The long-term effects of unreliable, inconsistent support in CAMHS

When we discuss the high staff turnover, lack of reliable support, and other issues within CAMHS services we often think about the immediate distress that is caused to the young person in need of care and treatment. However, the ongoing effects can be just as distressing.

My experience of CAMHS, as with many other’s experiences, was of unreliability, numerous staff changes, lack of communication, and stop-start therapy. I’d invest my trust in a therapist only to have it broken when they departed at short notice. This happened over and over again. It was this continual loop of breaking my trust which has left me with some pretty serious insecurities.

Over the past couple of months, my therapist, whom I have been seeing for over a year, has had to take significant leave for various reasons outside both our control. Unexpectedly, it has triggered some deep insecurities within me. Yesterday she informed me that she’d have to take time off and I wouldn’t be able to see her for another 3 weeks. I am feeling incredibly vulnerable and upset over this. I don’t trust that she will come back, I don’t trust that I won’t be left stranded without support, I don’t trust that my trust will not be broken. Part of me feels that I can’t continue seeing her, that I should disengage because it hurts too much to have my trust broken over and over again. I know that this decision would leave me without any support, but right now that seems less painful. Another part of me is compelled to do something drastically self-destructive in order to prove to the CMHT that I really need support, that I’m not safe and can’t deal with this on my own. Unfortunately, my experiences have also taught me that the only way to get help is to do something drastically self-destructive.

I have very little point of reference for a stable, consistent therapeutic relationship, where I don’t need to continually prove I’m sick enough to be worthy of support. Therefore, it makes sense that I struggle to engage and trust in mental health professionals. My experience is that they cause me more pain, build my expectations and then let me down, and wait until the last minute to provide patchy support. Its almost as if I’m in an emotionally abusive relationship. Why should I invest my trust in professionals, when this is my previous experience?

The most shocking thing to me is that had I not had these experiences of CAMHS I wouldn’t have these trust issues and insecurities. I grew up in a loving, stable, nurturing environment, this fear of trust, abandonment and neglect didn’t exist before CAMHS – it was CAMHS that caused them. How can it be that a health service can cause this long-term damage? I put my trust in a service to support me and help me get better, but instead I was left with the acute distress at the time and long-lasting issues which are having a great impact on my ability to engage in therapy now as an adult. I have always veered away from blaming anyone, but actually right now I’m pretty f*cked off. It is completely unacceptable for a service’s failings to have left me with such a deep-rooted fear of trust, abandonment and neglect. I had, and still have, enough difficulties to deal with without this on top.

For now, I’m going to have to get myself through the next 3 weeks somehow. I logically know that the reasons for my therapist’s absences are out of her control, so I will do what I can to negotiate with the urges to disengage or self-destruct. If there’s one thing I’ve learnt about myself over the years, it’s that I have an ability to ‘get through’ things even if I’m metaphorically on my hands and knees and dragging myself along.

I’d be interested in knowing if this is a common experience of those who have accessed CAMHS? Is my experience unique? Have you experienced long term effects of poor care and treatment?