Prescription pain killers: share your stories with us

Prescriptions of powerful pain killers, such as codeine and tramadol, have doubled in the past decade – with the number of prescriptions issued rising from 12m in 2006 to 24m in 2016. NHS Digital figures show that one of the highest increases in prescriptions has been for oxycodone, which shot up from 387,591 to 1.5 million – a 206% rise – over that period.

But doctors warn that more should be done to monitor these drugs, and that they should not be given out so readily. The Faculty of Pain Medicine and Royal Pharmaceutical Society said more patients should be persuaded to try psychological means of dealing with pain, such as mindfulness, instead.

They warn that while opioids can be effective for cancer patients and for tissue damage, they do not always help the growing number of patients now taking them for long-term pain. These drugs also have side effects, such as severe constipation and dangerous sedation.

One of the main concerns is the risk of becoming addicted. Yasir Abbasi, a psychiatrist with Mersey Care NHS Trust, said: “Being dependent or addicted to prescribed painkillers can lead towards a slippery slope of illicit behaviour which can pave the way for hardcore drugs. There are not enough non- pharmacological interventions available to reduce our reliance on opioid medication.”

Share your experiences

We want to hear from our readers about this topic. Have you been given pain killers for chronic pain? Did you feel you had enough support while on these drugs? Did you become addicted? Do you think there should be more support services for those who become dependent? Tell us your stories and experiences.

Prescription pain killers: share your stories with us

A&E in England registers record delays: readers share their experiences

A&E patients in England endured a record-breaking month of delays in January, with more than 60,000 people waiting between four and 12 hours for a hospital bed, and more than 780 waiting over 12 hours.

The figures are at the highest level since 2004, when a target was introduced that 95% of patients must be seen and either admitted or discharged in under four hours.

We asked Guardian readers to share their experiences of A&E in January. Here’s what they said.

‘It angers me that this is being portrayed as a normal winter crisis’ – Laura White, 30, Wiltshire

On 19 January, I was rushed to hospital by ambulance. I suffer from severe asthma so spend a lot of time in hospitals. The staff were swift, calm, professional and outstanding, but as someone with much experience of emergency care over the past few years, a marked increase in response time is noticeable. I am always a high-priority case as there is a real risk of sudden death, but even then there simply aren’t enough paramedics to cover demand. I was extremely ill en route and the paramedic had to help me to breathe. He phoned the hospital to warn them of a high-priority case coming in and allow them to prepare for arrival.

I was wheeled straight around to the high-dependency area. I was shocked to see around half a dozen trollies in the corridor with patients on. This has never been the case in my experience of this hospital.

The staff were caring and helpful and trying to attend to all patients, but they were clearly stressed. The lead doctor and junior had a discussion over my bed about needing to do a blood gas test, but were reluctant to because the only working machine was in intensive care. This was followed by a nurse asking how everyone was, to the reply: “I have a full resuscitation, a full high care, no beds available. But there is a woman in the corridor who needs to be in here so I have to choose one of these people who are extremely ill to put in the corridor. I can’t do this; this is not a decision I should have to make.”

It angers me that this is being portrayed as a normal winter crisis and the sort of thing we see each year. I can assure you it has got progressively worse in the past year and is currently well beyond breaking point.

‘No one was ever left waiting for attention or care’ – Hannah Powell, 47, North Yorkshire

I was admitted to A&E six times in four weeks at the start of this year, twice by ambulance, because of problems with my heart. On each occasion I was seen immediately, with almost no wait. I was admitted to the coronary care unit on three occasions and, although there was clearly a bit of bed juggling going on, there were beds available. There were some waits: two days to have pacemaker surgery, and a weekend to see a cardiologist. But on the ward no one was ever left waiting for attention or care.

Obviously heart trouble is a high priority at the triage stage, but it was clear to me that the hospital’s systems and processes were working well. Although the staff were under pressure the whole time, they were, without exception, utterly committed to the care they delivered and were not going to let shortages of beds or staff to get in their way.

‘A defining moment was seeing the tenderness with which the nurses and assistants treated an elderly patient.’ Photograph: David Sillitoe for the Guardian

A defining moment was seeing the tenderness with which the coronary care nurses and assistants treated an elderly patient, despite being rushed off their feet during a busy night shift.

‘A&E was extremely busy and there seemed to be a shortage of staff’ – Karen Hourihan, 57, social worker, Liverpool

I waited 55 minutes in excruciating pain for paramedics to arrive. I was taken to A&E and after a short wait in the corridor I was taken into a cubicle. My son was with me and he was able to advocate on my behalf by seeking out medical people and requesting updates. Nobody came to speak to me directly about my injury. I was taken to a holding ward while waiting to be admitted. I arrived at 8pm and was admitted to a ward at 4am when a bed became available. A&E was extremely busy and there seemed to be a shortage of staff.

Staff appeared to have little time to spend explaining things and reassuring patients. This was not too much of an issue for me as my son was present the whole time. However, for anybody alone or older I imagine it would have been an isolating experience. Having said that, the staff did their best to provide a good standard of care.

‘I was put in a room and forgotten about’ – Melanie Salinger, 53, Bishop’s Stortford, teacher

When I visited A&E, I was put into a side room and promptly forgotten about. Eventually, a nurse asked how my consultation had gone and I said I still hadn’t had one. It turns out I had been forgotten; they had no record of me. I was diagnosed with pneumonia and had to leave that room and sit in a chair for 10 hours as there were no beds. I was sat in a busy area with everyone looking at me. My blood pressure was very low, so I actually needed to lie down.

