate, we can help remind you to focus on what your child does well, show you how to effectively praise positive behaviours, how to notice and record triggers and so much more. We believe that parents have strong intuition, know their children better than anyone else and, equipped with the right tools and skills really can make a positive difference.

You can make contact with us here

References

  1. Parenting and Outcomes for children: Thomas G O’Connor/Stephen BC Scott for Joseph Rowntree Foundation 2007. (www.jrf.org.uk)
  2. A chance to change: Delivering effective parenting programmes to change lives: Brown/Khan /Parsonage 15 October 2012 www.Centreformentalhealth.org.uk
  3. BBC News24/9/18 https://www.bbc.co.uk/news/health-45607313
  4. https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england
  5. www.local.gov.uk/about/campaigns/bright-futures/bright-futures-camhs/child-and-adolescent-mental-health-and
  6. www.pulsetoday.co.uk/clinical/clinical-specialties/mental-health/child-mental-health-services-not-fit-for-purpose-says-top-psychiatrist/20037494.article

Tis’ the season for a Pantomine

Christmas is the time of traditions, and going to a Pantomine is a firm family favourite across the land. Pantomine is not originally a British tradition or a children’s entertainment show.

Pantomine began as entertainment for adults, it can be traced back to the ancient Roman “Saturnalia” Midwinter feast, at which everything was supposed to be turned upside down. Men dressed as women, and women as men, just like the pantomime dames and principal boy leading role. Continue reading “Tis’ the season for a Pantomine”

The Balance Act

The Author Alain de Botton said:

 “there is no such thing as work/life balance. Everything worth fighting for unbalances your life” .

Whether you find that re-assuring or not, when we talk about balance, we can get stressed and feel guilty just trying . What are we trying to balance? Is there a conflict in trying to achieve a balance between work, play and parenting? The Modern Family Index 2017 found that only 1 in 5 parents claim they have the balance right.

Achieving Balance is a hot topic right now, in the light of the headlines quoting how many of us are stressed. The emphasis is very much placed on achieving a balance between work, play and parenting, but by doing so, have we missed an opportunity here to integrate all these parts in what contributes to making us whole? Can we shift the emphasis on finding a balance between our doing and our being, that embraces all our parts , beginning with grounding ourselves to the authentic version of ourselves, without feeling guilty? Continue reading “The Balance Act”

Name it to Tame it: How to teach children to surf the waves of Emotions

I’ve just returned from a lovely holiday in Turkey, and learnt two things:

  1. Turkish is a beautifully emotive language
  2. I’m a rubbish paddle boarder!

Is anyone a Surfer or paddle boarder?

I’ve tried it and just can’t master it, everytime I try to get up on the board, I wobble and down I go, back into the water. Not got the core strength! But you know how to lift yourself up everytime.

The goal of raising children should not be simply to have an obedient and compliant child, but one that can take control of how they feel through making choices. We want children that can use their own strengths to get up again when they are knocked back, and be able to self- regulate when they lose their balance. Just like surf boarders, this takes a lot of practice! Continue reading “Name it to Tame it: How to teach children to surf the waves of Emotions”

A Parent’s Guide for A Level Results Day

How to prepare for A Level Results

 

This week, millions of children will be anxiously awaiting their A Level  results tomorrow and planning the realisation of their hopes and dreams of their next stage in life.

3 years ago I wrote a blog about my son , you can find it here

https://wordpress.com/post/wellerway.wordpress.com/30

I am so pleased to report that, having followed a new direction, a heart over head decision he has successfully graduated and has had the best time along the way. But the reason I wrote that blog was to encourage other parents to be creative on results day, if the results close one door, there are many doors open which are welcoming, beckoning and exciting . All it needs is a brainstorm and a leap of faith. Continue reading “A Parent’s Guide for A Level Results Day”

How Mindfulness can help improve Family Life.

This article is written by Melissa Benaroya on her Mind Yeti blog published March 18 2017 and I have re-posted.

A child’s anxiety is stressful to the child and can also be stressful for the child’s family. Anxiety can actually be debilitating for kids. Children may spend endless amounts of time and energy fixated on things such as grades, family issues, peer relationships, and performance in sports, as well as disasters they think might happen or dangers that do not actually exist.

Understanding the different types of anxiety and the options for treatment for children and adolescents is really important. Over the course of the last 5 to 10 years, the practice of mindfulness has received significant attention and gained recognition as an effective means of treating and managing childhood anxiety.

Mindfulness is defined as the ability to pay attention to the present moment with kindness and curiosity and without judgment. The goal of mindfulness is to intentionally draw awareness to thoughts, feelings, or sensations as they happen from moment to moment. Mindfulness helps children pay attention to the here and now, which allows them to distance themselves from what is upsetting them.

