My CAMHS Experience

As a teenager, for 2 years of my life, I had to visit a children's psychiatrist every week under CAMHS - The Child and Adolescent Mental Health Service. The first time I sat in that typical 'comfy' chair in that dingy room, eyes to the floor, trying to avoid the gaze of a bemused psychiatrist who was older than my dad, I came to a startling realisation that my life had seriously gone off course. I remember thinking to myself - 'Oh great, now I'm the mental kid!'  Of course I wasn't but that's how it felt at the time.  Straightaway I decided that this was a part of my life that no one was to know about and that I would prefer to deny was even happening myself.

That was 10 years ago.  Now I can admit that dark part of my life did indeed happen and I no longer see myself as that 'mental kid'.  I was a smart and intelligent young girl but I had a lot of problems, desperately needed help and there's no shame in that.  I therefore want to share the story of my CAMHS experience in the hope that it may help other young people who have been referred to the service and their families as well.  What I remember more than anything about my time under CAMHS was that it was a time in which I felt incredibly lonely, isolated and different to my friends.  As far as I knew, none of my friends had to go to see a psychiatrist every week and be told they weren't 'normal'.  Feeling that way certainly didn't help me fight a battle with my mental health and I would hate for anyone else to feel that way.  So many young people experience mental health problems,if you are one of them you are certainly not alone and so you shouldn't feel alone.  There is no shame at all in seeking the help you need; it's not a sign of weakness, it's a sign of great strength and honesty.  It can be far less daunting to seek help though if you have an idea of what to expect and I'm hoping sharing my story will help with that.

In order to get a CAMHS referral you have to be referred by your GP.  Other services, including your school nurse, can provide information to go alongside your referral but ultimately your referral has to come from your GP.  CAMHS treats a number of mental health problems in children and young people under the age of 18, it also offers support and advice for young people with other additional needs including autism and behavioural issues.  In my case, I had just turned 13 years old when I received a referral to CAMHS.  I had a very traumatic childhood although was completely shut off to talking about it or even acknowledging it.  The main reason I was referred to CAMHS was for an eating disorder.  Although I was referred to CAMHS at the age of 13, my eating disorder had begun long before then, I began to restrict my food intake at the age of 7 and from then onwards became extremely underweight.  My parents separated when I was 8 and my dad met my step mum shortly after.  From the get go, my stepmum was very concerned about how underweight I was.  As harsh as it may sound, my parents were very wrapped up in their own problems and so it made sense that it took an outsider to see mine.  After years of nagging from my stepmum and from my dad as well, when he was sober enough take stock of the situation (which wasn't often), I finally admitted defeat and agreed to be taken to the doctors about my weight.  My dad was an alcoholic and I had got it into my head that if I was the 'perfect daughter', he would love me more than alcohol and stop drinking.  I then thought that perhaps this was just the one thing he didn't like about me and if I did what he wanted and went to the doctors things would get better all round.  I thought it was just going to be a case of going to the doctors, being told to eat a bit more and being packed off home.

I was wrong.

As soon as the doctor saw me, he took one look at me and said, 'I would ask you how I could help today but I think I can already see the problem.'  

Within moments I was propped on the scales, had my height measured and the doctor told me my BMI. I was told that I was extremely underweight and was most probably suffering from an eating disorder. The doctor then asked myself and my stepmum a series of questions about the amount I ate and was interested to know more about my food phobias.  I was very reluctant to answer any of his questions sensing that things were quickly becoming a lot more serious than I ever imagined they would be.  However, I did say that I thought I started eating a bit less around the time that my parents separated but then quickly threw in that I really didn't think the separation affected me in anyway. The doctor heard all he needed to and informed us of his decision to refer me to CAMHS where there would be specialists to diagnose me with an eating disorder and offer support to tackle the problem.  I was in complete shock.  I remember sitting there completely frozen while the GP made the referral over the phone system in which he relayed our discussion.  It's always when someone talks about your problems out loud that they suddenly become a lot more real.