‘I had to sit in a busy area with everyone looking at me. My blood pressure was very low, so I actually needed to lie down.’ Photograph: Alamy Stock Photo

Once a bed was found for me the nurses in the ward cared for me very well. However, the noise at night was constant. It sounded like an all-night party. Someone on my ward complained so it went quiet for half an hour – then started again. How are we meant to recover? I asked to be discharged as I knew I would recover quicker at home.

‘Wonderful service, could not be beaten’ – Larissa, 38, Bexley

I injured my wrist on a Sunday afternoon, but attended the hospital on the Monday morning. I had been told of the awful waiting times so I came prepared with a sandwich, thermos and my kindle.

However, I waited less than 10 minutes to see the nurse. She took my details and asked a few questions about my injury. I was then sent for an X-ray. The nurse informed me there could be quite a wait, but I only waited around 10 minutes. The radiographers were lovely, caring and professional.

The nurse called my name after 10 minutes, showed me the X-ray of my fracture and put me in a temporary cast. I was triaged, X-rayed and plastered in less than an hour and a half. I barely had time to open the thermos, and the kindle remained shut.

Wonderful service, could not be beaten. The NHS staff were great.

A&E in England registers record delays: readers share their experiences

Ditch dating apps but share the love: finding a match for people with dementia

It was wonderful spending the day with Irene and sharing our passion for football by watching our rival teams – Leicester City and Chelsea – play each other. We had so many laughs together.

Fiona and Irene really hit it off when they met up, after being brought together by an online matching service. But if this sounds like the makings of a great first date, the relationship is actually far more complex than you might expect.

They were partnered up by Side by Side, an innovative matching service that we at the Alzheimer’s Society are launching today, which is designed to connect volunteers to someone with dementia.

Side by Side is a completely new approach to volunteering. From joining a local club, going to football matches or just heading out for a stroll together in the park, the app pairs up people with dementia and volunteers with shared interests. A third of people with dementia lose friends after their diagnosis, and nearly two thirds who live on their own feel lonely. We know that one of the most important things for those affected is to remain part of their community and continue to do the things they love. By taking part in activities with the support of a volunteer with similar interests, they can continue with their hobbies – or even find new ones.

My team set up the service which was particularly important to me after seeing my granddad’s experiences with dementia. As his condition deteriorated, he became increasingly confused; he didn’t know whether he had just arrived at church or was leaving it. Although he had great relationships with all the people at his local church, they had limited resources to support him. The moment he had to stop doing something he had done his whole life broke his heart. If a service like Side by Side had been available, he wouldn’t have had to stop.

Side by Side has got off to a promising start. There are almost 2,000 people with dementia waiting to be paired up and we are urgently calling for more volunteers.

What makes this volunteer programme different is the flexibility. Side by Side is designed so that almost anyone can volunteer. It is flexible, so meeting up can be easily arranged around work and family, and a telephone service is also available for those with more limited time.

I was so convinced of the merits of the scheme that I decided to put my money where my mouth is. Despite having a busy lifestyle, doing a job I love and running around after three kids, I signed up as a volunteer. My Side by Side partner, who has Alzheimer’s, shares my healthcare background and love of gardening. I’d always wanted to learn how to grow my own vegetables and now that I’ve met Maggie,I know how to do this.

Maggie isn’t just a volunteering project; she’s a friend. Her daughter told me that it was the first time she has seen her mum smile in a long time.

Kathryn Smith is director of operations at Alzheimer’s Society. More information about volunteering for Side by Side or accessing the service can be found here.

Talk to us on Twitter via @Gdnvoluntary and join our community for your free fortnightly Guardian Voluntary Sector newsletter, with analysis and opinion sent direct to you on the first and third Thursday of the month.

Ditch dating apps but share the love: finding a match for people with dementia

Share your experiences of care home closures

Care for the elderly is reaching a “tipping point”, the government’s watchdog warned this winter, as rising costs and council budgets squeezed by years of austerity struggle to meet the increasing needs of an ageing population.

Care homes are facing a perfect storm of financial challenges, as councils cut the rates they are paying to house residents and those who can afford to pay for their own care face spiralling bills, according to the Care Quality Commission, which oversees the sector.

The crisis has already forced some care homes to close their doors: the number of care homes in England has fallen, according to CQC figures, even as the demand continues to climb.

Share your experiences

We want to hear from readers who have been affected by the closure of care homes. Has your care home closed, or is it under threat? Do you have a parent or other relative in a care home threatened with closure? Or do you work for a care home company that’s currently under threat, or a council trying to deal with the challenges?

Please share your experiences in the form below, anonymously if you prefer. We will ensure that the information you provide us is kept secure.

Share your experiences of care home closures

Mental health: share your personal experiences

Earlier in January Theresa May announced that she wanted to reduce the stigma surrounding mental health issues. We’d like to understand more about how people’s lives are impacted by mental health issues.

Please show us how you or the people you know have been affected by sharing your experiences. We’re interested in your creative expression – artworks, pictures or poetry as well as hearing about your factual experience. We’ll feature a selection of contributions in a visual interactive on the site.

How to contribute

• GuardianWitness is the home of readers’ content on the Guardian. Contribute your video, pictures and stories, and browse news, reviews and creations submitted by others. Posts will be reviewed prior to publication on GuardianWitness, and the best pieces will feature on the Guardian site.

