Yesterday and Today

Tags

camhs, GP, housing benefit, Liberata, pain, random shit

Yesterday,

I went to therapy. We discussed whether it was working and my ability to talk about anything bar what I needed to. My therapist isn’t pushy enough so we’re both going to have to work on this. Otherwise it’s not worth it.

I spent 3 hours, 3 hours of my life I will never get back, gathering the information and documentation that Housing Benefit require to check my claim. I kid you not, 3 fucking hours. I sent it in to find out that my council has outsourced benefits so it’s all being checked by some faceless, nameless (Liberata) company who is aiming to make a profit on my housing benefit and no doubt gets a bonus for every few people it chucks off housing benefit or any other benefit.

It’s so tough, being young

Tags

camhs, emergency, rope, suicide

My son went to his school counsellor this week, luckily to the same one he’d spoken to a few years ago, and told her he was having strong suicidal thought, had equipment and a plan.

Hence the phone call that interrupted my Introduction to Counselling.

I was sort of pleased that it had got so bad he talked to a grown up and sad that it had got this bad. It’s been a couple of weeks since he had gone out with a rope and I had just been getting on with life, as seemingly had 3son.

The counsellor phoned up the GP and made an emergency appointment for later the same day. I went home and phoned up CAMHS to see if I could jump start negotiations. 3son finished with them just over three months ago and their queue jumping invitation expired a week ago. However mentioning suicide and rope got me into Tier 3 rather than Tier 2, a bit like levelling up a really horrendous computer game (Skallagrigg anyone?) as well as a strong insistence that they couldn’t do anything without an official referral from the GP.

So we went to see the GP. 3son was at his best at being non-communicative, saying that therapy sucked and he just wanted pills because all his friends had them and feel so much better. She was good at saying he needed to change his mindset just a little bit and be a bit more open to change, whether via therapy or pills otherwise neither would work and she wouldn’t be interested in prescribing him anything without some willingness on his part. He was as negative as he could be but considering he’d been talking about suicide that’s hardly surprising. The GP said she’d make the referral and that was it.

The next day I got a phone call from the different duty clinician at CAMHS who said they’d hope to send out an appointment soon and that it should be within 3-4 weeks. It’s a good thing he’s not desperate really, and again unsurprising he doesn’t really trust CAMHS or anyone else. He said he would go and see his school counsellor.

Everybody talked about keeping him safe in the meantime and having a safety plan. This consists of knowing you can go to A&E if you’re inconsiderately feeling suicidal outside of office hours and the possibility of talking to someone, anyone instead of committing suicide. We also talked about the fact that he has hidden the rope and I don’t know where. It might not even be in the house. I was also advised to remove all sharp implements and knives from the house and watch the medicine. I can’t say I felt that any of this was helpful for either of us.

I have to say I felt numb the whole afternoon. This feels like a process that we have to keep going through, that may get better or may get worse but other than being there for him there’s really fuck all I can do. I am patient, supportive and all those things and he has told the counsellor that I’m quite reasonable and he can talk to me; he just chooses not to.

Part of me wishes he would try and do something, fail, and at least be hospitalised and have a little more urgency in clinicians debating what to do with him. I feel that once again the burden is with me as it always has been. The power is with 3son. He spoke and we all jumped through hoops and yet he’s sitting there playing video games as if nothing happened. I’m the one feeling lost and not being able to focus.

I am feeling tired of it. I’m still fighting for funding for my autistic 2son of which more another time. That’s not going to be an easy one. Now he’s turned 18 they’re trying to chuck him on the scrap heap, although that isn’t quite the phrase they use. I’ve been fighting for him with the odd week off for quite a while and now that he is settled, happy, making progress at school and still with his girlfriend I would like to just be happy for him and stop worrying about him for five minutes. But I can’t. 1son and 4son are in good places and I’m just really grateful for that.

I’m angry. I really am at having to deal with 3son’s shit when he doesn’t want to. I have to hold myself in so tight when he does want to talk, to not give him a big slap and ask him what he’s planning to do to sort his shit out. I let go of all the fear and anger is left. I didn’t sign up for all this. No one ever does.

