Why do CAMHS fail Autistic service users?
Child and Adolescent Mental Health Services (CAMHS) are the main mental health services for children and young people in the UK. The service is largely known as a branch of the NHS, although private services often have their own CAMHS service. Their remit is to address mental health issues within people under the age of 18.
In principle, this sounds very good. A free NHS service that works with young people experiencing mental health issues. Unfortunately, their is a significant disparity in how they support Autistic young people. To be blunt, they dont, with the vast majority of Autistic people being turned away. This is problematic for a number of reasons that I will talk about in this article.
What happens when Autistic young people are turned away?
One of the most frequent things to happen is that Autistic young people and their families will be referred to MASH as a child in need. This is problematic for a number of reasons:
Institutionalised Parent Carer Blame (IPCB)
IPCB refers to the institutional practice of shifting blame for an individuals struggle onto their parents or carers. This practice often means that parents/carers are sent on courses to improve their skills while no meaningful support is offered to the young person. At the very worst, it has resulted in accusations of Fabricated or Induced Illness (FII).
Social workers can not provide therapy or medication if it is needed
It is not within the remit of social workers to provide diagnosis or treatment of mental health issues. Often, they are involved in the institutionalisation of those with mental health issues, but are unable to do more than refer on to other services.
Loss of trust
Many families of Autistic young people have negative experiences of social workers. Referring someone as a safeguarding issue compounds the trauma that we already experience frequently and has the potential to cause of loss of trust in services that is harmful to the young person.
Something else that often happens is the passing of the Autistic person to Learning Disability services. This is inappropriate and comes from the misunderstanding of what learning disability and autism are. While they can frequently co-occur, they are not the same thing. I have heard many learning disability professionals question why Autistic children are referred to them.
Some areas have specialist autism services. This might sound promising, but is afflicted with many issues:
Professionals lack competency with regard to Autistic experience and culture
The vast majority of professionals do not know that the Autistic community exists, let alone access it or learn from Autistic knowledge.
Some professionals have a great deal of ableism in their views
Ableism is everywhere, including the Autistic community. It should come as no surprise that services contain a higher rate of abelist views than the general population.
Services often focus more on teaching neurotypical skills than supporting the mental health of Autistic young people.
Teaching an Autistic child to mask their Autistic behaviours in favour of appearing more neurotypical is actually going to lead to further mental health issues.
There is, of course, another possible response at the other end of the spectrum. Autistic young people can be inappropriately sectioned and locked away in Assessment and Treatment Units for extended periods of time. Anyone who thinks that the days of institutionalised Autistic people is over need look no further than the more than 1,200 Autistic people currently in mental health units. This tends to be the result of no prior support leading to catastrophic consequences with many spending years lovked away.
Why do these failures happen?
Autistic people are positioned as lacking competence to run their own lives. We are also subject to worldwide dehumanisation and mistreatment. Many services claim to be neurodiversity affirming, but in practice, this is often very performative and used as more of a buzzword than anything else.
In order to effectively support Autistic people, CAMHS professionals would have to not only let us through the door but also learn a completely new set of skills and restructure the way services engage with those accessing them. Not only do the funding and resources currently not exist to do so, but a vast number of professionals believe there is nothing wrong with current ways of treating Autistic service users.
It is part of a wider issue in society with disabled people being told they should be grateful for their mistreatment and that we are burdens on a struggling system.
While CAMHS is failing Autistic children, we will continue to see needless deaths and suffering our community. When I think about my own experiences with CAMHS, I can’t help but think of my own privilege in being able to turn it around.
So many don’t have the privileges that I do.
How do we combat this mistreatment?
Changing CAMHS into something that works for everyone is a long process, but at the heart of it is the work of Autistic scholars and knowledge creators/communicators. Each of us must continue to make noise and speak about this issue. Nothing is more detrimental to human rights than silence.
Silence is a de facto compliance with oppression. The paradox of tolerating mistreatment and dehumanisation is that we allow it to perpetuate. Services can be viewed as broken at this point. The only way to recover is through open communication and acceptance and correction of past mistakes. The usual service line of “we will learn from this” is not enough for all the Autistic children who have been fatally failed by CAMHS.
The only way this situation changes is by each of us telling our story. We need every person failed by CAMHS to speak out. We must draw a line in the sand at this point and say no to the exclusion of Autistic people from support they are entitled to.
For more information, visit the CAMHS Crisis page of this website.