The Coronavirus Pandemic has meant that CAMHS services have had to change how they work with children and young people to ensure support can be accessed safely.

Key changes that you may see when accessing CAMHS Services:

  • New referrals are being accepted at this time.
  • There will be an increased number of appointments and assessments that are completed virtually or over the phone. For more information, please click here.
  • If you attend an appointment on site you will be asked to wear a mask, wash or sanitise your hands and remain 2 metres away from the nearest person. Please note appointments will only be given onsite if there is a clinical need and it is not possible to provide a therapeutic intervention remotely.
  • The pandemic has led to some delays in access and communication, you may experience increased waiting times for assessment and support. It may also take us longer to respond to some of your queries.
  • If you are assessed as requiring urgent support, you will be seen within 24hours.
  • If you need to speak with a member of your local CAMHS Team you can still ring your local children centre for access to information and advice.

Information for children and young people

Are there things I can do to make me feel better?

Things are very strange and different at the moment and it can sometimes feel overwhelming. You may feel anxious or uncertain, even sad at times. It’s important to remember you’re not alone. We all have these feelings at different times, particularly when there is a lot of change going on and we are not in our usual routines. It’s when these feelings do not go away and happen often that you may need more support (See further information below).

To help with these feelings and keep yourself feeling positive and well, some of the activities below may help.

Keep Connected: It is really important to stay in touch with those you love and trust. It can be difficult with the restrictions that are in place to see people face to face, but a quick chat over the phone or a virtual call can really help you to feel more connected. Being able to talk through your feelings or just feel that sense of normality can make you feel better. Lots of children and young people who do not have the internet or a mobile phone have started to write letters to love ones or have become pen pals, it’s a great way to stay in touch and something that a member of your household can help you with.

Sometimes it’s easy to forget that support can be closer than you think, being at home more with family/carers/guardians gives us more time to talk and spend time together. We all want to close the world out sometimes, but just checking in with the people you live with everyday can make you feel more positive and less alone. Telling your family/cares/guardians honestly how you’re feeling and discussing how you can be more connected to the people who are important to you is a great first step.

Important: Sometimes the things we think are keeping us connected are not always good for us. Spending a lot of time on social media can make us feel not great about ourselves. Whilst it can be a good way to keep in touch with friends and family, it’s important to remember that not all of the images and information presented there is accurate or a true reflection of peoples real lives. If you start to feel like your mood is changing when you use social media it might be a good idea to take a break for a few days and do some of the other activities suggested below.

Be Active: Scientific research tells us that one of the best ways to keep us feeling good is to do some physical exercise. Exercise doesn’t always mean competing in a sport, even though that is a great way to feel good. Sometimes it can be going for a walk or jog, playing at the field or park, doing a physical home activity or work out, swimming, skipping, running, dancing etc. Just a little bit everyday can have a positive effect on your mood and improve your confidence.

It’s good to hear that indoor organised sports are starting back, you can find out about what sports clubs are open in your area and if there are any free activities you can take part in by contacting your local Family Information Service.

Keep Learning: A good way to keep our minds active in a positive way is to try something new or learn a new skill. Being at home more is a good opportunity to do this. Lots of young people are taking more time to read, draw/paint/craft, cook/bake, try a new instrument or practice singing, learn a different language, join online clubs and other groups etc.

If there is something you think you would enjoy, now is a good time to give it a try. If you need some inspiration and ideas, it’s good to talk about it with family and friends. Schools and colleges can provide useful information and ideas too. There is also lots of information online.

Give: Right now, maybe more than ever, there are opportunities to support others. Science tells us that helping someone else can change how we feel about ourselves and improve our mood and confidence. There are a lot of charities and organisations that would love your support by volunteering, and you can find out about these opportunities through your Local Voluntary Council.

But remember sometimes it is the smallest things that make a difference. Just taking the time to help around the house, making a kind gesture, saying thank you or listening to friends and family/carers can have a positive effect on you and the other person.

Take Notice: A good way to be more aware about what’s going on with your emotions is to think about your thoughts and feelings as they happen and take notice of the things around you when they do. A good example is to think about the sights, sounds, smells and tastes around us and how we feel in that moment. Many young people find a quiet and calm space the best place to give this a try. Some will also try slow and calm breathing with their eyes closed, to help them relax.

