Case studies – the problem

Here are some recent real life examples that have come to the attention of the Commissioner’s Investigations and Advice team ahead of the original publication date in March 2020:

  • A child who has experienced complex trauma and attended A&E multiple times following suicide attempts. Due to the severity of violence towards their parents, police were called out to the property most nights of the week, attending for several hours each time. The child was receiving support from their local social care department, but no therapeutic support. The family were told that Child and Adolescent Mental Health Services (henceforth CAMHS) are unable to help.
  • A family believed their child needed a secure placement, as they were a danger to themselves. We were told that social services were trying to source alternative placements and had approached dozens of residential facilities, none of which could accommodate the child. We were told the reasons given were because they did not meet their criteria. The child remained at a mental health in-patient unit, even though professionals agreed it was not an appropriate placement. The child then spent months on a paediatric ward, which was not a suitable setting for their needs.
  • A child with a learning disability whose home environment was no longer safe for them to stay at. The child has been placed at several different locations across Wales as services have struggled to deal with the child’s behaviours. At one of these placements there were no therapeutic interventions available and as the child was much younger than others at the placement, the older children bullied them, causing further trauma.
  • A child with a life limiting condition and related significant healthcare needs had been receiving health care in one local authority, and then changed foster placement to another Health Board area. The two Health Boards involved were now disputing who has the responsibility for the health needs of this young person as they had reached the age of 18 over the course of the move.
  • A child was kept in mental health facility for weeks despite having no mental health diagnosis as there was no alternative provision.
  • A child had attempted suicide three times in three weeks. Their parents felt that they would not be able to keep the child safe at home but felt no one listened to their requests. Eventually the child was discharged, without appropriate follow up.
  • A child displaying behaviours and difficulties which suggest dyslexia and dyspraxia who has not been in school for over four months due to social and school anxiety issues. They were referred to CAMHS, who said that the young person did not meet the criteria for further support. CAMHS stated that the young person may have Autistic Spectrum Disorder (ASD) traits. The child’s school completed a referral to the neurodevelopmental team. In the meantime, the concerning anxiety behaviours got worse and the family were extremely worried. The local education service has identified an EOTAS provision that would help the child study for their school exams but this cannot be actioned unless the child is actively receiving mental health support through CAMHS. The family asked the GP to re-refer the young person to CAMHS. The child has recently been seen by primary care CAMHS and offered therapeutic support to help with their anxiety. The child is still not in school.
  • A child had taken an overdose which resulted in them being admitted to hospital. Since being discharged from hospital, we were told that the child received no support, despite the family being told that the child would be able to access support in the community.  The family called the local CAMHS service and were told the child is on the waiting list for an appointment with CAMHS but they were unable to provide a date. The child was also on a waiting list for their school counsellor. The social services department told the family that it is CAMHS’ responsibility to support the child and as a result they did not offer any support.
  • A child had been detained under the Mental Health Act and was taken by police to A&E. The child had not been diagnosed with a mental disorder. The child was placed at the hospital on an adult ward and supervised by two agency staff from the mental health unit they had previously been at. The child was unable to return to the unit as they were unable to manage the young person’s behaviour. The child was moved to another hospital, again on an adult ward but this time segregated from the rest of the ward. A multi-agency meeting was arranged to agree next steps. The meeting was attended by 16 professionals, including one from the child’s local CAMHS, the relevant social services department, and one of their lawyers. The meeting was chaired by the Clinical Director for CAMHS in the child’s Health Board. Social Services maintained that they were not able to provide the child with any form of secure accommodation as the young person was about to turn 17, and not subject to a Care Order.