Friday June 1, 2018 ranks as one of the most difficult days in my life. A scant hour before Shabbat was due to begin, I found myself sitting in a coffee shop in Brent Cross, cartoonish tears dripping off the end of my nose into my Americano. Generally a pragmatic, optimistic sort of person, I just could not seem to pull myself together.
I had just admitted my almost 17-year-old daughter into an adolescent psychiatric unit, following a two-week stay on a children’s ward in our local hospital. The experience had been hugely unsettling; from the ambulance journey that transferred us from the Royal Free to the Priory North London, sitting on a backwards-facing bench, unable to see where we were going, to the bag search on the ward where ‘contraband’ such as a plastic container of rugelach, and the drawstring on her pyjamas, was confiscated and locked away. It hadn’t occurred to me that for a desperate teen, almost anything is a potential tool for self-harm.
Our story began nearly three years previously, when we noticed that our daughter was starting to exhibit repetitive behaviours that might indicate OCD. A visit to our GP wasn’t especially helpful — we were told that as the behaviours weren’t interfering with normal functioning, we didn’t really need to worry. With the benefit of hindsight, this was poor advice — our daughter was already struggling to cope. It wasn’t long afterwards that she began to suffer from anxiety attacks in school, so we embarked her on a course of Cognitive Behaviour T herapy (CBT) with a private therapist. But there was little improvement and our daughter’s difficulties were worsening. To fend off her anxiety attacks, she would scratch ferociously at her skin, or sit trembling, unable to respond to anyone who approached.
At that point we asked for a referral to CAMHS, the NHS’s children and mental health service. Three months later, our daughter was refusing to see the private CBT therapist, but even though we were finally called into CAMHS for an assessment around that time, she didn’t begin to start seeing a regular therapist until the six-month mark had passed.
These waiting times are typical, according to a report released last week, commissioned by NHS Digital. Nearly 50 percent of young people who received a referral to CAMHS in 2017 waited longer than six weeks for an appointment, and the average waiting time was nearly two months. With an astonishing 25 percent of young women under the age of 18 currently suffering from a diagnosable mental illness, these waiting times are clearly unacceptable.
Something that we have learned the hard way over the past few years, is that unlike many physical diseases, treatment for adolescent mental illness is a hit and miss affair. Since her referral was accepted by CAMHS, our daughter has tried several different medications and therapeutic interventions. Along the way, our “shock threshhold” has had to get higher, as the manifestation of her illness has intensified. Unsurprisingly, given the underfunded and understaffed nature of the service we’ve been engaging with, not enough “joined-up thinking” has been exhibited by the professionals responsible for her care. My poor daughter had been trying to express for a long time that no-one was taking her seriously enough — her psychotherapist, after all, only saw her for an hour-long window once a week if we were lucky, and if it happened to fall on a ‘good day’, it was chalked up to the recovery process. It was only after she seriously self-harmed under the nose of a dozing mental health nurse on the ward at the Royal Free, that she was finally deemed a candidate for in-patient treatment. It’s been an uphill battle all the way.
I cannot really fault the care my daughter has received in the unit over the past few months. While there have been challenges, largely due to sporadic communication from staff to ourselves, she’s finally been able to benefit from the “joined-up thinking” that was so lacking up until now. With individual therapy, group therapy, family therapy and occupational therapy, plus regular meetings with a psychiatrist to manage her medication, she has had access to world-class treatment.
Unfortunately, the funding issue has reared its ugly head more than once, with the NHS Commissioner threatening to transfer her to a different community unit (with a lower nightly fee) because she was taking “too long” to recover. Clearly this would have been a false economy — it’s no mean feat for a traumatised teenager to open up to a therapist and learn to trust her caregivers— asking her to start all over again in a new location would be incredibly counterproductive.
Fortunately, with the help of organisations such as NOA Girls and JAMI, who are always at the ready with advice and support, we were able to argue our case and keep her in the same unit throughout. But as worried parents, we could have done without the added layer of stress and uncertainty and I’m sure it set back our daughter’s recovery too. And not every parent has the education and ability to be able do this — we were also lucky she is only twenty minutes from home and not halfway across the country.
Half a year since my very own “black Friday”, I’m sitting in a different coffee shop, typing these words under very different circumstances. My daughter is at home as part of a four-day leave, healthy enough to be left unsupervised, working towards a BTEC in Health and Social Care; she plans to study nursing when she leaves school.
Just a few days after this article is published, we’ll hopefully be attending a meeting to discuss the logistics of her discharge from the Priory. The future looks a lot brighter than it did, but there are still many challenges ahead. Back in the care of the “community team”, will the services she accesses ensure that she builds on her current progress? And will her teachers have sufficient training to be able to respond appropriately to her, when she experiences emotional difficulties at school, as she undoubtedly will? I don’t know the answers to these questions— I can only hope that the fact mental health is currently such a ‘hot topic’ means that funding and provision continually improves, and that pilot projects such as the JLC’s plan to recruit well-being practitioners for Jewish schools, will bear fruit.
On World Mental Health day in October, my daughter posted the following on her Instagram: “To anyone who suffers from a mental illness, you are so very strong. Nothing is more terrifying than fighting with your own head every single day.”
We owe it to these brave but struggling young people to ensure they have access to proper care and treatment. My daughter and her peers have endless worlds of untapped potential within them – it will be at enormous cost to every single one of us if we allow the system to fail them.
