Possible Adolescent Mental Health Unit Admission

Thank you all for your replies. I do think James has had difficulties coming to terms with & understanding his diagnosis. Since his CDAC assessment confirming ASD last July, we have had no specialist input at all. We were handed some leaflets & contact numbers of charitable support groups but have had no contact with an ASD professional or paediatrician since. James’ next scheduled appointment with the paediatrician is scheduled for late December, despite our attempts to bring this forward. 

Previously we have been in contact with Families in Focus with regard to James’ educational needs. We have felt under pressure to help James return to school from both the LEA & CAMHS as their feeling is that if James were able reengage with education this would help extend his social experiences & enable him to learn coping strategies. However we have received no actual support to help James return & every day that James has not been able to attend feels like a huge failure for us.

We were encouraged by James’ psychologist at CAMHS to refer James to our local social services department for assessment by the disabilities team. We now do have an appointed social worker for James who is actively trying to arrange a meeting of the professionals involved in James’ care (School, CAMHS, Social Services)  but we are waiting for a date & a list of those who we able to attend. Our local service for ASD children with challenging behaviour (PALMS) has stated they cannot help James in transitioning back to school.

We are greatly relieved to hear that James cannot be forcibly admitted to an adolescent mental health unit.  He does not pose a danger to himself or others. The inpatient admission has never been mentioned before until our last CAMHS meeting on Friday & we were very shocked at the tone & manner in which this was presented to ourselves & James. It had not been discussed as a possibility with my husband or I at any time previously & the psychiatrist clearly told James he must understand he could not “opt out” otherwise she would make a referral to a specialist unit. We are concerned now that James is more distressed & that this has added to his mistrust of professionals.

We have contacted the NAS helpline & are awaiting their advice. We certainly feel a placing James on an adolescent mental health ward would be harmful & will not consent to this. We will also put our concerns in writing to CAMHS.

Thanks again for your input.

Hi Cassie G,

It may be helpful for you to contact the NAS helpline for advice,

www.autism.org.uk/helpline

Best wishes,

Coco (Moderator)

This is dreadful. Taking your son forcibly can only be done under a sectioning order, otherwise he would be considered 'voluntary' and therefore free to leave at any time. There is no treatment for ASD, so they cannot claim that 'forced' treatment for therapeutic reasons is necessary, and they are left with 'a danger to himself or others'. I know it's unlikely, but is he?

He is best left at home with you. A strange environment can only do harm. I also think that it is completely disingenuous to expect you to deal with him. What do they want you to do, solve his life in three weeks? Ludicrous!

You'll understand from this page just how we feel about this, and I agree - you need some advocacy. You could maybe find a Solicitor for him too, specialist ones are out there, could be there's one near you.

Transition into secondary is traumatic and 13 seems to be a common age for pressures to build up, mainly because the peer group is responding to puberty in a collective and conformative way from which he will be progressively isolated.

You say he was only diagnosed last July. Does he know and understand the diagnosis? How has he taken it? Was there a long lead up to getting a diagnosis or was this dropped on you as the explanation for the disorder?

You say he has had no help adjusting to the diagnosis. I do wonder what the specialists you are dealing with think you or your son are meant to do with the revelations and adjustments. They sound heartless and self-interested. 

There is the danger they are trying to cover their own mistakes by getting an inpatient referral. They may have been told they need to get him assessed in a controlled environment if they've been asking for guidance on perceived complications they do not comprehend as normal for autism.  You don't want him treated for early onset schizophrenia by people who aren't qualified to assess autism.

Do you have contact with a parents' group, either NAS or independent? You can find out about these using the little red map on the home and community pages of the NAS website (tends to bring up London first but scroll down). You clearly need support and advocacy.

It does worry me particularly that they are not informing you of everything and just carrying on as if this is just about themselves. You should be getting better support from these 'professionals'. You say they are not autism specialists? That may be a large part of the problem - without sufficient understanding of all aspects of autism they may be reading in other factors where they don't belong.

Bullying in teenage years can be a big factor in behavioral change. He may have been subjected to name calling, intimidation and aggravation within or out of school.

For that age group "Martian in the Playground - understanding the schoolchild with Asperger's Syndrome" by Clare Sainsbury Lucky Duck Publishing ltd 2000, despite its age is still a good book on what goes on in school. A biography with insight on growing up is "Making Sense of the Unfeasible - My life journey with Asperger Syndrome" by Marc Fleisher 2003 Jessica Kingsley Publishers might help.