Mental health: share your personal experiences

Ambulance services in the UK: share your stories and experiences

The pressure on the NHS ambulance services is increasing. Recent figures showed that of the UK’s 13 ambulance services, only Wales was reaching emergencies within the target time of eight minutes. They also showed that the number of patients waiting for ambulances for more than an hour had almost tripled in the past two years, and that ambulance crews were wasting more than 500,000 hours queuing outside hospitals.

Keith Willett, the director of acute care at NHS England has called it, “a system-wide problem … it is about an increase in demand for urgent healthcare need. Of all the parts of the healthcare sector, the ambulance service has seen the largest increase in demand at 7.3% in the last year.”

Paramedics too have reported working under tremendous pressure as a result of increasing demand. Many say they continue working well past the end of their 12-hour shifts, and rarely get meal breaks. So what impact is this having on patients?

Share your experiences

We’d like to find out what it’s like to receive care. We also want to hear from those working in the service about their daily challenges. What have patients experienced? What impact did it have? What parts of the service are effective and what’s not working so well? What worries you about the future?

Share your views and stories in the form below. The information you give us will be confidential and we will be in contact with you before we publish any contributions.

Ambulance services in the UK: share your stories and experiences

Black women and breast cancer: share your story

Black women in England are more likely to get advanced breast cancer than white women, new analysis by Cancer Research UK and Public Health England shows.

It was concluded that late-stage disease affected almost twice as many black women (22% of black African women and 22% of black Caribbean women) than white women (13%).

Experts say this is for many reasons, including possible differences in tumour biology, low awareness of symptoms and screening and barriers to seeking help.

While spotting the disease early is key, Heather Nelson of BME Cancer Voice, said in an interview with the BBC: “Women of colour are less likely to go for screening.

“You’ll get leaflets through your door and they will be predominantly of white, middle-class women. There’s no representation of South Asian, African descent et cetera.

“If you get information like that, you’re going to look and think, ‘That’s not about me.’”

One woman said to the BBC: “A lot of us black people bury our head in the sand: ‘Oh, me, well, I don’t need to go, there’s nothing wrong with me.’”

But lots of work has taken place around breast cancer prevention. In October, the international community celebrated Breast Cancer Awareness Month. The pink ribbon has become a symbol to express moral support for women with the disease.

So, why is this work not reaching everyone? If you’re a black survivor of breast cancer, we want to hear your thoughts. When did you find out you had cancer and what has your experience been? What do you think of the prevention messages available? Does it talk to a diverse range of communities? Why do you think that black women are less likely to go for screening?

Share your story with us.

Black women and breast cancer: share your story

A male pill matters because both partners can share the side-effects | Deborah Orr

An experimental male contraceptive jab has proved just as effective as the pill is for women. Trials were abandoned, however, because side-effects included depression, raised libido and acne. Which is weird, because the pill has similar side-effects – although sometimes it can cure acne. The pill’s other common side-effects include nausea, headaches, breast tenderness, anxiety, weight gain and, sometimes, decreased libido. However, suggesting that the pill isn’t an almost perfect form of birth control tends not to go down very well.

This is understandable. The pill has given women agency over their own lives like nothing else. And women don’t want that great freedom to be tarnished. The advantages of an equally reliable male contraceptive, of course, are much less direct. If anything, the pill freed men from worry about contraception or “getting a girl pregnant” to the extent that an unwanted pregnancy is often looked on as something that’s entirely the fault of the fool who’s enceinte. It’s hard not to look on all those anti-abortionists and morning-after pill killjoys as people determined that foolish women should pay for their own singular mistakes.

Yet a male contraceptive is simply more sensible, in biological terms, than a female one. In her book, Sweetening the Pill, and in numerous articles, Holly Grigg-Spall points out that men have no fertility cycle, while women are only fertile for six days every month. Women take a lot of responsibility for those six days, while the constant risk is not from their ova but from ever-ready sperm.

Grigg-Spall, who is a passionate advocate of raised awareness about the pill’s risks to women, believes that its side-effects are minimised not just because of feminism, which cannot help but see the pill’s advantages as outweighing its disadvantages, because they do, but also because of sexism, which tends to dismiss female problems as trivial and male advantages as important. It’s hard not to agree with her, when comparing this latest research, in which side-effects were given such emphasis, with Danish research published last month that linked the pill to depression and gained little more than shrugs.

‘Shared responsibility for reproductive freedom still seems so far away.’ Photograph: Garo/Phanie/Rex/Shutterstock

Yet it’s precisely because hormonal contraceptives have side-effects, and that these vary from person to person, that a decent male contraceptive would be such a good thing. If one partner finds the side-effects unbearable, then the other can take up the mantle. If one partner has been on contraceptive hormones for a long time, he can give his body a rest and ask his partner to take her turn. A male pill would promote the idea of shared responsibility. Which in matters of sex and reproduction still needs a lot of promoting.

The pill unleashed sexual freedom on a grateful world. It took a while for feminism to realise that this was not by any means always to the advantage of women. Ever since that time, discussion about the male pill has tended to focus on casual sex – whether a woman would trust a man who said he was on the male pill, since a lie wouldn’t leave him up the duff. But the truth is that barrier methods remain necessary for casual sex, to protect against sexually transmitted diseases, whether other contraception is being used or not. Hormonal contraception for both sexes is at its most positive as a goal in stable relationships, where it is so important for responsibility and risk to be shared.