Taking this time can help us not to think too much about some of the things in the wider world going on around us and can help us to deal with anxiety and stress. If you would like to learn more you can go to www.nhs.uk/conditions/stress-anxiety-depression/mindfulness/.

 

How do I tell someone I am struggling and need support?

Talking about how you’re feeling to someone you trust can often help you see things differently. They may have ideas about how to help you change things in your life that worry you. Once you speak to someone and they know what you are going through, they can be there for you and offer ongoing support.

Putting things into words sometimes helps. It’s good to say what’s on your mind. Talking to someone could make you feel like you don’t have to deal with it on your own and make things feel more manageable.

Some things to think about:

  • Choose someone you feel safe with (This may be an adult you trust a teacher, GP, parent/carer, sports coach, youth worker, social worker, your friend’s parent, a school counsellor or nurse, a neighbour, etc.).
  • Plan what you want to say.
  • Try and pick a time to talk with them when they are not distracted.
  • Remember you can say as much or as little as you like. Sharing what you feel is right at the time.
  • You can ask them at the beginning of the conversation to keep what you say private and not to share it.

How to start a conversation:

  • “I want to talk to you about how I am feeling.”
  • “This is hard for me to talk about, but I really want to tell you how I have been feeling.”
  • “I need some advice on something I’m stressed about.”

If you’re still not sure how to start a conversation, there are lots of things you can do:

  • Write a letter.
  • Talk about something else first.
  • Talk about a friend experiencing something similar to you first.

 

I feel like I am struggling with my mental health. Where can I get support?

If you are going through a difficult time or you’re worried about how you’re feeling, we understand it can be really scary and upsetting. The important thing to know is that you’re not alone, and there are lots of places you can get good information and support.

Advice: If you feel ready, try talking to a trusted adult or close friend about how you are feeling, very often they can help you find support. If you are in school or college, there will be in most cases confidential support available or help to access support services. You can also access information, advice and support through your Local Authority Family Information Service who can help get you the support you need.

The support you can access is different depending on where you live. However, there will be a CAMHS Service in your County. The first step to getting help from CAMHS is usually that you will be referred for a CAMHS assessment. This referral can come from your parents/carers, or yourself if you are old enough (depending on where you live). Professionals like a teacher or GP (most GP surgeries will offer phone appointments) can in some areas refer. If you’re being supported by social care, a youth team, or a service at your school, they might also be able to refer you.

If you’re not ready to speak to someone you know or are isolating don’t worry, you can still access confidential helplines and useful online resources. www.dewis.wales is a good place to find services in your area. See below for other useful links and services that can help:

 

Hwb Young Person’s Mental Health Toolkit

Here you will find six playlists to direct you to a wide range of online resources to help you through the lockdown and beyond. In each of the playlists you’ll find self-help websites, apps, helplines, and more that are here to support your mental health and well-being. To access the playlists, click here.

 

CALM HARM: Mobile App to help teenagers resist or manage the urge to self-harm. (Free)

CHILDLINE: www.nspcc.org.uk 0800 1111

HARMLESS: Offer advice and Information regarding young people who may self-harm or experience such thoughts. www.harmless.org.uk

YOUNGMINDS: www.youngminds.org.uk 0808 802 5544

SELF HARM UK: Offers an online space to talk and ask questions about concerns in their life. www.selfharm.co.uk

RETHINK MENTAL ILLNESS: www.rethink.org.uk/ 0300 5000 927

NATIONAL SELF HARM NETWORK: NSHN is an online forum that lets you talk to other people in a safe, controlled environment. www.nshn.co.uk

THE MIX: 0808 808 4994

PAPYRUS: Papyrus HOPElineuk 0800 068 41 41 www.papyrus.org.uk

YOUNGMINDS CRISIS MESSENGER: Text YM to 85258 for free 24/7 support

HEADSPACE: Is a mindfulness app with lots of different programmes to support mental health.

SANE: Saneline operates from 4.30pm to 10.30pm daily for mental health support. 0300 304 7000

WELLMIND: This App was developed by the NHS and helps with symptoms of anxiety and depression. It’s a great way of keeping track of your thoughts and feelings.

