Son in CAMHS, emergency SEN review, social care assessment

[hsmum]

Hi,

 

I have posted on this forum several times with respect to this topic,so forgive me if some of the content sounds to familiar. My son has Asperger's syndrome and at the end of last year his mental health began to deteriorate rapidly, he could not cope with school and he was admitted into a local CAMHS unit in April with anxiety, depression and what seemed, at the time, to be a thought disorder. To cut a long story short, my son's mental health has improved and I attended a Care Planning Meeting two weeks ago fully expecting discharge to be discussed. However, I was shocked when the mental health social worker who is attached to the CAMHS unit informed me that he had made a referral to Social Care for a core assessment and another member of the team present said that temporary fostering may be the recommended option from the assessment. I was very angry that such a referral had been made without parental consultation and I voiced my complaints to the local authority. However, my son had refused to come home a few times and he had run away form the unit after visits home, so I could almost understand why concerns may have been raised. I also knew that I needed support from the unit an authorities to help my son move to a more specialised educational provision. So I agreed to the assessment. It should take about 30 days to complete.

 

Today my husband and I attended an emergency Interim SEN review at my son's school. The meeting was supportive to a great extent. The school stated that they could not meet my son's needs, the Consultant Psychiatrist from the CAMHS unit said he would support our application for a more specialised provision. However, the Head from the special school we visited, who had seen my son on the unit said he was very concerned about my son's dark thoughts and the fact that he mentioned them so openly. He added that there were very vulnerable pupils at the target school and they would not be able to cope if my son talked to them about such matters. Again, I was a little taken aback because the school specialises in provision for boys with AS and I felt that the Head must surely have come across boys who said totally inappropriate things at interviews. However, I accepted that what my son had almost certainly talked about some graphic and possibly sexual content and the Head had to consider safeguarding. The Consultant Psychiatrist did confirm that my son's dark thoughts were being managed more appropriately on the unit now and he now has a set of rules pertaining to who he mentions the thought to and so on.

 

The representative from the Local Authority noted that school had said they could not meet my son's needs and there was no alternative provider named so she said she would go back to the council and look at what was available. Provision in a PRU was mentioned, but there was a resounding cry against this and a 'bespoke package' of perhaps a tutor teaching my son in a learning centre of other establishment was considered as a temporary measure until something more concrete was available.

 

I have just completed a sweep of specialist provision for boys with AS in our local area and the situation is quite grim.; two providers are closing down and the others specialise in placements for pupils with severe emotional and behavioural difficulties or or with severe or moderate learning disabilities. Whilst I have no doubt they are excellent places, they would not meet my son's needs and he would not really fit in. The school that we had visited seems ideal and my son had written a statement expressing how he would like to go there (the fact that the Head had visited him on the unit seemed to reinforce his assumption that the school was a real option).

 

So, now we face the imminent prospect of a core social services assessment with an unknown outcome; my son has no secure educational placement for the next academic year; there is a danger of my son becoming institutionalised and I feel like the wheels of the system are taking over.

 

I am convinced that a placement in the target school as a weekly boarder would really change my son's life and if Social Care have any concerns about parental ability to cope, the semi residential placement would buy us more time to jump through the necessary hoops without any question of fostering.

 

I would love to hear from anyone who has had experience of navigating through the above systems. I am a bit lost at the moment.

[Sharn]

Hi

I have had similar situations and I wonder how old your son is? It took me until my daughter was 15 to get appropriate provision for her and do not accept accusations from ss as they and LEA are trying to protect their budgets. Find out as much as u can about the law and get a solicitor if u can afford. I managed to do it on my own, but u have to evidence why each educational establishment cannot meet needs. It is worth it. Look anywhere in the country as u have to, but there is more choice for boys. U have to fight all the way and the 'so called professionals' will think its your fault even though, like mine, ur child may have had it from birth.

Don't trust authorities or social services, get legal advice and fight for u son's needs to be met. Soley focus on that and u will get there.

Let me know what happens

Kind regards

Sharn

[Sharn]

I meant to say that when school says they can't meet needs, thats your ticket to find appropriately provision, dont just accept what they offer. They will offer cheapest option. You know your child, find best provision and evidence why others arent appropriate. Nothing s perfect but some are a thousand times better than others. It sounds massive but is worth it when ur child is more stable.

[Sally44]

I would also advise you to get in touch with the Family Rights Group. They are a charity that specialises in giving legal advice for families where Childrens Services have become involved.

 

We have been in a slightly similar position, but for different reasons.

 

Firstly, why do Childrens Services think that fostering is going to be of any benefit to your son rather than him staying with his family? Is any professional attributing any of his behaviour or thoughts to issues at home?

 

Are Childrens Services talking about a Section 20 residential placement in school?

