What do you do when CAMHS can’t help?
CAMHS Services around the country are often under-resourced and over-stretched. If a child or young person develops a mental health issue, CAMHS may be able to offer regular appointments but there may be a long waiting list for an initial appointment. Most young people with a mental health issue are at home for most of the time, and that means there are thousands of parents who are the only or main mental health safety net their children have. I’ve been one of those parents, and it’s a very scary and isolating place to be. Along the way I learnt some things that might be helpful to other parents which I’m passing on here.
I have no psychological training whatsoever. I am not an expert, so these tips are not intended to be used instead of support from mental health professionals. These are “stop-gap” ideas for when you are on a long CAMHS waiting list, or when such support is not available at all to your family.
There are dozens of reasons why a child might have developed mental health issues, so here I’ll only be dealing with general, fairly universal coping strategies to hold the fort until things either get better or more formal support becomes available.
Don’t beat yourself up
Your child’s mental health condition is not your fault. Your child has a disorder or a condition or an illness that is as real and as concrete as any physical illness, except that there is far more stigma attached to having a MH condition, as well as far less understanding and empathy extended to those who have them. MH issues are rarely discussed, so we are not comfortable with the vocabulary, nor are we familiar with the symptoms and behaviours associated with these conditions. Parents often soul search to try and remember an incident or a moment when “it all went wrong”, but there almost certainly aren’t any. MH issues are complex, multi-layered and unique to each individual. They are almost never caused by something a parent did or didn’t do, so please stop beating yourself up. THIS IS NOT YOUR FAULT.
It’s not your child’s fault either
He or she isn’t behaving this way because they want to, or because they are being naughty, or because they want to upset you or wind you up. They have no choice; their MH condition is causing any unusual behaviour or symptoms, they don’t want to be like this. Inside they are hurting like hell, and just like the adults around them, they too don’t understand why or have the vocabulary to explain how they feel or why they are behaving like they are. They are frightened, they are unlikely to have any greater insight as to what is happening to them than you have.
Take care of yourself too
There are no quick fixes or instant solutions to MH difficulties, you and your child are likely to be in this for the long-haul. It helps if you can accept this as the reality as soon as you can, and then plan ways to look after yourself. Looking after yourself is essential; your child needs you to be there for them and to be as strong emotionally as you possibly can be. Seeing your child in inner turmoil is one of the hardest things for a loving parent to bear; it hurts like hell, it tears us apart, and it is frightening and bewildering. You will be tired and drained, your thoughts will be working in over-drive, and you are at risk of a depressive illness yourself unless you can find a way to pace yourself, switch off sometimes, and take time out. Make sure you always have at least some ring-fenced time just for you every day. See if there is anyone else – a partner, a relative, a good friend – who can take over the reins and be with your child instead of you sometimes so that you can get out of the house and recharge your own batteries.
Protect your child from your own negative feelings
Your child is having enough of a tough time dealing with their own emotions, they simply don’t have the resources or the resilience at the moment to deal with yours too. A lot of us make the mistake as parents of trying to let our child know how much we love them by telling them how upset/hurt/frightened/worried/whatever we are about them. We may keep on trying to demonstrate our love by insisting on hugs all the time or sitting next to them telling them how much we love them while we are unable to hide our own tears. Right now, your child needs to know that you love them, but they can’t handle knowing how much their own MH issues are impacting on your own emotions. They need to know that you are there for them, strong and able to cope. If they see you wobble, they may feel their whole world is shaky, and to see how their problems are affecting you may make them feel incredibly guilty on top of the already negative emotions they are struggling to cope with.
Keeping the channels of communication open
Parents often feel a need to talk the MH issues over with their child repeatedly, trying to reason with them, or to encourage their child to reveal their innermost thoughts and feelings. It’s not going to help, and it could make your child feel worse. Instead, do everything you can to keep the channels of communication open, but in a way that is friendly, chatty, open and as normal as possible. I know that’s hard, particularly if your child is withdrawn or aggressive or you’re facing some very difficult challenging behaviour, but it is so important. Even if any attempt at conversation is always met with grunts, or shouts or something being thrown at you, carry on making attempts at conversation. These conversations are sometimes very one-sided, often uncomfortably so, but they are vitally important.