CATCH THAT THOUGHT: This app is great to monitor difficult thoughts and emotions, when you experience them and where.

THE STRESS AND ANXIETY COMPANION: The app encourages positive thinking through its simplified CBT process and helps you to understand triggers.

THRIVE: This app helps you collect your thoughts and understand your emotions.

MEIC: MEIC is the helpline service for children and young people up to the age of 25 in Wales. From finding out what’s going on in your local area to help dealing with a tricky situation, MEIC will listen even when no-one else will. We won’t judge you and will help by giving you information, useful advice and the support you need to make a change. www.meiccymru.org/

MIND: www.mind.org.uk/

 

How long will I have to wait for support from CAMHS?

How long you have to wait depends on the waiting times in your local area. These have been affected by the pandemic and may be longer than usual. You can find out how long you will have to wait by contacting your local CAMHS Team.

It is important to remember that you can access support whilst you are waiting for an assessment. There are lots of services that will be able to offer good information, advice and early help to you. Support organisations are quickly finding new ways of providing their services safely, online, over the phone and face to face.

In North Wales there are a number of organisations who will be able to offer you support. You can find what is available in your area on www.dewis.wales or by contacting your Local Family Information Service.

 

What will my support from CAMHS look like now?

If you have been referred to CAMHS, you will be put on a waiting list for your first appointment, this appointment is sometimes called a ‘Choice Appointment’ (which often is the beginning of your ‘assessment’). There is no need to worry, it is normally just a chat so the team can get to know you & the best way they can help.

The key change is that this appointment, may now happen virtually or in some cases over the phone, but only if you are happy with this and have the right technology at home to access the virtual system. If your appointment cannot be completed virtually or via the phone you may be offered a face to face appointment. However, this depends on your individual circumstances and local team. This appointment will generally take place at a CAMHS clinic. But in some circumstances, they may meet with you at your school, but not usually at home at this time. When you attend your appointment, you will be asked to wear a mask, wash or sanitise your hands and remain 2 metres away from the nearest person.

It is important to note that some CAMHS Services will have longer waiting times as a result of the current pandemic. If you are on the waiting list, your local CAMHS Team will be in touch as soon as there is an available appointment. If you begin to feel worse during this time, you can still contact the team for help and advice or get in touch with some of the support organisations listed above. Your GP may also be able to help and make an urgent referral. If you feel in crisis you can contact 101 for advice, your local police force or attend A & E for urgent care. Please only do so in an emergency.

During your first appoint you will normally meet one or two members of the CAMHS team. If you’re under 16, your parent(s), guardian (s) or carer(s) can be invited to join for part of this meeting.

When you meet the team, you will be asked some questions. This is to help the team understand what you are struggling with and to get a better idea of what support you need.

Towards the end of the session, the team will talk to you about what happens next and what support they think you might need. Please remember you can also ask any questions you have. If you do not feel confident to ask question it can help to write these down before you go in or speak to a parent/guardian/carer about what you want to know before you attend.
You may also feel you need support from an advocate (An advocate is a trusted person, sometimes a professional who can support you to be heard and to help you communicate what you think and feel). There will be professional advocacy services available in your area and your CAMHS Team should have information on these and be able to make a referral on your behalf for support. If Welsh is your preferred language than you should be offered your assessment and support in this language.

During your appointment, the team may talk about ‘treatment’ or a follow up ‘Partnership Appointment’ to discuss your treatment – This just means you will be putting a plan in place about the work you’ll do together to help you feel better. The Team will talk about when you may need to see them again or whether they will be completing any further parts of your assessment.

Following your assessment, you will receive a letter, which will tell you about what your assessment has shown and what support you may need, this can include therapy and/or medication. If you require further support the team will write you with a follow up appointment, describing what will happen next.

Follow up appointments could again be held virtually, by phone or face to face depending on your circumstances and the type of treatment you need.

 

Information for parents and carers

We are living in difficult and uncertain times, leaving many of us feeling overwhelmed and stressed. It is a worrying time for many parents and carers who are concerned about the impact the pandemic is having on the emotional wellbeing of their children. However, there are ways we can support our children and young people to give them the best chance to stay mentally healthy at this difficult time. The information below will help you to support your child and to know how to access support.

 

How will I know if something is wrong?