 

Are Childrens Services questioning parental capacity?

 

Has any professional talked about the type of placement your son needs?

 

Can you get a definite answer from your parental choice of school as to whether they could meet your son's needs?

 

Can you be a bit more specific about what it is your son has said that they are so concerned about?

 

Why was your son refusing to return home and running away from home?

Edited July 14, 2014 by Sally44

[Sally44]

Childrens Services are supposed to provide services and support to keep children with their families unless there are safeguarding issues relating to neglect, abuse or parental capacity.

 

My son's SW talked about fostering. We think that was said to try to scare us. In our case our son has ASD and OCD and has been refusing school. Then he did something that potentially could have resulted in him seriously injuring himself. Because we had been asking for support for our son and help for us and nothing was being offered, I had said that due to increase in school refusal we were unable to be at home to supervise him and he could potentially be left home alone. That caused Child Protection Meetings to start and CS offered to fund 5 nights residential a week under a Section 20, with us retaining parental capacity. Anyway, things seem to be getting back on track now. I have said that he has never been left alone. And CS seem to accept that.

 

But I had basically put us in a dangerous position where my son is vulnerable, and then he had done something where there was potential to injure himself and I had said he is left alone. Not a good idea. But at the time I was desperate for professionals to actually do something instead of continually fobbing us off and not supporting our son so that he could access education. So basically I had lied to try to get the support my son needed in place. But it could have backfired and he could have been taken into care. I didn't realise the seriousness of what I had said at the time. I just said it out of sheer frustration, not thinking how Childrens Services would view the information I had given them.

 

Childrens Services are a law unto themselves. They do not seem to listen to any other professional. I have had to complain about this. For example, CAHMS Psychiatrist has said that the OCD compulsions my son has to cut his hair and eyelashes is due to OCD and is not self harm. Childrens Services continue to be of the opinion that it is self harm and that parents are being negligent in not removing all items that he could use to self harm with.

 

Our argument is that he can use the hairclippers and sissors safely. If we remove those items he will still have his OCD compulsions and will try to cut his hair using something else, that might be more dangerous than using hair clippers.

 

Regarding fostering. We argued that our son is on the autistic spectrum and therefore he needs consistency. Changes in those that care for him and changes in transitions will cause him more anxiety. Our son has never said he did not want to be at home. Yours has. Childrens Services will be listening to what your son wants. So what is your argument against what your son is saying to Childrens Services?

Edited July 14, 2014 by Sally44

[Sally44]

My understanding is that if it does go to Court ie. Childrens Services decide he should be a Cared For Child and that parents do not have parental capacity, then your son can get a solicitor to represent him and because they are representing a child, you do not have to cover the fees.

 

The problem in your case seems to be the fact that your son is saying he does not want to be at home. So you may need to prove that your son does not have capacity to make that decision.

 

But I am not 100% sure on that, so get advice from The Family Rights Group.

Edited July 14, 2014 by Sally44

[hsmum]

Hello,

 

Thank you again for the helpful replies. My son is 15 years old. The dark thoughts that he has can sound pretty disturbing: they express his anxiety that he may commit violent and even sexual offences. Professional opinion at the CAMHS unit is that the thoughts are a manifestation of anxiety and there is no real risk that he will act on them. However, my son will talk about the thoughts to anyone who he trusts. The Social Care referral came as a shock to us. My son has run out of the house a few time and he has run away from the unit after visiting home. However, he has also run away from the unit 10 times when he has not had a visit home; once he ran into town and was escorted back to the unit at 1 a.m. by a drunk man! Far from not wanting to come home, my son has expressed a wish to return home as soon as possible. However, he has only managed to sleep over once since he was admitted to the unit in April. I am willing to work with Social Care and the CAMHS Unit to gradually build up the time my son spends at home, however, I am worried that the insecurity about his school may lead to further anxiety. I am totally opposed to the idea of fostering because the problems do not lie at home, although I acknowledge that we need support to keep things stable for my son. The representative from the council who attended the meeting yesterday told us that the Section 17 Core Assessment will take about 30 days to complete. Then the council will need additional time to consider reports from the CAMHS unit and to consider other placements. I have no faith that anything 'bespoke' will be adequate. The next meeting was scheduled for late September, so it is possible that my son will have no full time education until October.

 

 

We have had two initial assessments from Social Care before. Both cases concerned parental ability to cope (my husband has AS and mental health problems and I am away from home for extended periods during the day) . Both cases were closed and we have worked with the CAMHS team to develop strategies we can use to help my son at home. The prospect of fostering has never been discussed before.

 

I will contact the FRG. I have read the discussion boards there and they offer good advice.