The teenage son of a friend of mine had a very serious depression that lasted several years, and he made a number of very determined suicide attempts during this period. It was very normal for him to withdraw to his bedroom for days at a time, lying on his bed, doing nothing other than stare at the ceiling. His mum, worried sick that he might be making yet another suicide attempt, used to ensure she went up to his bedroom at least once an hour and chatted to him. He rarely replied or even acknowledged she was there. She racked her brains to find things to talk about but always managed to talk about something, no matter how mundane or boring. For all those years she felt he was hostile and resentful towards her, she felt that all his troubles were in some way her fault. She even wondered if her continual nattering was making his depression worse.
He made a full recovery in his late teens, and some years later they were talking about those years, and she admitted that she always felt awkward coming into his room and forcing him to listen to her prattling away about nothing. Her son was astounded, and then gave her the biggest hug he’d ever given her. “Mum, you were what kept me going”, he said. “Through everything, I always knew you were there and you hadn’t given up on me. I used to love those chats, and when I heard you coming up the stairs I felt something close to happy”. At the time, she hadn’t had a clue that she even mattered to him, she had had no inkling whatsoever that she was lightening his load a little by her perseverance. I’ll never forget that story, and it has helped me enormously at times with my own children.
Invent your own MH vocabulary
Whilst it’s probably not a good idea to try and probe deeply into your child’s difficult feelings, it can be useful to have some way for them to communicate whether it’s a good or a bad day, and whether they feel up to doing something or if they need to be left alone. If you can, encourage your child to find their own name for their moods. I know a child who was either having a “chocolate” day or a “broccoli” day. Some children can express their moods by using words like “metal”, “wood” or “gooey”. Some families successfully adopt a number system – 10 means that a child feels up to eating a whole meal with the rest of the family whereas a 1 or a 2 indicates that they feel very vulnerable indeed. Animals or colours work well sometimes, too. Suggest the idea to your child, but if they can choose their own words for it, so much the better. Anything at all that keeps them in the driving seat can only be good.
I’ve recently read about how important it is for people with MH issues to stay connected with others. A sense of connectedness can actually have a preventative effect on suicide risk; those with strong connections to others are less likely to take their own lives than those who feel isolated and unconnected. The more connections you can keep going for your child the better. Even if they are in their bedroom most of the time, you can still have friends and family coming over, who can pop their heads around the bedroom door to say hello while they are in the house.
It’s also often easier to chat with any child, regardless of their mental health status, when there is something else happening. Many parents have found their child suddenly opens up on a car journey, or when watching TV or cooking together. Sometimes it may be that its easier to talk more naturally when they are distracted, or when they aren’t expected to maintain eye contact.
All behaviour is communication
Sometimes a child with mental health issues can behave in such a way that they can be hard to like, never mind love, all the time. It’s perfectly normal to have negative feelings about your child sometimes, so again, please don’t beat yourself up over it. It helps to try to separate the behaviour from the child, so that you can love the child without liking their behaviour.
All behaviour is communication, or so the experts say. Your child is behaving in a particular way because somehow, deep down, there may be some pay off; in some way the behaviour is serving a purpose. There will be some sort of logic behind whatever behaviour they are exhibiting. Children with sensory processing disorders sometimes have aggressive meltdowns to try and stop them from hearing, seeing or smelling anything else because they are already on sensory overload. It’s well documented that teenagers who cut themselves do it to distract themselves from a deeper emotional pain. Children sometimes hurt others as a way to let the adults close to them know that they have been hurt in some way. Try and trust your child, try not to judge them, just let them know they are loved. They are not doing these things to be naughty, they are doing them because they are hurting, so punishment will only hurt them further, and may damage the trust you and they need to have in one another.
Finally, beware of the armchair psychologists!
Every family has them; people in your closest circle who will not be backwards in coming forwards to tell you exactly what you’re doing wrong as a parent, and what you should be doing instead. Any sentence that starts “Well, in my day….” or “You’re much too soft…..” or ” What that kid needs is a …..” or “Well my children would never dream of doing…..” is unlikely to auger well.
Remember, nobody else has ever brought your children up, and that makes you the undeniable expert, and a pretty damned good one at that!