Approximately one in eight children and young people experience behavioural or emotional problems growing up. For many, these will resolve with time, while others will need professional support.

It can be really difficult as a parent to know if there is something upsetting your child, or whether this is maybe a mood swing or a sign of a hormonal/development change. There are ways to spot when something is wrong. Some things to look out for are:

  • Significant changes in behaviour, which are out of character for your child.
  • Ongoing difficulty sleeping and periods of exhaustion during the day.
  • Becoming withdrawn and removing themselves from social situations.
  • No longer wanting to do the things that they would usually like to do.
  • Self-harm, this may include making small cuts by scratching or using a sharp object, pulling out hair, aggressive outburst of bunching and hitting themselves.
  • Neglecting themselves, no longer wanting to bath or wash, clean their teeth or change their clothes.
  • A change in eating habits, a reluctance to eat, hiding food or binging and then being unwell or vomiting.
  • Expressing feelings of worry and concern on a regular basis, not wanting to be separated from a parent or carer, no longer wanting to attend school or leave home very often.

The most important thing to remember is you know your child best, if you’re worried, think about if there has been a significant change in their behaviour that has lasted for an extended period of time. This could be at home, school or college; with others or on their own; or in relation to specific events or changes in their life, including changes caused by the pandemic.

If you’re concerned or unsure, there is lots of support out there, including professional help. www.dewis.wales is a good place to find services in your area. You can also contact the Family Information Service and your Local Children Centre. Other useful sites include:

Useful sites and resources for your child:

 

Hwb Young Person’s Mental Health Toolkit

Here you will find six playlists to direct you to a wide range of online resources to help you through the lockdown and beyond. In each of the playlists you’ll find self-help websites, apps, helplines, and more that are here to support your mental health and well-being. To access the playlists, click here.

 

CALM HARM: Mobile App to help teenagers resist or manage the urge to self-harm. (Free)

CHILDLINE: www.nspcc.org.uk 0800 1111

HARMLESS: Offer advice and Information regarding young people who may self-harm or experience such thoughts. www.harmless.org.uk

YOUNGMINDS: www.youngminds.org.uk 0808 802 5544

SELF HARM UK: Offers an online space to talk and ask questions about concerns in their life. www.selfharm.co.uk

RETHINK MENTAL ILLNESS: www.rethink.org.uk/ 0300 5000 927

NATIONAL SELF HARM NETWORK: NSHN is an online forum that lets you talk to other people in a safe, controlled environment. www.nshn.co.uk

THE MIX: 0808 808 4994

PAPYRUS: Papyrus HOPElineuk 0800 068 41 41 www.papyrus.org.uk

YOUNGMINDS CRISIS MESSENGER: Text YM to 85258 for free 24/7 support

HEADSPACE: Is a mindfulness app with lots of different programmes to support mental health.

SANE: Saneline operates from 4.30pm to 10.30pm daily for mental health support. 0300 304 7000

WELLMIND: This App was developed by the NHS and helps with symptoms of anxiety and depression. It’s a great way of keeping track of your thoughts and feelings.

CATCH THAT THOUGHT: This app is great to monitor difficult thoughts and emotions, when you experience them and where.

THE STRESS AND ANXIETY COMPANION: The app encourages positive thinking through its simplified CBT process and helps you to understand triggers.

THRIVE: This app helps you collect your thoughts and understand your emotions.

MEIC: MEIC is the helpline service for children and young people up to the age of 25 in Wales. From finding out what’s going on in your local area to help dealing with a tricky situation, MEIC will listen even when no-one else will. We won’t judge you and will help by giving you information, useful advice and the support you need to make a change. www.meiccymru.org/

MIND: www.mind.org.uk/

 

How can I support my child?

Be there to listen

It’s important to regularly ask your child how they are, so they get used to talking about their feelings and know there’s always someone to listen if they want to talk. Creating a fun space can help with this, some parents find during activities their children can open up more about how they feel. This may include baking, arts and crafts, sports, board games, reading stories and talking about them afterwards.

The important thing is trying to be engaged with your child and giving them your time without distraction. Paying attention to their emotions and behaviour, will help you to note important changes and understand their needs better.

Stay involved in their life

Many children and young people grow in confidence and feel supported when a parent shows an active interest in their life and the things important to them. It not only helps them value who they are but also makes it easier for you to spot problems and support them.