My referral to CAMHS was surprisingly quick, I had my first appointment within 5 days of seeing the GP. The referral was put through as urgent as I was at an extremely low weight.  As I've said, this was 10 years ago, unfortunately I've heard lots of stories since of referrals to CAMHS taking months.  The only advice I can offer on this front is to just keep up the pressure and get as many other people as possible to also put pressure on them (GP, school nurse, charities etc.).  In my case, my parents were fully aware of my referral to CAMHS as it was them who more or less instigated it.  To my knowledge, you can present yourself to your GP on your own and ask for a referral to CAMHS without your parents knowing.  However, once you have been assessed by CAMHS and if they agree to offer you support, your parents do legally have to be made aware.  If this is something you are really worried about, CAMHS can offer you support in having these conversations with your parents.  In many cases, it can actually be really helpful to have your parents on board to support you with your mental health problems, especially if you are living at home.  Also, it can be hard enough suffering from mental health problems without worrying about hiding things from the people you live with.  You do have a say in how much involvement you want your parents to have in the support you receive from CAMHS.  Depending on your case, CAMHS may encourage you to bring your parents along to your appointments, may prefer to work with you on your own or may go for a combination of the two.  You also have a say in how much information you would like to be shared with your parents but in some circumstances, if CAMHS are concerned about your safety, they have a duty to inform your parents or guardian.

I went to all my CAMHS appointments with my stepmum as I was in complete denial about my mental health problems and would not have engaged in the service at all otherwise.  I also suffered from selective mutism as a child and could find it difficult to speak to someone I had not met before and certainly when it involved talking about personal issues.  My dad was encouraged to come to some of my appointments and my mum was asked to attend a one to one appointment.  The psychiatrist I saw was keen for my whole family to be involved in my recovery but not in a family therapy type arrangement.  They were more there to take responsibility for my food intake and give their account of how I was doing as I could not be relied upon to give a very honest account.  I was only ever given one opportunity to speak to the psychiatrist on my own which lasted all of a couple of minutes as I would not say anything to him.

Your first appointment with CAMHS will be an assessment appointment.  In my case, the assessment was carried out by the children's psychiatrist I carried on seeing for the course of my treatment but this is not usually the case anymore.  I remember being asked a series of questions about my mood, my interaction with friends and whether I was anxious about anything.  I was conscious to give the answers that people would want to hear rather than divulging the truth in the hope that it might be my ticket out of there!  This was not clever and not a tactic I'd recommend for anyone to use.  Whatever problems you face in your life, if you want help to overcome them then you need to let people in so that they can know how to help you.  I had never been very good at letting people in and I quickly decided that the psychiatrist was not someone that I wanted to even give a chance to.  The psychiatrist drew my family tree in which he asked for limited details from me about each family member.  Perhaps the fact that the only thing I was able to say about my dad was that he liked going to the pub may have offered a bit of a suggestion as to the problems in my home life.  Yet that was the full extent of my conversation with the psychiatrist about my family background, he never asked any further questions.

The psychiatrist went on to ask questions about my eating as that was the main purpose behind the referral.  I had my height and weight measured and was shown on a graph where I fell compared to other people my age.  This did not deter me in anyway, I told the psychiatrist that I wasn't at all afraid of eating, did not feel at all unwell, had boundless energy etc.  Needless to say, he wasn't convinced and my stepmum, much to my displeasure, filled in a lot of the gaps for him.  I did however openly admit that I was phobic of certain foods, I wasn't sure of the reason why and that I did want to address the problem so that I could be less awkward for my family to feed.  I was quickly told that we would not work on that until I had gained weight by eating the foods I would eat as my weight was such a big concern.  He then listed to me all the health complications I would encounter and said what it all boiled down to was that I would be lucky to make it to my next birthday, let alone my 16th.  

I sat there still and emotionless.  From my perspective, there was absolutely no truth in what he was saying, it was ludicrous - I wasn't going to die!  My eating disorder made me feel invincible, I was so absorbed in it that the reality seemed alien to me.  As much as I tried my hardest to hide it, I was terrified though.  I suddenly realised that I was going to be made to face my worse nightmare - I was going to have to eat and gain weight.  My stepmum was told to keep a diary of what I ate during the week and despite the fact that I had not yet been diagnosed with an eating disorder, due to severity of my condition, she was instructed to double all my portions.  I tried to give the impression that I was not at all bothered and that eating more would not be a problem for me - yet again constantly searching for my ticket out of there.

At my following appointment, I was diagnosed with Anorexia Nervosa.  You have to be referred to a psychiatrist in order to receive a diagnosis but as I was already seeing one, I had the information collected for my diagnosis within one of my usual appointments.  A lot of my CAMHS appointments were a bit of a blur to me, especially this one but I do remember being asked questions about what I saw when I looked in the mirror, whether it was important to me to mature like other girls my age, whether I thought it would be bad to be fat, about how I felt when I ate and so on.  I could see exactly where the psychiatrist was going with his questions and I was conscious not to give him any fuel for his fire.  Despite all my evasion, the result of all that questioning was that I did still receive my diagnosis for anorexia.  I was shocked.  I was so deluded by my eating disorder that to be told I had one felt as though the world had gone mad.

