For anyone who has been following my writing recently, you will be aware that there is an ongoing campaign regarding the failings of Child and Adolescent Mental health Services (CAMHS). In particular, there has been a great deal of discussion around the fact that they will often refuse to see Autistic children and young people. Beyond this though is a pervasive lack of skill and competence among professionals working Autistic service users.
CAMHS failures don’t rest solely in the hands of under-trained staff. To understand the issues that present themselves, we have to consider the lack of resources and funding.
“There remains a clear disparity between adult and child mental health spending in England. CCGs spendOffice for the Children’s Commissioner (2019/2020 report)
an average of 12.9% of their overall allocation on adult mental health services – approximately 13 times
more than on [children and Young People’s Mental Health Services]”
This disparity means that staff do not have access to a robust budget that allows for in depth training on emerging knowledge around the Autistic experience. Much of the training that staff have access to is horribly outdated and biased towards deficit-based understandings of autism. Of course we have the Oliver McGowan Mandatory Training, but I am yet to find an Autistic person who thinks this training goes far enough or demonstrates the truly dynamic nature of being Autistic.
Autistic Burnout and CAMHS
When considering the understanding that CAMHS staff have around Autistic experience, perhaps one of the most misunderstood aspects of autism is that of Autistic burnout.
“Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”Raymaker et al (2020)
Burnout in Autistic people is often misunderstood as looking like depression, but like many aspects of being Autistic, it is dynamic and diverse in it’s presentations. Trying to quantify burnout within observational methods is like trying to quantify snowflakes. Each instance is unique in it’s own way, even though they all have some general similarities. Sadly, CAMHS staff often don’t even know burnout is an issue for Autistic people, let alone what to look for or how to support children and young people through it.
My own experience with CAMHS
Aged 15, I found myself no longer to attend school. After a series of traumatic life events, my mother found me sat in our living room rocking back and forth, unable to speak. I have written about how CAMHS nearly killed me, but there is more to that story. CAMHS had me labelled a school refuser. They failed to recognise that I was experiencing Autistic burnout. When they should have been supporting me, they instead empowered an abusive school environment.
I was forced to return to the same school environment that had destroyed me. I was bullied by staff and students alike. I dragged myself through my final months in that school, leaving with few GCSE’s and a distinct lack of trust for education and mental health professionals. CAMHS failure to support me as an Autistic person in burnout led to my own suicidality, self-harm, and ultimately addiction and psychosis. CAMHS has the opportunity to provide meaningful crisis intervention, but due to their lack of knowledge labelled me as depressed and difficult.
Autistic burnout is not depression
Admittedly, on the surface, burnout and depression can look similar. The withdrawal from others coupled with loss of interest in previously enjoyable activities are hallmarks of both in the standard sense. However anti-depressants will not end Autistic burnout any more than water will extinguish the proverbial chip-pan fire. When staff labelled me as depressed instead of burnt out, they signed me up for decades of medication and gave my school the power to drag me back into an environment that was killing me.
At a time when I needed support from a community of my peers, I couldn’t even access an accurate diagnosis, let alone discover the huge community of others like myself.
The current state of CAMHS
“CAMHS did not have the knowledge or the skills to identify or treat mental health problems in [Autistic children].”Read & Schofield (2010)
If CAMHS staff are unable to accurately identify Autistic burnout, it is likely that many children and young people will receive incorrect diagnoses and subsequently inappropriate support. It’s not uncommon for Autistic people to recieve diagnoses of personality disorders and bipolar conditions; this could be because of a disregard and lack of knowledge around atypical burnout, and the diverse range of burnout presentations in general.
Not only are Autistic people being turned away from support, those who make it through the door are actually being made worse. This is not how Autistic people experience mental health support. Children and young people are building towards an adulthood that will already be complicated for them, why do we set them up to experience an even harder time? Our children are dying at the hands of CAMHS.
Please sign this petition to help make a difference.
To learn more about Autistic burnout, please sign up for this burnout seminar by myself and Tanya Adkin (August 9th 2023 @ 7pm), free to Autistic parents.