Encourage their interests

Supporting your child to keep active, learn new skills and be connected with their community and friends is one of the best ways to keep your child’s emotional health on track. Whilst we are spending more time at home together it is a great opportunity to talk to your child about their interests and what they enjoy, you can then think of ways to support them in those interests. Very often these things don’t have to cost a lot of money and very often your local Family Information Service will be able to tell you what’s free and reasonably priced in your area. Schools, colleges and your local authority will also have good ideas or may be able to access things that will support your child’s interests.

Take what they say seriously

Listening to your child and valuing what they say, without judging their feelings, in turn makes them feel valued and grows their trust and confidence in your relationship. This isn’t always easy, sometimes when your child describes how they are feeling, it can be difficult to hear, even accept. Particularly when we hear this for the first time. The most important thing is not to react in the moment or disregard the child’s feelings, but listen calmly and show that you are engaged and want to help. It’s good to talk about why they may be feeling like they are, but remember many children and young people do not know why, but they know how they feel. It’s good to talk about what they think will help and what you think with help and some things you can try. Sometimes just talking about it and having a plan in place can make a big difference to your child.

It’s good to check in with your child, but try to let them take the lead in how much they share, it’s a tough balance but over questioning can sometimes lead to a child becoming reluctant to share, so take your cue from them and offer regular opportunities without any pressure.

Build positive routines

We know it is not easy to create a routine and structure at this time, with the regular lockdowns and the need to self-isolate, our usual routines can be thrown out of balance. Research does however tell us that the majority of children feel better with a positive routine in place. Routines and structures can support a child’s wellbeing and encourage positive behaviours. A good place to start can be to reintroduce regular routines at home around healthy eating and exercise. A good night’s sleep is also really important – try to get them back into routines that fit with school or college.

Looking after your own mental health

Parenting or caring for a child or young person can be tough at times. It’s really important to look after your own mental health and wellbeing, as this will help you support those you care for.

Recognising and acknowledging when you’re feeling low or overwhelmed is an important first step. Struggling with something or experiencing your own mental health problems does not mean you are a bad parent or carer.

It’s completely normal to be anxious and worried during difficult times, the most important thing is that you recognise this. You may be feeling exhausted, emotional and anxious and if these feeling persist it may be time to start thinking of ways you can look after your mental health better and this may include getting professional support. Below we have provided some useful information you may find helpful.

The Five Ways to Wellbeing sets out the simple steps we can all take to look after our mental health and wellbeing. You can also read useful ‘tips for everyday living’ on the MIND mental health charity website and find practical ways to look after your mental health on the Mental Health Foundation website.

You can also find specific resources on how to look after your mental health during the COVID-19 pandemic here.

It also might be helpful to speak to a friend, fellow parent or carer you trust enough to tell how you’re feeling. Maybe there’s family, friends or a colleague who could support you or allow you a break? There’s plenty of help out there. You should never feel like you have to cope on your own. See our Adults mental health FAQ’s for further information.

 

How do I talk to my child about their mental health?

Starting a conversation can be hard, especially if you’re worried that your child and what they may be feeling. The most important thing is you give your child the opportunity to talk if they want to. It doesn’t really matter what topic the conversation starts with – it’s about the opportunity it gives you both to talk about feelings and to provide comfort.

Here’s some conversation starters:

  • How are you feeling?
  • What do you want to talk about?
  • What was the best and worst bit of your day?
  • If you could start today again, what would you do differently?
  • What did you do today that you are most proud of?

Lots of parents find it useful when starting a conversation to pick a current topic they know their child would be interested in. This may be a new song that talks about emotions, a magazine with an interesting article in, a film you recently watched together, or a storyline in a soap or TV programme. This places less focus on the child and often leads to natural conversations about feelings. As mentioned above sometimes doing a fun activity together can help too and provides a relaxed and comfortable environment to get the conversation started.

 

What should I do if my child tells me they’re struggling?

Thank them for sharing what’s happening with you, try and encourage that their openness and honesty is a very positive thing and acknowledge how they’re feeling.

Let them know that you love them, you’re there to support them and that they can talk to you, you are listening and ready to help and listen more when they need it.