But it is paramount you get some advocacy - someone with knowledge who can help you talk to these 'professionals' - either a local parents group, or community advocacy, or use the NAS helpline.

What you are going through is appalling and I'm sorry you've been caught up with clearly inappropriately qualified specialists.

hi Cassie

It could be the stress of the changes that have affected your son so much.  

A different school building, rules, lessons, and people, - they are all big things to deal with and take a lot of getting used

My daughter who is now 15, moved to senior school 4 years ago, and she was very socially anxious, had no self esteem, and no thoughts for her future.

She had also had sensory and other issues anyway, and I'd always thought it was 'just how she was' and she was happy when she was on her own. 

But all the changes and pressures of the bigger senior school affected her badly, and even now she often she doesn't want to go, but I perservere and walk her to school some days, even if it means she goes in quite late on occasions.  Her attendance has not been good either.  

In the past the GP tried to help by talking to her, (medication didn't help as side effects were too bad,) and eventually she was referred to camhs last year. 

Camhs have tried to help with her social anxieties mainly. They couldn't help with her sensorty problems at all.  She has been tested to see if she is on the autistic spectrum and I am waiting for results so don't know how long that will be.  

Meanwhile camhs said they can't help with a lot of her issues, and have said that having an ASD is not a mental health issue.  Perhaps it only becomes an issue if depression or anxiety is causing severe problems in life?

Camhs suggested I looked on the internet to find out more, and try to find things that could help, and said I could try the autism helpline which I haven't called yet.

I think she will be discharged from camhs soon, as she doesn't appear to be depressed on their mood chart.  So I am trying to help her myself, as I always have anyway, and I hope to find out as much as I can.  

But there is no support in my area for ASD either, so it isn't easy.

If camhs have said they might want your son as an inpatient, they may has serious concerns about him?  I would have thought that would be on a voluntary basis?  So you could choose and decide as his parent?  I would have thought you would have to sign to give your consent.  Ask them what they hope to achieve and ask them to explain what would happen.  

Maybe a way to express your concern so they listen would be to write a letter to your local camhs office, and give a copy to the psychiatrist.

We all only want the best we can for our children, and that's the most important thing.

Hi Cassie, I would say that something has deeply upset your son. He may not be aware of what it is, so be unable to talk about it.

There is a condition called ALEXITHYMIA, emotional blindness. It is still being researched and does not seem to be recognised by many psychiatric teams.

Sometimes, if I have a very upsetting problem, such as bereavement, bullying, accidents etc, I tend to push the problem aside, if I do not feel able to cope. I have a sort of internal cupboard for things I cannot cope with. The problem does not go away, but festers within, poisoning my daily life and causing depression or psychosis. It is a very serious problem, because I am no longer aware that there is a problem and will tell everyone that there is nothing particularly wrong, that I just feel bad. It is a bit like PTSD. For example, I lost 2 close relatives, with only a short gap between. I dealt with the first loss, but shelved the second, thinking I was unaffected. It was 2 years later, that I got really down around the time of their birthday. I had to drag the event back into my conscious mind, by thinking about them using photos and music to help me remember. I then began to grieve.

If this is your son's problem, you may be able to help him, by going through events and seeing if you think anything distressing has happened, which he feels unable to cope with. If he has become school phobic, it may be a bullying issue. Bullying is such a difficult area, as schools often do not want to admit it is happening, and it is very humiliating for the victim. He may have been convinced that he deserved to be treated badly. He may have memory of an upsetting events but not the emotions that go with them.

I am not sure what to suggest, except that you could google the subject, to find out about it yourself and talk about things with your son, perhaps in general terms. Please remember that he may well say something is not a problem when it is. You may need to spot subconcious reactions, such as increased stimming when the subject is mentioned. You may well be better placed to help him, as he knows and trusts you. Psychiatric teams are strangers. On the other hand, he may want to talk to a stranger. It is a difficult area. You could also ask the CAHMS team if they are aware of alexithymia.

I personally found that certain drugs made the situation worse. It is easier to push a problem away, if medication is getting rid of the worst symptoms. This is only one possibility and I am not suggesting that you stop medication without proffessional advice.

I do hope you can sort this out. Best wishes