I recently wrote an article about my experiences as a former patient of CAMHS (Child and Adolescent Mental Health Service). In this article, I spoke about the effect that failing to support me properly had on my developing individuality and the immense suffering it led to in my early adult life (please find the article here). It was a widely shared piece of writing, but one theme has come up that I feel is important to address.
What are the specific ways that CAMHS fails Autistic children?
This is difficult to summarise. There is an interconnected network of systemic failings that culminate to create a potentially deadly set of failings. Every single day CAMHS turn away Autistic children, denying them support at a time of their life when they desperately need it. To summarise, it is a service that actively works against Autistic children and their families, but I believe we need to get a bit more specific.
1. Staffs knowledge of autism is pathologising and outdated
Staff within CAMHS tend to still favour medical models of autism, seeing it as a pathology that requires fixing (but not by them) and largely believing the incredibly harmful research of so-called experts like Simon Baron-Cohen. Talk of extreme male brain theory and theory of mind deficits would not be unusual in CAMHS. This could be remedied by engaging with emancipatory research models and the wider Autistic community. Unfortunately, this is yet to happen.
2. CAMHS professionals blame everything on autism when faced with an Autistic child
Despite the very specific diagnostic criteria outlined in various editions of the DSM over the decades, autism is still seen as the root cause of psychological distress in Autistic people. This is self-defeating on a number of levels. Most commonly we hear “this child is anxious because they are Autistic”.
Anxiety is not a part of the diagnostic criteria as outlined in the DSM 5. Neither is any other form of psychological distress. Models such as The power threat meaning framework have shown us that environments and power dynamics are the leading cause of distress. However, staff still blame autism, and then use that to refuse to support the child.
3. Parent/Carer Blame
I have spoken at length about institutionalised parent/carer blame and insinuations of Fabricated and Induced Illness. CAMHS are one of the institutions that will contribute to this. Parents who approach CAMHS for support are met with dismissal or blame for their child’s struggles. It is incredibly harmful as this can lead to children being removed from families and families facing criminal proceedings.
4. Medical Gaslighting
Many Autistic people are misdiagnosed. Teenagers in particular, especially those who are assigned Female at birth (AFAB) face diagnoses of personality disorders. Personality disorder diagnoses come with a level of moral judgements where those labelled as such will be told that their distress behaviours are an attempt at manipulation or attention-seeking.
Those misdiagnosed face the realities of carcerative care and testimonial injustice on a near daily basis. Misdiagnosis of such “conditions” is also used to label people untreatable and, once again, refused treatment.
This is not an exhaustive list
This is just some of the ways that I have witnessed professionally and experienced personally, the daily failure of Autistic people. CAMHS is in crisis. Staff are woefully undertrained, and the service does not receive anywhere near adequate funding. The problems with CAMHS can not be changed at merely the service level. We need to make a change at the law and policy level.
Until this is done, the Autistic children of the UK are in danger.
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