[cathcart3303]

Under section 17 all children with autism are 'children in need' and so entitled to a core assessment. Your son is definitely a child in need. I would be concerned about the person who has said your son needs fostering before the assessment is carried out. This happened to me. What should be identified is how best to enable your son. If your son and you both want your son at home then this should be supported.

 

This is actually separate from the educational placement unless consideration is given to social care funding some of a residential school placement? If the school are saying they are concerned at the thoughts your son is expressing this is not going to change if he is fostered. It sounds like your son needs strategies for dealing with expression of his feelings. This is for the services to implement and sounds like he needs ASD specialist psychological intervention. Has he had an assessment from an ASD specialist psychologist? I know a parent whose son has PDA but he is verbally expressing lots of sexual words. If your son wants to attend this school then he needs to know when and where during the school day he will be able to express himself and to whom. Is this part of a coping mechanism for him? Strategies he learns now may need to be carried forward into adulthood so it is important to address this now. What has your son said about the school thinking his verbal expression is a concern to him accessing an education there? At the moment he is in a place where people have continually told him to express his feelings and thoughts. They can't expect him to know that is not appropriate all the time and he needs to be taught this. I would speak to the ASD school again about how this could be managed.

[Sally44]

Cathcart is right about the funding of residential being under the Statement and Education.

 

However we found ourselves in a situation where OCD was causing the school refusal and low attendance, which is a mental health disorder. OCD is affecting his ability to access education, but the LA have refused to fund any residential. The NHS has also not agreed to fund any residential eventhough OCD is a health disorder.

 

So that left Childrens Services, who can only fund a certain amount of residential via respite. After that they can only fund further residential under a Section 20, and that means there has to be concerns by Childrens Services about the child's safety and capacity of the parents.

 

You may find yourselves in that position.

 

As said above, fostering is not going to resolve any of the issues. It will make them worse.

 

You need the right placement for your son, probably a weekly residential with your son coming home at weekends and during holidays? That is what you need to be seeking.

 

Be very careful of Childrens Services involvement because they do assess very differently to other professionals and they don't necessarily agree with or even consider other professionals opinions and advice.

 

You need a definate answer from the ASD school about whether there is a place available for your son and what support he would get in school via his Statement - as you may well need to go to tribunal to get the placement and to get the right level of support and therapy into the Statement too.

[hsmum]

Hi,

 

Thank you again for the replies. Sally, you are absolutely right about what we consider to be the most beneficial placement for our son. That would be a place at a school that specialises in meeting the needs of young people who are on the autism spectrum as a weekly boarder. This would give my son the structure that he craves and it could help him develop social and interaction skills that he finds difficult to develop at home. One of the psychologists from my son's unit is going to contact the Head of the special school to see if there is any possibility that he would consider my son as a potential pupil if evidence could be provided that the expression of his thoughts was under control, as Cathcart states, he needs strategies that can ensure he can manages his verbal behaviour. I think there are traits of OCD in my son's profile: he has become obsessive about cleanliness and his hands are red because he uses so much hand sanitiser.

[Sally44]

Then OCD needs to be recognised and diagnosed.

 

What you need to consider is that Childrens Services will look at how your son is vulnerable, and how he might be a potential threat to other children at home or in school etc with the things he is saying?? So you will need medical evidence that what he says is not what he wants to do.

 

If you look into OCD you will find that alot of people with OCD have sexual thoughts that they maybe paedophiles or other types of sexual thoughts. That does not mean they are going to act them out. That is what OCD can be to some people.

 

Have a look on www.ocduk.org on the discussion forums to see what kinds of worries and obsessions people have.

 

This is a link that gives a brief outline of what OCD is and it includes sexual thoughts. http://www.ocduk.org/obsessions-compulsions

 

There is alot more to OCD than being an obsessive cleaner.

[hsmum]

Hi,

 

Thank you for the link Sally. In one sense, my son is fortunate to be in a setting where additional needs, such as OCD may be more easily recognised and even diagnosed. I would normally be reluctant to ask for an assessment for another condition, however, in this case, such diagnosis may help other people (including ourselves) interpret his behaviour more accurately and reassure them that he will not act on these thoughts.

[Sally44]

I think it could be especially useful as part of the OCD maybe these sexual thoughts.

 

Have you queried about OCD with CAHMS? Because he does sound like he has it. I suggest you bring it up and ask that he is assessed for OCD to rule it in or out. I'm not sure what a "thought disorder" is. OCD is a thought disorder relating to anxiety.

 

And without a diagnosis of OCD [if that is what he has], he will simply be given another 'diagnosis' such as a "neurosis" or "psychotic episode".

 

OCD is very common with those on the spectrum. Many just have traits, but not enough to be clinically significant to the extent they are affecting the persons life. Your son's life is being effected quite significantly.