Yet shared responsibility for reproductive freedom still seems so far away. One reason why the development of an effective male contraceptive has been painfully slow is lack of enthusiasm for the idea. Money for research isn’t there because big pharma doesn’t think men will be keen enough. The prospect of more equality, empathy and understanding between the sexes just doesn’t thrill the market.

Unlike Grigg-Spall, who had a terrible time when she was on the pill, and suffered major side-effects such as panic attacks, I’m not against hormonal contraceptives, even if they are risky. I stayed on the pill for a long time, maybe too long, and eventually I couldn’t face it any more. I’d have very much liked it if my partner could have taken his turn too. That alternative wasn’t available. But that isn’t just scientific and pharmaceutical happenstance. I’m troubled by the idea that risks women are routinely encouraged to take are risks that men are not willing also to take. There are related risks that men won’t take either. Vasectomies are at a historically low level. Addressing this particular inequality is a huge step towards addressing many others.

With double as many people willing to take a contraceptive pill, fewer women would have to suffer in silence for the sake of worry-free sex. I’m sure that some men would be happy to take a hormonal contraceptive. But the market tells us that not nearly enough are interested, while research tells us that even when they are, they’re too risk-averse for the idea to be driven forward with enough urgency.

Reliable contraception is a Great Thing for humanity. It’s about time that half of humanity stopped shirking and joined women in engaging in the physical challenges that are undertaken in embracing it.

A male pill matters because both partners can share the side-effects | Deborah Orr

Schoolgirls with autism share experiences in young adult novel

A novel told from the point of view of a teenage girl with autism, written by schoolgirls with autism, has been published after the students – frustrated by their experience of a world that rejects and ignores them – decided to take matters into their own hands.

The pupils at Limpsfield Grange school, the country’s only state-funded residential school for girls with special needs, mined their own most painful – and uplifting – experiences to write M in the Middle, a young adult novel created with the help of their creative writing teacher, Vicky Martin.

“If society just realised the very simple fact that girls can have autism as well as boys, then the life of girls with autism would instantly be so much better because we wouldn’t be so scared of being labelled as weird, abnormal and strange,” said Francesca Warren, 14, one of the 70 girls at the school.

“Because people think autism is something only boys have – and because girls with autism behave completely differently to boys – girls have to constantly mask their condition,” Warren added. “But having to pretend to be someone else is debilitating and humiliating. And it doesn’t even work: people can get annoyed with you even when you mask [because they sense your inauthenticity].”

Warren sits with her friends in the office of Sarah Wild, the headteacher at Limpsfield Grange. Fizzing with as many different opinions as any other group of teenage girls, they only speak with one voice when it comes to the question of whether boys with autism have an easier life.

“Yes. Yes. Yes!” they shout in passionate union. “Ding. Ding!” whooped one girl, for added emphasis.

The hilarity quickly ebbed away. “I’m prey in a world of predators,” said 12-year-old Lauren Mittelmeier, quietly. “Life is really hard for girls with autism. Why is life so difficult?”

The struggle to get their condition recognised is just the start of the battle for girls with autism. Even when girls are diagnosed, their life doesn’t necessarily get any easier: there is virtually no specialist support, academic or otherwise, for girls.

Mittelmeier’s parents moved home from Dorset so their daughter could attend Limpsfield Grange school, in Oxted, Surrey. This is not unusual: another family moved from Cornwall. One other girl boards during the week and travels the 250 miles back to her home every weekend.

Mittelmeier said: “I was diagnosed at eight but my autism wasn’t acknowledged by my school. They just thought I was an idiot. They were trained to work with autistic people but I’m guessing it was boys they were trained for, not girls.”

There is no official data on autism diagnoses, although the National Autistic Society (NAS) is calling for local authorities to start collecting it, as well as ending the “autism diagnosis crisis” that sees children waiting for nine years and more for a diagnosis.

Statistics appear to show that more men and boys than women and girls have a diagnosis of autism. The study most quoted, written by Leo Kanner in 1943, found there were four times as many boys as girls. In later years, various studies, together with anecdotal evidence, put the men to women ratio at anything from 2:1 to 16:1.

But Sarah Wild, head of Limpsfield Grange, believes there are just as many girls with autism as there are boys.

She said: “I genuinely think there are equal numbers but the stereotype that it’s a male condition is self-perpetuating: the diagnostic checklists and tests have been developed for boys and men, while girls and women present completely differently.”

According to the NAS 2012 survey of 8,000 people with autism, just 8% of girls with Asperger syndrome were diagnosed before six years old, compared to 25% of boys. Only 21% of girls with Asperger’s were diagnosed by the age of 11, compared to 52% of boys. Many adult women who took part in the survey didn’t have a diagnosis at all: 10% compared to 5% of males.

An added problem facing girls and women with autism is that if their true condition isn’t identified, they are at risk of being misdiagnosed, said Wild. “If, for example, a clinician asks a girl with autism if she ‘hears voices’ or ‘sees people’, she’ll say ‘Yes’ because she’s being entirely literal – and then she’ll be misdiagnosed with schizophrenia or another mental health disorders,” she said.

The NAS survey suggests that 42% of females have been misdiagnosed, compared with 30% of males. Many women remain undiagnosed well into late adulthood until they self-diagnose: females in the NAS survey were more likely to have paid for their diagnosis (14% of females, compared with 9% of males).

