Child and Adolescent Mental Health Services (CAMHS) are the main providers of mental health support for children and young people on the UK. Despite this, many Autistic people and their families find that they are turned away from these services because CAMHS are not equipped to work with us. Autism, it seems, represents a riddle they are unwilling to solve. However, CAMHS failure to support Autistic children is broader than gatekeeping access.
How far does CAMHS refusal to support Autistic young people reach?
To really answer this question, we have to consider the myriad ways that CAMHS has become an inappropriate service for the support of Autistic children.
- A lack of competency around Autistic experience and presentation
- In this context, I am talking about neurodivergence competency. This requires more than theoretical study of autism. To be competent in neurodivergent experience and culture requires us to be fully engaged with communities and participatory/emancipatory research. It requires us to have an intimate knowledge of the kinds of challenges that Autistic people face.
- Poor diagnostic practice
- Due to the lack of aforementioned competence in neurodivergent experience, many Autistic young people face receiving incorrect diagnoses that follow them for many years. In particular, young people face the implication that their burnout is depression or school refusal related.
- Institutionalised Parent/Carer Blame
- This is a significant issue. It ranges from the implicit blame that is assigned when parents/carers are sent on parenting courses to the explicit and life destroying use of accusations of Fabricated and Induced Illness (FII). This forms part of a wider pattern of defensive practice that aims to shift responsibility from the service into the family unit.
- Crisis Driven Intervention
- This is as applicable to adult mental health services as it is to CAMHS. Services will very often not act or intervene until there is a risk to life. Such intervention models do nothing but raise the already exorbitantly high rates of suicidality in Autistic young people.
Collectively, this non-exhaustive list of failures set the scene for a service that can be actively hostile towards Autistic service users. The fallout of these practices and significant gaps in knowledge are broad in impact. Not only are we looking at the risk to the child, but also the collapse of entire family units.
When CAMHS mistreat and present hostility to young people, it is the entire family unit that suffers. What we are looking at is the systemic traumatisation of all who support the child or young person. For every young person failed by CAMHS, entire families are becoming potential mental health service users. For a country that speaks so often of the need to reduce expenditure, we are certainly making things more expensive when we fail a single service user so badly that we create multiple new ones.
Autistic children and young people deserve more than this, and so do their families.