I have a mad weekend planned for January. Really mad. The maddest thing I’ve ever done and I’m wondering if I can still do it. As a responsible adult the idea of leaving the two of them alone for a few days is unnerving at the best of times but under these circumstances is it folly? If he wants to kill himself he will. But I would never forgive myself if I wasn’t around at the time. But I could equally be out at the theatre for the evening and not taking calls so what’s the difference?

I’m fed up and think it’s about time life gave me a break.

P.S. There’s a really fascinating discussion on reddit about this image, entitled “One of the most powerful image I’ve ever seen” offering perspectives on suicide.

Struggling For Two

Tags

ASD, autism, camhs, council, funding, mental health funding

As far as 2son goes, he is doing remarkably well. After forcing him back to school in June he has settled back in and the three months consistency there has led him to progress. He’s got a girlfriend – he said that my abandoning him back there led him to feel he had nothing to lose by trying to move the friendship on to the next stage. She’s at a different site so he’s start using the bus to travel independently which is the first time in a couple of years.

It took a great deal of effort to get funding to cover him over the summer holidays and now we’re repeating it all over again for half terms. At the last LAC review the school staff were adamant that he needs routine and stability and with that they could inch their way forward. They also said that he stood a better chance of actually taking his GCSEs if he knew he could stay at school afterwards, thinking that he’s worried that funding might be perversely cut if he does well. So we asked for the funding panel to discuss 52 week funding and funding over the next 3 years. No to both was the answer.

We now have a week left until half term and I don’t know if he’s returning to us or not. The social worker did phone up and say they would put some sort of activity in place for part of the half term. I said his best interests lay in staying at school and that was pretty much it.

3son is stressing me out almost as much as the council is. His attendance is now down to 73% just for this half term which is worrying to say the least. He was referred to CAMHS last year and after six months we got a letter saying he’d been put on the waiting list. He had some counselling last term which seemed to do some good although he was very non-committal about it. His counsellor also said he would refer 3son to CAMHS in the school’s borough which would be faster and I’m now trying to confirm this was done.

We’ve just had 4 days without 3son at home due to a school trip and 4son and I have been amazed at the difference. 3son is always angry, frustrated, moaning, aggressive in some combination and it puts a total strain on the rest of us. In these last few days I have worked harder, done more housework, had a day out, put up pictures that have been waiting for a couple of years and have barely sat down or felt tired. It’s been amazing.

Now he’s returned and not gone to school this morning and I’m struggling to stay awake. We did go and see the GP a few weeks ago and she will prod CAMHS to hurry up but they are struggling with lack of funding and haven’t got the staff.

I don’t know what the answer is. School have to refer him to Education Welfare as he hasn’t got a diagnosis so I’m being threatened with the prospect of court proceedings. I’ve asked for help but there’s none on offer. He’s driving me mad and I’m feeling sorry for him at the same time. I’m going to crack down on bedtime as that’s about the only area I feel I can make a difference in. But I struggle to find the energy to do that.

A Miserable Relief

Tags

2son, ASD, camhs, fear of institutionalisation, placement panel, SEN, senior management, social care, social services

After three weeks of chasing an ever-increasing number of people at the council they have finally more or less agreed to fund 2son through the summer after he returned to school. Final confirmation will wait until somebody returns from holiday on Monday. So it’s agreed, but we’ve been asked not to tell 2son until it’s agreed.

I resent bitterly the fact that people I’ve never met, whose names I barely know and whose titles I’m only vaguely aware of make such momentous decisions about our life. The people who do talk to me directly refer to them as “senior management” which couldn’t get much more faceless as a description.

It’s been a tough three weeks. I’ve had to dig my heels in and say phrases I don’t want to have to say.

He can’t come home.

Failed Intervention

Tags

2son, camhs, education, future, placement, social worker

So it’s been 3 weeks since 2son announced he wasn’t going back to school. Since then we’ve had a visit from the new social worker, who has yet to sound as if he doesn’t need further support and training.

Ten days after the announcement we had a meeting at school (attended over the joys of the internet by me) with about seven members of staff (which is why it took so long to happen) to discuss the options. No one from council, whether care or SEN was able to attend. The best plan was to knock 2son out and bung him in the back of the car and drive him up. It’s still a tempting option.