Misdiagnosis and no diagnosis, as well as a lack of support, understanding and recognition once a correct diagnosis has been made, leave girls and women in a dangerous space. According to the NAS survey, 38% of females with Asperger’s have another serious mental health condition, including eating disorders and depression.

But momentum for change is starting to gather pace: in January, the National Association of Headteachers is holding a girls on the autism spectrum conference to prepare a call for action on the issue.

Before that, on 8 November, there is a private House of Lords roundtable organised by the autism and girls forum – itself set up just 18 months ago.

“We set up the forum because there is so much energy coming forward now from parents, academics, children and young people’s mental health services (Camhs), and teachers, that we’re missing identifying this group of girls,” said Professor Barry Carpenter, chair of the forum.

“The pattern we’re seeing is that these girls come badly unstuck in their teenage years. They manage to mask it when they’re younger, which means when they crumble, they don’t have any coping strategies and structures to fall back on for support,” he said.

The House of Lords roundtable has a quest, said Carpenter: “We need to engage political will, without which nothing will change. There needs to be a systematic review, either under the women and equalities committee or we need to set up a new, cross-governmental task force.

“We need to harness all this evidence coming to us and marshall it to incentivise more research, more help for schools and Camhs.

“We have a very vulnerable group of girls here,” he said. “I can’t personally live with the fact we’re not doing nearly enough to help them.”

M in the Middle is published by Jessica Kingsley Publications (£8.99). Click here to buy a copy for £7.37

Schoolgirls with autism share experiences in young adult novel

Bad IT, grazed knees and bureaucracy: NHS staff share their frustrations

An ambulance is called for someone who has fallen over and grazed their knees

We get inappropriate calls from the public who seem to be too scared to get people to stand up after falling over. For example, a person trips in the street and grazes their knees. A crowd gathers and persuades the person to stay on the floor until the ambulance comes. People look on in wonderment as the ambulance crew ask the person if they can stand. The person stands and is full of gratitude but 30 to 40 minutes is spent on the scene doing basic checks that we have to do before discharging patients and paperwork. The person could have got themselves up and gone to the chemist for wipes and a plaster.

Paramedic, ambulance service, Wales

Clunky IT systems detract from my work in A&E

Once I have assessed people in A&E, I have to write up the medical notes by hand or on a computer system. Because I work in the community and am based at a different NHS trust I then have to duplicate the assessment information to rewrite it on my own trust’s electronic system. I have no access to the local social care notes system which can cause a delay in finding out important collateral history. None of the different IT systems are linked. It can be very frustrating when making difficult decisions about people’s care and treatment.

Senior mental health practitioner, London

A patient arrived by ambulance complaining of a sore ankle. He then stormed out of hospital on said ankle

I recently had a patient arrive to my A&E, by ambulance, with the complaint that his ankle had been hurting for the last five months. When I explained that A&E is not the place for longstanding problems such as this because we specialise in emergencies, and that he’d have to see his GP to investigate, he was incredulous. After angrily berating me for not arranging him a same-day MRI scan, he stormed out of the A&E department walking on said ankle.The patient wasted both my and the ambulance service’s time which should have been spent looking after genuinely acutely unwell patients. It is so frustrating and demoralising to then be abused by patients like this on a daily basis. The public’s expectations and understanding of different healthcare services is central to this problem. People need to be properly informed of what is appropriate for A&E, when to go to the GP, when to use a pharmacy and when to self-care.

Doctor, emergency medicine (A&E), London

Sore throats do not constitute an emergency

I see many people with urgent sore throats.

GP, Dorset

I spend time fighting other parts of the NHS over who should pay for what

This is not a direct clinical issue, but applies to how the members of the information team (a staff group that often our colleagues and the public alike are not aware of), may be called on to support bureaucratic processes – instead of contributing towards improving the running of the organisation. One particular example is in the ongoing battle for charging, taking place between the trust and the commissioning support unit (CSU).

Each month, our team is sent spreadsheets listing thousands of instances of patient care that the CSU is challenging as being incorrect or inappropriate – so called SLA (service level agreement) challenges. If we don’t answer each individual example, the trust will potentially lose any payment for that activity.

I understand that this sort of process is a necessary check to promote value for money, and of course errors do get made that need correcting. Unfortunately, in the current climate, the attitude seems to have changed from this being a check and balance, to being a significant cost saving opportunity for the CSU. As such, they apply more staff resource to scrutinise and challenge trusts – using more inventive thinking to claw back money from providers. I have heard anecdotally that CSU analysts are incentivised based on how much they can claim back from trusts.

We, on the other hand, are not in a position to hire more staff to scrutinise and check and to answer to these sorts of overheads (in fact we tend to pay equivalent staff less) – instead redirecting resources that would otherwise be spent on trying to improve how we run the organisation.

Of course, we still continue to accept and treat patients as we always have. The actual cost of seeing the patient stays the same. The administrative burden, however, inflates the more we bicker about whether CSUs should or shouldn’t pay. The trust, of course, does not hold the purse strings and does not, therefore, have a position of power in these matters. While the CSU itself may profit, it certainly feels like the NHS is spending a lot of time withholding money from itself.

Information analyst

A colleague was woken up to prescribe a sleeping tablet for a patient. When he reached the ward, the patient was asleep

A colleague was once woken up in the middle of the night to attend to a private patient. The request was to change the aerial on the patient’s TV set.

Another colleague was woken up to prescribe a sleeping tablet for a patient. When he reached the ward the patient had fallen asleep but he prescribed the sleeping tablet anyway. The ward staff woke the patient to administer the tablet and then the patient could not get back to sleep again.

