Experiences with Child and Adolescent Mental Health Services (CAMHS)

Child and Adolescent Mental Health Services (CAMHS) are the NHS services that assess and treat young people with behavioural, emotional or mental health difficulties. In many parts of the country, CAMHS is undergoing significant changes to their services, which means that parents and young peoples’ experiences might change over time. CAMHS plays a role in referring young people to the Gender Identity Development Service (GIDS).
In our interviews, parents spoke about their own experiences and their trans or gender diverse children’s experiences with CAMHS. Some of the things they highlighted included:
  • Experiences with CAMHS;
  • CAMHS’ approach to trans and gender diverse young people; and
  • Lack of capacity in CAMHS.

Experiences with CAMHS

Josie talks about her daughter’s good and bad experiences of seeing CAMHS therapists.

In our interviews, parents and carers spoke about good and bad experiences with CAMHS. These were sometimes put down to the different working styles CAMHS’ professionals had and how these resonated with their young person. In some instances, parents felt that the support from CAMHS was sometimes inadequate or insufficient. Still, for some young people whose parents we spoke to, CAMHS was an important source of support that at times helped them to explore and make sense of their gender identity. For example, in the case of Ross’s child, although it took the CAMHS therapists a while to ‘put a finger on it’ and identify gender issues, they felt that the referral to GIDS was helpfully made by CAMHS. Some parents, for example Kate, felt that what was available via CAMHS was not enough to ensure her son was sufficiently supported. This made Kate feel like there was nobody other than her ‘keeping an eye on him’ in what was a stressful period for the family. She also felt that she had to ‘keep fighting to get back into a service’ to get any support for her son.

There was no clear moment of coming out as trans for Ross’s child, but they first explored gender issues in CAMHS appointments.

Kate feels support from CAMHS has been disappointing and worries her son will have no support whilst on the waiting list to the Gender Identity Development Service.

CAMHS’ approach to trans and gender diverse young people

From our interviews with parents and carers, CAMHS’ professionals approached the issue of a young person being trans or gender diverse in different ways.
A couple of parents felt that too much weight was given to the fact that their child was trans and as a consequence any difficulties they experienced were explained as resulting from their gender identity not of other issues. Both Lesley and Kate felt this was not always a fair or helpful thing to do because it could be ‘stigmatising’ for the young person by ‘equating’ trans with mental health problems. Kate felt that her son was not listened to carefully: ‘They [CAMHS] basically said, ‘Everything that he was experiencing was because he was trans. He has self-harmed, with thoughts of suicide and, they put that all down to being trans… But he [himself] doesn’t feel that it’s all down to him being trans.’ For Kate it was important to acknowledge and make a distinction between the things that her son was experiencing because he was trans and the ‘normal teenage stuff.’ She felt her son needed more support because his life was more complicated.
Whilst Lesley felt there were some supportive CAMHS professionals (such as the care coordinator) that helped her son, she felt that overall CAMHS’ approach to her son’s gender identity was based on the belief that her son being trans was a mental health issue. She saw that as a reflection of CAMHS’ ‘cisnormative’ approach, an approach based on the assumption that peoples’ gender identity always matches their gender assigned at birth.

Lesley felt CAMHS saw her son being trans as part of a mental health difficulty.

Faced with prejudice towards trans and gender diverse people, some parents and carers we spoke to chose to challenge this. Read more about parents and carers challenging prejudice and acting as advocates for their trans and gender diverse children.

Lack of capacity in CAMHS

Not everyone we spoke to had experiences with CAMHS, but the parents who did often felt that lack of capacity and funding within the services was a key issue in their experiences. In our interviews, many parents and carers perceived CAMHS as overstretched and therefore only able to offer support to those in the most dire circumstances. Richard felt that the thresholds of who can get help from CAMHS are ‘increasingly higher.’ Many parents and carers felt that only children who are at high risk could access help from CAMHS: E and D emphasised young people have ‘gotta be pretty suicidal to get CAMHS to take them on.’ Some parents also pointed out that the lack of capacity results in long waiting times at CAMHS.

Elijah talks about CAMHS being massively inundated. His daughter passed through there quite quickly.

Adele wanted continuing psychological support from Child and adolescent mental health services (CAMHS) for her son.

Whilst CAMHS see young people for a variety of issues, not everyone we spoke to felt that their child’s gender identity issues were something that CAMHS were willing to take on. Some parents, including Adele, thought that CAMHS did not offer support for children if their distress was seen as only related to their gender identity, as the services see it as the domain of the Gender Identity Development Service (GIDS). This can at times create a support vacuum for some young people and their families; in particular as the waiting time for the GIDS can be long too. One parent did not feel her daughter needed immediate input from CAMHS because she felt her daughter was doing fine and had no mental health issues. However, for Adele and Kate, they felt there was a lack of support from CAMHS because they wanted their children to be able to access it not just in relation to transitioning, but more generally, to be better equipped to deal with whatever happened in their life.
Even for young people who were experiencing a lot of distress, the support within CAMHS was at times limited. Ali shared that she begged CAMHS to keep supporting her daughter after a suicide attempt and self-harming incidents, but they were nonetheless ‘cut loose.’ She felt that was because of both lack of funding and the fact that her daughter’s gender identity issues had come to the fore.

After Ali’s daughter attempted suicide, she received time-limited support from CAMHS. She felt cuts in CAMHS’ funding meant her daughter was left unsupported.

Suicidal behaviour and self-harming are issues that affect the whole family and can cause a lot of anguish to parents and carers of the young person.
You might also like to find out what parents and carers we spoke to said about supporting their trans and gender diverse children’s mental health.
Learn what people we spoke to said about neurodiversity and autism.

Experiences with the GP

GPs have an important role to play in supporting trans and gender diverse young people and their families. For some parents and carers, the GP...