Discharge

Tags

2son, camhs, CATE, Child Protection, commissioner, CPA, EP, mental health, SEN, son, statement

I didn’t realise, when I went to the progress meeting on Thursday, that discharge was a done deal, that it wasn’t up for debate. The Commissioner, a shadowy unnamed figure that sounds more like a Batman character than anything else, decided that it was time, 2son should leave.

Hooray, he’s cured! No. He’s leaving because he’s not making progress there, because he’s been there six months and it’s very expensive. Somehow I think the latter mattered more than anything else.

I expressed my astonishment that there is nothing in between a mental health unit for teenagers who are at high risk of committing themselves physical harm and being supported at home. Surely there’s a need here. But no, it seems to be all or nothing.

They acknowledged that they hadn’t really got 2son talking, that he avoided the emotions group above all of their group therapies and that when he did attend any of the group therapies he said as little as possible. They seem convinced that getting back into school and the real world is much more important than talking about it, a sentiment I’m reluctant to share.

The ASD diagnosis seems an optional extra. They’ve decided on the diagnosis but we don’t have to talk about it if I don’t want to. It’s important to treat the patient, not the symptoms.

An EP (educational psychologist) turned up from the borough, as part of the statementing process. He observed. He or one of his colleagues will turn up to CATE to assess 2son as part of the whole process. But no decisions will be made until the end of October as to what 2son’s educational needs are and how they can best be met. He did point out to 2son that education was a legal requirement. Oh look, he’s been breaking the law for 3 years and you’ve only just noticed.

Social Services proved the most useful, with the social worker bringing along her line manager, offering a Protected Child Case Conference which in effect means that they can draw on hitherto unavailable resources. These will start off at providing transport to and from CATE or  CAMHS and possibly providing someone to come to the house and help 2son with morning/evening routine. Other help could be provided as needed. Although he doesn’t actually need help in getting to CATE unaided (or hasn’t so far), actually having another person to share the responsibility will help. Having a stranger turn up to take him to school might well help encourage him to go.

They’re forced to offer a contingency plan in the paperwork. This consists of the out of hours telephone number for CAMHS and social services. What a plan!

So that was Thursday morning. As I wasn’t expecting to have to take 2son home straight after the CPA he stayed in overnight, which gave him the opportunity to say his goodbyes to the other patients. I picked him up, took him straight to CAMHS and onwards to CATE.

We had a good meeting with the family therapist and set up 4 weekly sessions. We talked about what’s going to work, help, hinder 2son and the fact that if he doesn’t get off his arse of a morning and go to CATE then we might have to repeat the whole process of removing him to the unit etc. He doesn’t want to go back but I’m not sure he’s ready to move forward. I then took him to CATE (which stand for Continued Access to Education) in time for him to meet his fellow students for lunch and take part in the afternoon sessions. They are truly lovely  and 2son can do well there if he so chooses.

He’s supposed to be in Year 10 and this adds further pressure. He can certainly get half a dozen GCSEs at CATE but he’s got to start now if he doesn’t want to mess that timetable up. Once he hits 16 the provision of education becomes very different, as does the support and it all gets so much more complicated. Now is the time.

What about me? I sat at the CPA meeting listening to talks of discharge and got shit-scared. No other word for it. I thought to myself that I am now responsible for trying to get him to bed every night at a reasonable time so he can get up in the morning (he managed to get up on Saturday ten minutes before midday). If I don’t get him off to CATE at the appropriate time then that means my morning will be taken up with trying to get him up and out, with not just that time taking away from my plans but the stress just goes up and up when I’m trying to get him up.

Whether social services really will be able to offer practical help in getting him up remains to be seen. In the meantime, it all goes back to being down to me and 2son.

Scared? I’m bloody petrified at what this week might bring.

P.S. I’ve just noticed this is my 200th post. And it’s not about me. Typical.

Plan B

Tags

2son, camhs, children's act, decisions, mental health act, plan b, self-neglect, social services

I went to the GP today, along with 2son’s therapist and the consultant psychiatrist. Social services were supposed to attend but she’s ill.

We discussed Plan B.