And the benefits of mindfulness practice are significant! Here are just a few of the many benefits of using mindfulness with children who are anxious:

  • Helps bring attention back to the present, away from worries about the future
  • Reduces stress
  • Breaks the cycle of worry, where one fear feeds on another until it snowballs into full-blown anxiety or even a panic attack
  • Teaches children to identify and accept emotions, rather than feel consumed by them
  • Allows children to practice awareness and acceptance without judgment

Incorporating mindfulness into your family life can be quite simple. Parents don’t need previous experience to start using mindfulness with children. Begin by introducing your child to the practice and explaining how you will use it. You can let them know that mindfulness can be as short as three minutes or as long as an hour and that there are a range of styles and topics. My favorite Mind Yeti sessions for anxious kids include: Anchor Your Boat,  Candle Can Do and Tree In The City, but you should explore all the sessions and chose the ones you and your child like best.

Once you have discussed mindfulness with your child, come up with a plan together for how you will use this . You can offer some choices concerning the length of their first session or the topic. By allowing your child to choose and help come up with the plan, you increase their buy-in to implement and participate in the practice. The more consistently and frequently you practice, the better. By practicing at the same time each day, you ensure consistency and increase efficacy.

Want some more ideas on how to help your child manage their anxiety.  Check out these tips from my conversation with Karen Young, psychologist and Hey Sigmundfounder: 

Letter from a Teenager

Another glorious piece of writing from The Circle of Security International.

The Letter Your Teenager Can’t Write You
by Gretchen Schmelzer

Dear Parent:

This is the letter that I wish I could write.

This fight we are in right now. I need it. I need this fight. I can’t tell you this because I don’t have the language for it and it wouldn’t make sense anyway. But I need this fight. Badly. I need to hate you right now and I need you to survive it. I need you to survive my hating you and you hating me. I need this fight even though I hate it too. It doesn’t matter what this fight is even about: curfew, homework, laundry, my messy room, going out, staying in, leaving, not leaving, boyfriend, girlfriend, no friends, bad friends. It doesn’t matter. I need to fight you on it and I need you to fight me back.

I desperately need you to hold the other end of the rope. To hang on tightly while I thrash on the other end—while I find the handholds and footholds in this new world I feel like I am in. I used to know who I was, who you were, who we were. But right now I don’t. Right now I am looking for my edges and I can sometimes only find them when I am pulling on you. When I push everything I used to know to its edge. Then I feel like I exist and for a minute I can breathe. I know you long for the sweeter kid that I was. I know this because I long for that kid too, and some of that longing is what is so painful for me right now.

I need this fight and I need to see that no matter how bad or big my feelings are—they won’t destroy you or me. I need you to love me even at my worst, even when it looks like I don’t love you. I need you to love yourself and me for the both of us right now. I know it sucks to be disliked and labeled the bad guy. I feel the same way on the inside, but I need you to tolerate it and get other grownups to help you. Because I can’t right now. If you want to get all of your grown up friends together and have a ‘surviving-your-teenager-support-group-rage-fest’ that’s fine with me. Or talk about me behind my back–I don’t care. Just don’t give up on me. Don’t give up on this fight. I need it.

This is the fight that will teach me that my shadow is not bigger than my light. This is the fight that will teach me that bad feelings don’t mean the end of a relationship. This is the fight that will teach me how to listen to myself, even when it might disappoint others.

And this particular fight will end. Like any storm, it will blow over. And I will forget and you will forget. And then it will come back. And I will need you to hang on to the rope again. I will need this over and over for years.

I know there is nothing inherently satisfying in this job for you. I know I will likely never thank you for it or even acknowledge your side of it. In fact I will probably criticize you for all this hard work. It will seem like nothing you do will be enough. And yet, I am relying entirely on your ability to stay in this fight. No matter how much I argue. No matter how much I sulk. No matter how silent I get.

Please hang on to the other end of the rope. And know that you are doing the most important job that anyone could possibly be doing for me right now.

Love,

Your Teenager

if you are confused as to how you can best support your teenager or are struggling to connect please contact me for some Wellerway strategies.

http://thewellerway.co.uk

My emotional path to Parenthood

This is a piece that I asked a very special person to write, she has had a rocky road, but is celebrating 5 years being clean this year, and her recovery  is a testament to her determination and the beautiful person that she is. It’s all about second chances. I hope you find her words as inspiring as I do.

I was sat in the reception area of Holloway prison for the first ever time. I heard the words “you are pregnant”.  There and then, I believed that this miracle was meant to happen, and this was my way out of a lifestyle of destruction. Sadly this was not the case, being in the grips of addiction is more powerful than a mothers love for her child. I was incapable of stopping using drugs, which resulted in my daughter being adopted.