Doctor, anaesthetics, London

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

Bad IT, grazed knees and bureaucracy: NHS staff share their frustrations

What"s your experience of mental health in the workplace? – share your stories

A new study suggests more than three quarters of workers aged 16 to 64 have experienced symptoms of poor mental health, and nearly two thirds of those with mental health problems believe work was a contributing factor.

Many of the 20,000 employees surveyed by the charity Business in the Community employees found their employers lacked awareness, training and responsiveness to mental health issues. More than half said their employers took no action when they disclosed their symptoms of poor mental health.

We’d like to hear from you about your experiences of mental health in the workplace. Do you feel able to discuss mental health in your workplace? Have you had a positive or negative experience when you have discussed your mental health? Are you an employer who has experience of building a workplace culture that supports good mental health?

You can share your views by filling in the form below – completely anonymously if you would prefer. We’ll be putting together an article highlighting your views to coincide with World Mental Health Day on Monday 10 October 2016.

What"s your experience of mental health in the workplace? – share your stories

Children"s mental health in crisis – readers share their stories

New figures show in June that nearly a quarter of a million children and young people were in contact with mental health services for problems such as anxiety, depression and eating disorders.

The NHS data highlights the scale of the growing crisis in young people’s mental health. But what help is there for those who need it? Research shows 28% of children referred for support in England – including some who had attempted suicide – received no help in 2015.

We asked for your experiences of children’s mental health services in England, receiving responses from parents, teachers and young people themselves. Here are some excerpts from the comments we received, condensed and edited for clarity.

Beth Ackers, 18, Merseyside

I went to the doctor last year because I was feeling depressed and anxious. I was nervous about going to see my GP as I wasn’t sure what was wrong with me. My mum came with me and I think she did most, if not all, of the talking. I was just too emotional and worked-up to speak properly.

I was immediately referred to child and adolescent medical health services [CAMHS] and an assessment appointment was set up. After this, I was told I would only have to wait six weeks, but when I hadn’t heard anything by 12 weeks I was told that they would need to do the initial assessment again. I was then referred to cognitive behavioural therapy and given six sessions. However, when I got to the end of these sessions they said that I actually needed different treatment. The person who saw me felt that my issues were more ingrained and talking to a counsellor or therapist might be more appropriate. I was told this at the beginning of June and still haven’t got an appointment to talk with someone. Since then, I’ve turned 18 and am not sure how this will affect my treatment. The whole experience has made me feel quite isolated and abandoned. It took a lot to talk about how I was feeling, and now I feel like I am being ignored. I also found the service quite disorganised, and doing the assessment again was stressful. I cannot afford to get private counselling and am just hoping that I was will be offered someone to talk to at my university when I start soon.

Azia, 17, West Yorkshire

I went to see my GP in 2014 about anxiety and depression. I had been feeling hopeless and helpless, tearful, with no motivation or interest in doing anything. I was not getting any enjoyment out of life and had suicidal thoughts. From around the age of 13, I also experienced anxiety. The physical symptoms were headaches, soreness in my limbs, bloatedness (and with that increased trips to the toilet), sweats and shivers, loss of libido and increased sleeping.

My doctor recommended that I get help from a local mental health charity called The Market Place before considering children’s and adolescent’s mental health services. The counselling was not helpful, so I went back to my GP who referred me to CAMHS.

My assessment happened within three to five months and I was given a case manager and began family therapy soon after. We soon discovered that it wasn’t the right therapy for me and so I began mindfulness-based cognitive therapy (MBCT) a month later.

I am currently undergoing cognitive behavioural therapy (CBT), which I am finding very helpful. The waiting period for this therapy was over six months however, which was very frustrating. Having said that, I could still contact my case manager if I needed to, and she was always very helpful.

Overall I have had few problems with CAMHS and all the medical professionals I have come into contact with are excellent. They are superb listeners and have always asked me what I felt was best for me as well as giving their professional opinion. Many people slate CAMHS without appreciating the good they do and the lack of control they have over certain areas, such as waiting periods.

The waiting period I endured for CBT was rather long and it allowed my problems to get worse. However I am reluctant to criticise CAMHS for this because if they were given adequate funding from the government this wouldn’t be a problem.

Rose Grace, 24, Manchester

I was 14 when I was diagnosed with anorexia. Having an eating disorder was one of the worst experiences of my life, a situation made worse by children’s mental health services. Firstly, the therapist I was assigned to made me feel uncomfortable; it felt like he was blaming my parents for my situation and I didn’t feel I was being listened to. I ended up working out for myself what was causing my eating disorder.

Eventually, my condition got worse and I was admitted to hospital as an inpatient. However, I wasn’t admitted as a patient in a specialist unit for eating disorders and the staff didn’t seem to have any experience treating people with conditions such as my own. They made me feel I had brought this all on myself. A few weeks later I left hospital and despite being physically better, I was psychologically worse. It was only because of my parents that my condition improved over the next few years. They spoke to another therapist who helped them understand how to help me. The biggest step forward was talking about my anorexia differently and viewing it as a negative voice separate from me. My parents then would say to me, “I know that this is not you, it’s your anorexia” and I would realise they were right. Being able to visualise it that way helped me to beat it.