2son has not had a bath for a good month. He’s now got dirt patches stuck on his feet and wherever he sits down he creates a pile of hair, dried skin and nits from his scratching. Makes me so glad I took up the carpets downstairs last year. So his self-care has taken a turn for the worse with the total lack of bathing.

On the other hand, he’s noticed that 3son is driving me totally batshit with his pre-teen never-ending arguments, back chat, condescension and moaning. So he’s stopped any belligerence or anger and has been helpful in mediating between his brothers. That’s nice but what gives?

2son is barely talking to his therapist, maybe trying one session out of three and this is still over the phone. Sometimes he feels capable of talking about himself and others he clearly doesn’t. She gives him tasks to practice over the week, starting at opening the front door and looking at the outside world until he feel anxious and then until he calms down afterwards. He will do this with her, sometimes but not at all on his own and he only once did it with me.

So basically, although we’ve given him all the time in the world to come to his own decisions, all he is doing is retreating.

So 3 possible plans of action, and I wasn’t taking notes:

1. Do nothing. Hope he comes out of this by himself and decides to use his therapy. Even this has a deadline as I have certain parental control and rights that dwindle away once he’s 16 or so. He will continue to feel as safe as he currently is but may not shift at all.
2. Mental Health Act – section him. This doesn’t apply as he’s not a danger to himself or others. GP pointed out that you could just about argue that he is a danger to himself, from the self-neglect causing him physical harm, but it’s not really applicable to him.
3. Children’s Act – this I can’t separate from Social Services taking the lead, but can forcibly remove him to a hospital, attend to his physical needs and then attempt to give him a psychiatric assessment, keeping him in for several days. As far as I can tell, either I take the lead or Social Services do but it amounts to the same. This has to be done before he’s 16 and his rights change.

Essentially then we are looking at a forced removal from the house for a few days (and I have no idea how long/short a few is), clean him up, try and talk to him, and hopefully make a diagnosis and move on from there. It may work. It may not. If he won’t respond to the assessment we won’t achieve anything very much. Who knows. But it’s better than doing nothing and leaving him to it.

I’m not that sure.

The one factor he’s talked about over the past years is this need for security and safety. When all the various services started to intervene they wouldn’t go and interrupt him in his bedroom, recognising it as his refuge and not wanting to take away that safe point from him.

We’re now talking about not just invading that space but forcibly removing him from it, which will cut the ground out from under him. That’s a dreadful thing to do, but it might just work.

Therapist and psychiatrist came back with me after the meeting and had preliminary words with 2son about all this, to just let him know we were looking at this sort of thing. The psychiatrist is going away to find the right type of unit to do an assessment of 2son and we’ll have another meeting there.

So with this hanging over me, and 3son’s constant badgering, I’ve lost the plot somewhat. I’ve just been exhausted ever since half term and now Spring is starting up my hayfever has kicked in. I’ve completed 2 full months of exercise and have skipped a few days this week for the first time. I am constantly exhausted.

Do Something

Tags

2son, camhs, CATE, clinical depression, doctor, therapist

I’m skipping #15 today.

This week I went to a review meeting about 2son. We had quite a good team together, with his EWO (Education Welfare Officer), his CATE leader (Continued Access To Education) and both CBT therapist and consultant psychiatrist from CAMHS (Child and Mental Health Services). That’s a bit of a mouthful.

I talked about his behaviour over Christmas and the fact that he had perked up a little, mainly for playing games on Wii but that he had ultimately got on with visitors over Christmas. I spoke of the game I’d bought him for his birthday that he was contemplating earning game play time for. He’d said that he would see his doctor on a home visit in exchange for computer time.

This is all talk with no action but he spoke to his therapist on the phone last week for a full 50 minutes for the first time. He’s got three more sessions over the phone before she wants him to try visiting him. 2son told her that he just found the outside world too bright, big and noisy, nothing surprising there considering he hasn’t ventured out for what is now 4 months.

The only idea for moving forward is the doctor’s home visit. She’s agreed to do one but I haven’t been able to set a date despite frequent phone calls.