I suppose you could say that was the start of 'my eating disorder recovery journey' but I'm sad to say that it never felt that way to me.

My eating disorder recovery programme consisted really only of these weekly appointments with the psychiatrist in which I would be weighed, be questioned on what I had eaten and told to gain more weight.  I also had to go for regular blood tests, most of the results of which were lost.  I was never given a meal plan, other than my stepmum being told to just feed me more and more.  I was told by the psychiatrist that I would be seen by a dietitian who would look more closely at the food I was eating, educate me about food and come up with meal plans.  Throughout the 2 years I was under CAMHS, that dietitian appointment never happened.

Every week when I went to my appointment, the first thing that would happen would be that I would be weighed.  I did have a target weight to work towards and I was expected to gain 1-2 kilos a week.  The least I was expected to do was gain, even if it was not by much.  My stepmum would then read out a diary of what I had eaten during the week and how much exercise I had done.  I was never stopped from doing exercise throughout my treatment so long as I ate everything I had been given.
If I had gained weight then generally all was okay.
If I hadn't that was another story...

The psychiatrist would ask me again and again if I had made myself vomit as the amount of food I had eaten and my change in weight did not add up.  I have never purged but repeatedly the psychiatrist questioned me.  It felt as though I was being pressurised into saying 'yes' just to provide him with an explanation and that upset me a lot.  The thing with weight gain is that you naturally plateau at points.  It was really difficult to be 'told off' when I had eaten everything I had been given and followed everything I had been told to.  It didn't feel fair.

A lot of people say losing weight is hard but I swear gaining weight is harder.  I tried to give the impression that eating such a large amount of food wasn't a problem as I was still keen to show people that there was nothing wrong with me.
In truth, it felt like torture.
It is so hard to feel more full than you ever have done in your life and know that you still have more meals to face.  When you've become extremely underweight, in order to put on weight, you have to eat far more than the daily recommended allowance and this is very difficult for the anorexic mindset to accept.  For some peculiar reason, the psychiatrist was keen that I drank a pint of milkshake before I went to bed every night.  This I found the hardest after eating so much during the day.
I despised milkshakes after a week or two!

Every session, the psychiatrist told me that if I didn't gain weight, he would stop me going to school and would put me in an inpatient unit.  He reminded me during every session that due to the irreparable damage I had done to my body at such a young age, I would never have children and that there was every chance my organs would shut down and I would die.  Then came the clincher - he said that the reason I was anorexic was because I was 'mollycoddled' and spoilt as a child, with everyone 'pussy footing around me' and that I ought to think about just how much I was hurting my family.

As ever, I sat there emotionless and speechless.  The anorexia definitely numbed me but still inside, those words destroyed me.

All I ever did was care about my family, much to the detriment of my own needs.  My home life was so chaotic and out of my control that food was the only thing left that I could control, so I hung onto it for as long as I could.  If the psychiatrist spent one day in my childhood, he would have realised that there was nothing 'mollycoddled' or spoilt about me, in fact quite the opposite.  Everything the psychiatrist said to me just increased the self blame and guilt I was already consumed by.
Of course, I never spoke back at what he said.  My parents were always present at my appointments and I wouldn't have dared say anything in front of them out of fear of what might happen when I got home.

My dislike of the psychiatrist...
He was always late.  As my appointments took place during school time, this meant I was missing more lessons than I needed to.
Whenever he saw us in the waiting room, he smirked at us.  It always felt as though he was looking down on us.
He had this tendency to measure me against the 'average teenager' which made me feel even more abnormal.  To give an example, one he said to me that I come across as being very serious, without much of a sense of humour!  I responded that I didn't think this was the case at all as most of my friends would describe me as being funny and a bit of a joker at school (which was true).  He then sat back and said, "Fine.  Do something funny for me..." as though he was expecting me to act on the spot like a performing monkey!
The worst thing about him - despite seeing him for two years, not once did he ask me how I felt.
He didn't really ask anything about my life or my interests.
He never asked how my week had been, what I had been up to,  what I had done over the holidays etc.
The only question he would really ask me was, "How's your weight?"
The thing with eating disorders, which sounds strange to a lot of people, is that it's not about the food.  It's about why people don't eat and it felt as though he didn't care enough to even attempt to find out why.
I certainly did not trust him or felt able to speak with him openly in any way.