This was 10 years ago and the battle I had throughout this process still feels like it was yesterday. The heartache I felt when social services drove away with my daughter in the car, knowing deep in my soul that she would never be in my care again was the most soul destroying feeling I have ever experienced. For many years in my life after I lost my child I honestly believed that I never deserved to be happy ever again. So I continued to punish myself in many different forms trying to prove that sadness, heartache, guilt, shame, self-hatred is all that I was allowed to feel. How dare I even attempt to have some form of happiness in my life. I wasn’t able to step up and be a mother when I was given the chance; I failed;  so misery was all I could have.

After coming into recovery in 2012 my life started to change for the better, slowly but surely my self-worth, respect and love started to grow and for the first time in a very long time I knew that I deserved to be happy in my life. The sadness never leaves you but you learn to accept the past and not allow it to control your future.

I have grown as a person in the last ten years, but at times I can be transported into that 18 year old whose life was absolutely broken beyond repair, helpless, full of hatred for myself. This recently happened when I found out I was pregnant, and I got that heart stopping phone call from social services saying they had to do an assessment on my ability to be a parent. Logically I knew this would happen due to my past. However trying to get my head and heart to be singing off the same sheet was harder than I thought possible. I felt exactly how I felt when my first daughter was taken out of my care. I was full of fear that the past was going to repeat itself, which like I say logically doesn’t make sense. I have changed my life beyond belief, I work with young vulnerable people and their children but in that moment I was that girl who had so much to lose and the fear took over.

I am currently 28 weeks pregnant and I experience my whole pregnancy in a different way, I believe that this is my second chance to do what I couldn’t do before. Be a mother that is able to offer security, love, care, and all basic needs that a child deserves to have to have the best start in their young life. I am overwhelmed at this whole pregnancy experience that us women get to go through. Yes it is hard, scary & emotional, but at the same time it is the most beautiful, life changing, exciting & loving experience I have ever had the pleasure to be a part of. I spend hours speaking, looking, touching my belly knowing that my little girl can hear me, the love I feel is so powerful I honestly never thought I would get this chance again.

Of course at times I am overwhelmed with feelings of guilt, shame and sadness that I wasn’t able to do this the first time around and yes I do get the stick out and beat myself up. I consider these moments as a process of accepting the past, and in some weird way forgiving myself. As I am able to be so much more available for my unborn child today. Which makes me believe that if I wasn’t caught up in the lifestyle I was, I would have been able to do what I am doing now,  ten years ago for my first child.

I would be lying if I said that the thought or fear of having social services back involved in my life doesn’t scare the life out of me. It does and I am okay with that today. I guess this will never leave me, once you have had involvement with the system that fear or what if will always remain. But what I do know today that whatever happens in life I am capable of dealing with anything with my head held high. I am a changed person and I am no longer that 18 year old girl lost and confused. I am a responsible adult who does her best in all areas of my life, and I will always be proud of what I have overcome and what I continue to achieve in life.

Today I know my daughters are loved beyond belief. Yes one may not at the moment be present in my life and that will always hurt. The beauty of the word hope is though one day she may be, only time shall tell. My other daughter growing away inside of me will be sheltered with a love, care & happiness. For me I get that second chance to become what I am meant to be, a mother whose whole life is devoted to her children. A dream for many years which again has now become reality. The past is the past I cannot change that but I can change my future which I made a promise to myself I would do and continue to do. My life is a beautiful gift I will never forget that.

The Thirteenth Flaw

This is a repost from The Circle of Security international written by the lovely Deidre.

The Thirteenth Flaw of Parenting
January 19th 2016
Pretend for a moment that every parent on the planet has this one simple fact in common: we all have exactly twelve flaws as parents. Not that these flaws are the same for everyone. Many of us have similar configurations fitting into similar patterns while also being stunningly unique in how messed up we actually are.

Now pretend that someone comes along and tells you that having these flaws isn’t actually a problem . . . unless you also have “the thirteenth parenting flaw,” the one that makes the other twelve almost impossible to deal with.

Continue reading “The Thirteenth Flaw”

Hidden in Plain Sight

A bitesize snippet of how an attachment based Parenting approach helps with responding to challenging behaviours whether it is the terrible 2’s or the troublesome teen:

The Circle of Security® roadmap helps to increase caregiver’s observation skills. Using the Circle roadmap, we are better able to shift our attention away from focusing on the child’s behaviour, and onto what is Hidden in Plain Sight.

Continue reading “Hidden in Plain Sight”