Leo Winkley, 45, headteacher, York

This is a really important issue for schools – the simple fact is that we are having to plug the gaps in provision and cover the ridiculous waiting times for children to be seen in a massively overstretched and under-resourced CAMHS. Solutions that we have put in place include training teachers in mental health first aid, employing a team of counsellors for drop-in sessions and developing a more proactive mental health and wellbeing course within our personal, social, health and economic programme. We are very lucky to have the resources to do this. There needs to be investment to allow schools to equip teachers better; whether we like it or not, teachers will be in the frontline on the critical issue of children’s mental health.

Whether we like it or not, teachers will be in the frontline on the critical issue of children’s mental health.

Leon Winkley

There are times when a school really needs to refer a child on to experts. This is where the real problems lie – the lengthy delays. With an under-resourced CAMHS, the management response seems to be to make the referral thresholds higher and higher. In this situation, the school can only put its own support, monitoring and reporting measures in place and put all reasonable pressure on the local CAMHS provider. It’s very important that pastoral care in a school doesn’t desensitise the public to these issues and only deals with the most acute or chronic cases. Early and sensitive intervention can make a big difference.

Anonymous, 17, London

Initially, I went to the doctor for my low and high moods, including hallucinations, delusions and suicidal thoughts. Going to the GP was daunting, but I found the doctor empathetic and professional. She called CAMHs and the reply was instant. I was contacted the next day and asked to come in the day after. Everything happened swiftly. I met a family therapist for my first session in which I gave information about my symptoms and what had happened to me. My next session was with a psychiatrist whom I then started to meet weekly, even though I was reluctant to talk. My psychiatrist was very helpful and compassionate, and seemed to care about me as a client. I regularly attended sessions in which we would discuss techniques and strategies, go through my thought processes in trying circumstances and discuss what was important to me. I was made to feel comfortable and secure, and never judged. I was very satisfied with how things were going. However, I do understand that friends who have gone through CAMHS have not been as lucky. I was told in all of my sessions where I could go for help, who I could talk to and I was given all the support I needed.

I am still attending my fortnightly sessions. I have not yet received any medication, as they did want to put me on anti-depressants. However, they were worried about the potential increase of suicidal thoughts. They also wanted to put me on anti-psychotic medication, but, were reluctant because of my age. I have not received a diagnosis, but they are still investigating.

Anonymous, 51, Buckinghamshire

My children have had ongoing mental health issues and have received support from our local CAMHS over the years. However, local services have deteriorated significantly over the past five years.

My youngest child has had repeated referrals to CAMHS over the last two years by their school and GP for their deteriorating mental health difficulties. On every occasion we were told they didn’t meet the threshold for therapeutic help even though they were self-harming, threatening to kill themselves and having increasingly dangerous angry outbursts requiring police interventions.

In desperation, I insisted that my youngest be referred to a specialist hospital team for a second opinion. Their diagnosis was early bipolar syndrome. They prescribed medication to help and my child was referred back to local CAMHS for ongoing care.

Sadly, my child made another attempt on her life which required hospitalisation as an inpatient. After a seven-day wait at home, the only bed available was more than 300 miles away from our home. My child has been resident there for more than two months and no bed closer to home has become available.

Having my child sent so far away has left me feeling helpless and unable to support her as much as I would like. Communication has been very difficult both with my child and the hospital staff and I have found myself constantly having to chase for information and to reassure my child. Visiting has been restricted to weekends; it’s a five-hour drive from where we live.

Initially we were told the mental heath services would continue to seek out a bed closer to home but that has not materialised. My child was initially relieved to have had a bed located but upset that it was so far away. They miss their home comforts, our pets and family. These things have, I feel, added to everyone’s distress.

We are still waiting for local CAMHS to share their support plan for when my child returns home. Our local CAMHS does not offer family therapy such as art therapy, owing to cuts.

James Downs, 27, Cardiff

I was a high-achieving young boy and at 14 I developed obsessive compulsive disorder (OCD) and anxiety about my appearance. It got to the point that it would take me ages to get ready and I kept skipping school without telling anyone why. After a year of doing this, I told my parents and the school the reasons behind my truancy and was eventually referred to children’s mental health services. I was seen quickly but the quality of treatment wasn’t very good. I felt like they wanted to treat me for OCD without talking about any deeper issues going on. I was offered help but soon my OCD changed into an eating disorder and I became anorexic. I didn’t feel they were working with me to improve my health, but that they felt I was badly behaved. The whole focus was just on, “You must gain weight” rather than them asking, “What’s going on to make you feel this way?” Eventually I gained weight and was given a lot of medication (anti-depressants etc) which I wasn’t happy with. I was offered care in my community and sent home, with a team around me to help. I gained weight but developed bulimia and no one seemed to care about this, so I just stopped talking to people about it. I am still working through my issues with food and cannot help but feel that my life might have been different if these issues had been properly dealt with when I was younger.

I know there are more specialist services in place for treating eating disorders now, but I also know there are cuts to CAMHs and what’s on offer is quite patchy. This makes me worry for other young people as I don’t want them to go through what I did.

Tracey Lawrence, 31, assistant head, Leicestershire

Mental health is everybody’s business. The government needs to invest more so that we, as classroom teachers, receive proper training to deal with these issues and have the support in place when exploring the best way to move forward with a child. There’s a fear of delving into mental health because of a lack of knowledge – that’s why teachers need a clear structure for support. It’s an issue the government says it cares about, but at the moment it isn’t doing very much.