Ask them if there’s anything you can do to help or anything anyone else can do to help.

Spend time together thinking about what’s making them feel this way.  Discuss whether there any changes that could have made them feel this way and think about the things you can do to help.

Let your child know about the helplines, textlines and online chat services that are available if they need to talk to someone outside the family. You can find a list of these above in Q3 Child and Young Person Section.

If you think your child needs professional support to feel better you can speak to your Child’s School or GP, who will be able to advice you on how to access mental health services. Together you can discuss whether referral to Child and Adolescent Mental Health Services (CAMHS), an assessment by a mental health specialist, or referral for another kind of support is needed. You can speak to your GP, school or local children’s centre with or without your child.

If your child needs emotional support and help to make sense of their feelings, they might benefit from seeing a counsellor or therapist. You may be able to access this for free through your GP or your child’s school. If it’s an affordable option, you can also consider a private child counsellor. To find more information about accessing counselling services contact your local CAMHS Team.

 

Are CAMHS Services still available now?

Our CAMHS service has continued to work with children and young people since the beginning of the coronavirus pandemic. We have needed to change the way we run our service to comply with the Government rules. We are beginning to support many of the young people we see through either virtual consultations or via telephone. Where there has been a clinical need to see someone in person we have done this, but have continued to observe the social distancing guidelines.

We have undertaken a number of risk assessments at all of our clinics and we have started to introduce more face to face consultations where it is not possible to provide a therapeutic intervention remotely. However, the NHS still needs to adhere to the social distancing measures and nationally there is a requirement for all consultations to happen remotely unless there is a clinical need for this to take place face to face.

This means that we are not able to have as many people in the clinics as usual and as a result we need to prioritise which young people we see in person. This can cause unavoidable delays and increased waiting times. We ask that anyone contacting our services to be considerate to our staff who are needing to make difficult decisions at this time and are working tirelessly to see as many children and young people as possible.

To make sure we adhere to the government guidance you are likely to see some changes when you next come to see us. Here are some key messages:

  • Please DO NOT attend a Children’s Centre site unless you have been specifically advised to do so. You will have been advised of specific arrangements by your local CAMHS Team or within your appointment letter. If you are unsure please contact your local Team for support.
  • Please DO NOT attend your appointment if you are unwell and/or have symptoms of coronavirus. Further information on coronavirus symptoms and what to do is available at: www.nhs.uk/conditions/coronavirus-covid-19/symptoms/.
  • Due to a significant increase in the number of telephone calls we are receiving it may take us longer to get back to you. Please make it clear in your message if your query is urgent & please be understanding and patient with our staff – they are doing everything they can.
  • If we feel we need to see your child in person this will be discussed with you and the measures needed to keep you and our clinicians safe will be explained.
  • If you are unsure what your care plan is please ring the service.
  • Physical health observations (height, weight, blood pressure, pulse and temperature) will continue to only be done if absolutely essential. Please discuss with the clinician if this is required.
  • Please only go to A&E if you are in need of urgent medical attention.
  • Please be assured that your clinician has declared themselves well enough to be at work and will be observing the guidelines of social distancing (maintaining approximately 2m distance) and will be completing regular hand washing.

If we have agreed you need to be seen in person some examples of the things that might be different include:

  • Following new arrangements when attending the clinic, for example telephoning the clinic on arrival before entering the building. The local arrangements will be confirmed with you prior to your appointment.
  • Using hand sanitiser on entering the building.
  • Observing social distancing measures. There will be more signs in the clinic explaining the process, including the potential of one-way systems.
  • Sitting further apart in the clinic rooms.
  • Some staff may be wearing masks.

 

I need support now – my child is in crisis

If you are extremely worried about your child’s mental health and feel they need help right away, we would advise that you try to see your GP for an emergency appointment. Your GP can contact CAMHS to ask for an urgent assessment if needed. If your GP surgery is closed, you can contact the out of hours GP. If your child is at risk of harming themselves, or in a state of crisis due to their mental health presentation, you also have the option of calling 999 or going to the Emergency Department at your local hospital.

Once your child is medically fit for discharge, the Emergency Department will make a referral to CAMHS. The Mental Health Risk Assessment will be completed at the hospital or at the Child and Adolescent Mental Health Service.