The delay to receiving an assessment with CAMHS and start of treatment, following referral by our GP, was substantially longer than NHS England targets (in line with the data shown in the table accessible through the ‘Waiting times’ link, above). My child was suffering significantly greater distress by the time we got to the assessment appointment. We did seek advice from private sector specialists while waiting for the CAMHS appointment and got some limited but helpful information and guidance in this way. However, the private therapists that I contacted all indicated that they would prefer to work as an additional resource under NHS direction, given the age of the child at the time. 
 

At the end of the wait, the assessment appointment was booked for a duration of 90 minutes, involving 3 members of staff with reassuring-sounding job titles. However, when we arrived, the appointment was structured as a practice session for a trainee psychologist (a 4th member of staff), with the trainee leading the first 20-30 minutes of the meeting, slowly going through a list of basic questions and writing the answers down in neat handwriting on a large sheet of paper to create a diagram, while 2 qualified staff members sat and quietly waited and a psychiatrist kept popping in and out until this part was over. By this stage, I felt that we had been in crisis for a couple of months and the contrast between our experience and the way the staff conducted the meeting was exasperating.  

Although we were asked if we agreed to the presence of the trainee, we felt somewhat obligated to do so. My frustration about this is significantly magnified with hindsight, because after this my child had very little contact with qualified psychotherapists during their treatment for the next 2 years (apart from in group therapy, which they didn’t find helpful, and often avoided). We asked NHS staff if we could source some specialist involvement privately because access to it was limited, but were told that this wasn’t acceptable to them, because, they explained, the child was ‘on a programme’.
 

At this initial meeting and 2 subsequent very similar assessment interviews over the following days, we (the parents) were repeatedly asked to comment on the background to the illness in the presence of the distressed child. I think this approach can be detrimental to the parents’ relationship with the child. I could see that my child was understandably offended by some of the information that I provided in response to questioning by staff, but at the same time I thought that it was important to disclose as much background as possible.

I do not recommend answering any questions about potentially sensitive topics concerning your child in front of the child.
 

Following the assessment, it was determined that my child was now too ill to be treated in the community and needed to be hospitalised. I’m certain that this would not have been necessary if the response had been within the NHS England target wait time. The child was placed in a hospital operated by a private equity company, a two and a half-hour round trip from Oxford Services/Junction 8.
 

Several troubling things happened at the hospital. We started trying to ask for a transfer elsewhere after about 14 weeks, but were told that this was not possible. During this admission, our relationship with our child became strained and the ward psychiatrist told us that our child was becoming ‘institutionalised’. After about 6 months, we were told that we were not welcome for visits for a two-week period. When we were allowed back, our next visit was supervised by a care assistant. We found this very strange (as well as unsettling) because no-one had told us the reason for the suspension and we were certain that we were not by any sensible measure what might be called abusive parents.
 

Following an inspection 7 months into my child’s admission there, the hospital was downgraded by the Care Quality Commission to Inadequate. It took a further 2 months to secure a transfer out. Over the following months, the hospital’s senior manager and the ward psychiatrist both left their jobs.  
 

Before the transfer, my family was referred by a member of staff at this hospital to Social Services, who interviewed all of us and our other child’s (or children’s - I’m being a bit vague about this for privacy reasons) head teacher(s) and then closed the case. 
 

After about a year and a half in 2 different hospitals, our child was discharged to our home, with a care package that consisted of (i) between 90 minutes and 2 hours of support per week, on average, with a nurse, (ii) 10-15 minutes per week on the phone with a trained psychologist who was monitoring progress, (iii) a phone or Teams call every 4-6 weeks with one other specialist and (iv) prescription reviews with a doctor, about once every 2-3 months. It was regularly very difficult to contact staff by email or telephone. The child was told that they didn’t have to have any contact with us while in our home, so there was very little communication.
 

The referral to Social Services, although not at first accepted, became the first step in a process of paving the way for our child to cut off contact with us around the time of their 18th birthday, a situation that has now persisted for more than a year. We still haven’t been told what our child’s grievances with us are.
 

I found that the approach of many of the staff was often formulaic. My impression was that this was because some of the nurses and people with job titles like ‘coordinator’ and ‘practitioner’ didn’t have sufficient training to be able to knowledgeably react to individual patients’ circumstances.
 

I believe that the approach of NHS mental health staff in Oxfordshire towards patients and their families can, in some cases, contribute towards patients falling into the cracks between the NHS and Social Services, thereby experiencing long stays in hospitals or care homes, or medicated in sheltered accommodation, when such could have been avoided.​