Seen but not heard: An exploration of the care journeys and experiences of children, their parents and CAMHS (Child and Adolescent Mental Health Services) practitioners after children are referred to CAMHS for reasons of suicidality

Suicide is the leading cause of death amongst children and young people in the UK. Children seeking help with suicidality are generally referred to Child and Adolescent Mental Health Services (CAMHS) for assessment and treatment. However, CAMHS across the UK are unable to meet the demand for their services. Little is known about how many children are referred for suicidality, or what happens to these children after they have been referred to CAMHS. This mixed methods thesis sought to explore the journey of care for children referred to CAMHS for suicidality; capturing how this is experienced by the children, alongside the views of their parents and CAMHS practitioners. It endeavoured to provide insight as to what the children, parents and practitioners would find helpful. The study comprised four main phases: 1. Literature reviews 2. A retrospective cohort study conducted in two different CAMHS in Scotland 3. A series of 27 qualitative interviews with children referred for suicidality, parents and practitioners working in CAMHS. 4. Overall narrative synthesis. The retrospective cohort study found approximately one quarter of all referrals were for children presenting with suicidality, and the outcome of these referrals varied greatly between services. The qualitative interviews found most children and parents felt let down by CAMHS, and the service did not meet their needs even when they were seen. Staff were under pressure to deliver short interventions using a prescribed approach. Children, parents, and practitioners all prioritised the relationship with the child above the intervention approach. The thesis goes beyond describing what happens, to present an overall interpretation: even when children who are suicidal were seen by CAMHS they did not feel heard. This was found to reflect not only the current CAMHS systems, but a dominant discourse that denies childhood suicidality in favour of a dialogue around distress