Other than that the bad news is that the EWO is closing the case. Not because she wants to but because she’s in a different borough, along with 2son’s original school and they took him on because my local borough EWO refused to. It all comes down to whose budget the funds come out of. She’s been ever so good, understanding and sympathetic and I am sorry to see her go. I’ve had no contact with the EWO in my borough except for a five minute visit from one who graciously told me that they wouldn’t be taking me to court for not getting 2son to school. I didn’t know whether to thank her or punch her. So I did neither.

The comment from the consultant psychiatrist who has only seen a sleeping 2son from the bedside when she tried a home visit before Christmas was that unless he’s deteriorating then there’s nothing extra they can do. If the self-neglect was worse than they could start talking to social services about getting him admitted to hospital overnight for an assessment. I’m not sure how useful that would be but there’s that terrible feeling that he has to get worse before he can get better.

He’s not clinically depressed. On the basis that he still cooks for himself at night or in the day, mostly filled pasta and packet noodles, with the occasional giant size bacon sandwich for breakfast. He does have baths and changes his pyjamas when he wants to, not just when I tell him to so he is making decisions about his self-care. He’s making choices and not ignoring the world completely. So he’s either got to decide for himself that he wants to fight this, at which point we can all step in and help him or he’s got to get to a dangerously low level such that concern for his self-care and health trumps his rights as a child to say no.

It’s painful to talk through, and despite the fact that I have got a good team on his side who are trying the best they can for the most part (I’ll except Social Services here who have done absolutely nothing), they can’t actually do anything and are tied by his refusal to participate. For that I sometimes want to just scream “Do Something” at them.

I do understand that he needs to make his own decisions in his own time and that nothing else will help. My worry is that like an addict he will need to hit rock bottom before he can decide to start climbing out of it. All I can do is watch, wait, listen and tell him that I love him.

Getting Scared

Tags

camhs, counselling, decisions, emotions, fear, hump, therapy

It seems that a lot has been happening that I just haven’t written about. Mostly I’ve been getting scared.

Before half term I had a long talk with 2son’s therapist. We started off talking about how he’d made great progress that term and that we needed to talk with him about why he’d given up, whether he was feeling pushed or not. I then moved on to some of my own fears.

I’m anxious that despite all that I know about myself, that I’m teaching my children to hide their emotions as well, even though I strive so hard not to.

1son cannot deal with confrontation, to the point that he can’t tell one of his former best friends why he’s fallen out with him because he can’t handle that conversation. He dares not apologise to my sister for his extremely bad behaviour towards her because she does get emotional and start shouting and he doesn’t know how to deal with it.

2son won’t talk about anything that goes through his head. He missed last week’s session as his therapist was ill and I asked him why he wouldn’t go to CATE, whether it was the teachers/children/set up/pressure or anything else that was running through my head. I wasn’t getting cross with him but I was exasperated. He said nothing. He hardly ever says anything about what’s in his head.

3son and 4son for the most part are nice to 2son. Once in a while 3son will blow up and tell 2son he’s useless (with some inappropriate language thrown in) but for the most part they try to be nice. I recently discovered some writing from 3son where he said “[2son] is still fucking useless”. But, like me, they are both worried about expressing their anger towards 2son in case it’s counter productive so they bottle it up.

I’m worried that I cannot sort myself out in time to sort them out and that despite all my best efforts I won’t be able to get there in time.

I explained much of this to 2son’s therapist and asked if CAMHS had any pull with getting me more intensive/stronger therapy than I was getting. No, was more or less the answer but they’d have a think.

I also had my mother visit for not quite 48 hours this week which didn’t help my mood. Don’t think we really said much which considering it’s the first time she’s visited in over 2 years really says it all. She once referred to us not having long chats but didn’t take it further and she was fairly appalled when I asked what my nephew was reading at Oxford where he’s just started. Didn’t anyone tell me, she asked and I pointed out that 2sis doesn’t communicate with me at all, she didn’t and no-one else had bothered. We didn’t have huge amount of time together and my sister (1sis) came visiting with dog which helped.

The other thing that is of course like a ticking time bomb of a deadline is my ever increasing weight.