I felt like I didn't matter anymore.  Nobody cared about what I felt or thought anymore.  All they cared about was whether I had put on weight.
How did it affect me?
I became depressed and suicidal but I didn't even tell anyone about that.

It really saddens me to write about this because I hate that I felt that way at such a young age and didn't feel able to talk to anyone about it.  If I wanted this blog post to achieve anything it would be that if a young person reading this has ever felt like this, they would reach out for help in the way that I didn't.  However scary it feels, just tell someone, whether that's your parents, doctor, CAMHS, a teacher or a friend, just tell someone.

My whole experience of CAMHS more or less forms a repetitive blur of all the things I've mentioned above.  I gradually put on weight under CAMHS although never reached a healthy weight.  For me, it always felt as though I was forced into a body that I had not been prepared mentally to cope with.  In a sense though my experience with CAMHS was cut short as after two years my mum decided to withdraw me from treatment.  I have not mentioned my mum's role in all of this so far.  As I've said, my parents are separated and my referral to CAMHS came through the efforts of my stepmum and dad.  My mum was made aware of the referral after I received my diagnosis.  She agreed to follow the guidelines the psychiatrist gave with regards to food but was did not believe I had an eating disorder.  Some of my denial must have rubbed off on her, we had been through a lot in the past and I think my mum just wanted me to be okay and for none of it to have affected me so she convinced herself it hadn't.  I don't blame her, it was an understandable reaction.  My mum and dad had a very difficult relationship and the issue of my eating disorder seemed to drive an even bigger rift between them.  When I was 15 my mum wrote a letter to the psychiatrist stating that she refused to allow me to receive any further treatment from the service.  She made the decision on the grounds that I was having recurring nightmares involving the psychiatrist telling me that I was going to die and that I was never going to have children and felt that CAMHS had in fact had a detrimental impact on my mental health.  My mum received a letter of response from the psychiatrist in which he said that CAMHS would get the social services involved as I was still underweight, required further treatment and refusing to let me engage in the service was a form of abuse and neglect.  It was pretty scary to say the least but we never heard anything from the social services and at the time, I was just relieved not to have to see the psychiatrist again.

A part of me has always wondered though what life would have been like for me if I had continued my treatment under CAMHS.

I know that my CAMHS experience is probably coming across as being quite negative and in many ways it was.  I may have improved physically under CAMHS but mentally I was left far worse than before.  I often think that if I had a more positive experience with CAMHS I may not have experienced such severe mental health problems as a young adult.  Unfortunately I felt so traumatised by the experience that I would not seek any form of health care for 8 years after leaving CAMHS.

All that being said, I don't think I'd be here today if it wasn't for the intervention I received under CAMHS to improve my physical health.  I may not have wanted to admit it at the time but physically I did feel better for gaining some weight - I didn't feel as though I was going to pass out all the time, I wasn't cold all the time, it didn't hurt to lie down and my hair got thicker.  As awful as it felt and as hard as it feels now to even think about that time in my life, I don't think I regret my time under CAMHS.  I would say that if you hit a difficult point in your life, it is always best to reach out for whatever help you can get, even if you're not completely happy with it.  There are also a lot of things I know now that I wish I knew then.  It's important to remember that you are always entitled to speak up and let services know if you are not happy with the help they are providing you.  If you are under CAMHS or indeed any mental health service and you feel you are not clicking with the person who has been assigned to help you, you are entitled to ask to be changed to someone else.  I now see that my CAMHS experience could have been so different if I had received help from someone I felt comfortable speaking with, who would build my confidence, trust and help me to open up and reveal the bigger picture behind my struggles.

All CAMHS services are different.
  The CAMHS service I was referred to has since been signposted as a cause for concern.  I do know people who have had much more positive experiences under different CAMHS services.
This is also just my personal story and there were lots of factors that affected my engagement with CAMHS.

I want you to know that mental health problems are incredibly common.  So many young people suffer from them.  When I was going through that difficult time as a teenager I felt so alone and shut off from everyone.  Little did I know, there were others around me who were facing similar struggles. I work in a school now and I come across so many lovely young people who suffer from mental health problems.  I also see that there is always support out there.  I see many of them come out the other side, improve and become stronger people in the process.

Whether you want to seek the support of a mental health service or not, you should never suffer in silence.  We all need support at one point or another in our lives.  So if there's something that's been really affecting you or playing on your mind, take the plunge and tell someone close to you or who you can trust.  Talking about a problem goes a huge way towards dealing with it.

Love and Strength.

The One Day Seeker