After my mother’s first hour, she went off to have an afternoon nap and I got out the vodka. I don’t usually drink in the daytime but the pressure and anticipation had got to me. I realised this was foolish so I phoned up the place where I go for counselling and made an appointment for an assessment this week. I also made contact with a lady running group therapy that a friend of mine went to. This is a structured series of 10 sessions, for sufferers of domestic violence. I initially thought this was not really applicable but when you include verbal abuse then I suddenly can tick all the boxes so I’ve signed up for that in January. Plus of course I have my book which is swimming its way here that I mentioned in my previous post.

I need to stop being too scared to open up and learn to get my fears out there otherwise I will never be able to overcome them. I am at a hump at the moment and, as previously said, it’s not just a hump it’s a bloody great mountain or brick wall in front of me. I do feel that if I can just take a tiny step forward the rest will flow.

What’s been happening to 2son

Tags

2son, ASD, camhs, CATE, school, SEN

I talked about 2son’s ASD assessment which was back in April and the psychologist’s immediate response.

We were then presented with a five page report that detailed 2son’s history to date, suggested contributing factors and a conclusion that stated he hadn’t got ASD but that he needed counselling and the family also needed some family counselling. All exactly what I wanted and had been saying right from the start. We were also warned that actually getting a psychologist for 2son would not be immediate as they had to find the right person. So we walked away from our post-ASD assessment meeting feeling positive, but also that there might be a long wait.

It was barely two weeks later that we got a phone call to say that a clinical psychologist had been appointed (psych1) and could we come in. We were also told that 2son had been deemed a priority as he had been out of school for so long and that swift action needed to be taken.

So psych1 is very soft and gentle, speaking warmly to 2son and has a very non-threatening disposition. He gets on well with her and they are seeing each other once a week. He’s only had 3 sessions so far having missed a couple due to his other news. She’s been talking about anxiety and how to cope with it and is going to go incredibly slowly with him  as he doesn’t really want to open up at all. He is however quite willing to go although there are days when he just doesn’t want to get up.

The other result from the assessment is that that they referred him to CATE, which is Continued Access to Education. It’s a tiny facility that has a dozen or so students where they start off getting students to get back in the habit of attending school on a daily basis, give them an individual learning plan and have small lessons so they can catch up on their English, Maths and Science and hopefully be able to move back to school. These places are highly sought after (and of course under threat). So I was incredibly surprised to get a phone call from CATE a few weeks ago saying please could 2son come in for an interview. Even then I was expecting a place to be offered in September so when they said that the interview was the start I was overwhelmed.

As I think was 2son. He didn’t go the next day as planned. He’s had to very quickly make the adjustment to having a weekly meeting with psych1 and not long after that is asked to come to CATE every single day. He’s managed half a dozen appearances at CATE in the last few weeks of school and seems to be willing to go, but again, some days he just refuses to get up. That initial week was very stressful for me as I seemed to spend a lot of time running up and down stairs to try and get him to get out of bed, but hopefully he knows what he’s getting into and September might prove a little easier. Managing CATE and going to see psych1 is quite a lot to get used to but hopefully with the summer weeks of just seeing psych1 we’ll be able to manage both next term.

A lot has happened in the last few months to 2son and it’s all welcome. I wish it could all have started earlier, but I also recognise that 2son wasn’t ready or willing to talk to anyone until the ASD assessment which seems to have been the start of progress. Whether it was the formality of the assessment or whether all that time at home had given him the confidence to want hope I don’t know, but I’m just glad things are moving forward.

We have also been offered family counselling and have had one session with thera, she who I have never really connected with. Although a family therapist, she did ask me after the ASD assessment whether I really thought I needed family therapy and seemed hopeful that I would just drop it. Which I haven’t, but do wish it was with someone else. Those are going to be a bout once or month and I’m not sure if they are going to achieve anything but strongly feel that 3son and 4son need a platform to talk about all the changes over the last year.

We also have a social worker who has lasted for more than one visit. She seems very nice although I’m not yet sure what if anything she’s going to do for us other than monitor us and make sure we’re all right. But she’s willing and positive which is a good start.

School has also appointed an Educational Psychologist and was talking about arranging learning plans for 2son as they didn’t expect CATE to happen so quickly either. The EP is also talking about a statement for 2son which I’ve put off until he’s got settled into CATE which also has an on-site EP. So in many ways we’re swimming in professionals actually wanting to help which is marvellous.