The waiting time for CAMHS is not a hidden issue. You hear report after report about the impossibility of having a child referred and the lack of help when you get there. There is pressure for teachers to plug the hole left by a lack of services. We are constantly trying, without qualified knowledge, to help children and what we can offer depends on school funds and whether we can get specialist help, such as a counsellor on site. The CAMHS professional helpline is my biggest support. I’ve had many a conversation about children who I knew didn’t meet the threshold for referral but still needed help. The people on the lines are always supportive, never laugh when I say for the millionth “Sorry to bother you, but …” and “I hope I’m not wasting your time, but …” and they certainly always have a way forward in terms of strategies to implement and interventions to support a child. However, this usually isn’t enough and the children really need one-to-one professional help as soon as possible. We need to have a real focus on what the different branches of mental health are, how to identify them, where to go for support when you don’t meet the criteria for diagnostic assessment and examples of interventions to implement for each problem area.

Stacey Hirons, 42, work in crisis intervention, Coventry

I work for Coventry’s crisis intervention service, supporting young people aged 11 to 18 (although often we have younger referrals, too). In my experience CAMHS is a service under immense pressure with substantial waiting times. When support does come it can change crisis situations overnight. Frustratingly, this is the exception. We are also often told CAMHS cannot work with a child until their home situation is settled, but mental health issues put enormous stresses on families, meaning the situations are unlikely to be resolved without CAMHS support. It’s a vicious circle. One other bugbear is that CAMHS are not able to visit families at home and see the young people in their real-life contexts. This is especially difficult for our service: a young person who is too anxious, aggressive or violent to attend school and/or be out in the community is hardly going to want to come to hospital appointments. In my experience, sometimes there are delays and sometimes the service is brilliant at responding. What is really needed is investment from central government, and work done to create a positive message about the importance of mental wellbeing.

Stuart Hannah, child and adolescent psychotherapist, Leeds

I have worked in different child and adolescent mental health services in London and the south-east as well as the Yorkshire region since 2003, when I left social care to specialise in child mental health. The work is interesting and varied in as much as you never really know what stories people have to tell about their lives and what will unfold in the consulting room.

However, the work is undertaken in a context of perpetual change and economic uncertainty. Every service I have been in has suffered from collective low morale and very high levels of uncertainty about the future. To a degree, a traumatised workforce is trying to work with a traumatised population and this is a worrying cocktail.

Parents often arrive thinking there is something wrong with their child and expect you to make them better immediately. As stories unfold, it usually emerges that difficulties are collectively located in all family members to varying degrees, as well as the parental couple relationship, formative experiences in early childhood and the modus operandi of the parents.

I wonder whether CAMHS should be completely rethought and stripped back to basics. I am partly reassured by the Future in Mind agenda and some of the local transformation plans. The emphasis on multi-agency collaboration makes good sense as does matching service provision closely to local need, identified via robust data collection.

However, the collective wellbeing of children and families in our society directly correlates with economic and social realities and their impact on how people, particularly parents, feel. Now more than ever we need to encourage empathy in all human relationships, and in communities underpinned by core values of respect, compassion, tolerance and equal opportunities for all. Properly funded and creatively delivered, CAMHS can make an active contribution to empathy development in individuals, families and organisations, but it needs to be thought of as part of a broader picture of how we want our society to look in a decade’s time.

Anonymous, Herefordshire

When my daughter was 10, she struggled with the fact that her father had decided he no longer wanted contact. This really knocked her for six. She became angry and tearful. She’d come home and scream and hit her pillow. She’d burst into tears at random times. Her work at school suffered. I went to the GP and explained the problems and asked for counselling. He said her school should provide help for this. Her primary school had nothing they could offer so I asked for help through the NHS. She was referred to CAMHS but they sent a letter back explaining that they couldn’t help as she didn’t meet the criteria. I looked into private treatment, but as a single parent I couldn’t afford private counselling at £40 a session.

When my daughter reached secondary school, they were far more helpful and provided weekly counselling sessions for a year and a half. My daughter is now doing much better at school and is no longer angry any more. She understands that the situation is not her fault. If it hadn’t been for her secondary school I’m not sure what state she would be in now.

There appears to be no help for children experiencing mental health issues unless they’ve reached a point of self-harm. CAMHS need to intervene at an early stage to prevent further harm. In my experience, as an adult you can walk into a GP surgery and come out with a referral for six sessions of therapy. This facility doesn’t seem to exist for children.

Anonymous, 24

I was looked after by children’s mental health services from the age of 13 to 18. I went to see my GP at the age of 12 because of depression due to bullying. I didn’t know what to do and, when I went to see them, my parents didn’t know what to do. My school was terrible, really unhelpful. My doctor explained that there was a long waiting list to be seen and it was during this wait that I tried to kill myself. In fact, one of the only negatives of my experience was the long waiting time to get help. I understand it’s even worse now, which is worrying.

After I made an attempt on my life, I was seen straight away and the care I received from that point was excellent. There’s no doubt in my mind that the nurses and doctors who cared for me saved my life. I always felt supported and listened to. The nurses always wanted to help me. Even though it’s their job to listen, it felt like they really cared. Also, because I was 13, it would have been easy for those looking after me to just say, “We know what is best for you,” but they always took my opinion on board. They listened to my feelings.

I saw a range of psychiatrists and counsellors over the years, and was diagnosed with a variety of conditions including anxiety and agoraphobia (a fear of being in public places). I had my ups and downs, but steadily got better during my time with them. I never tried to kill myself again.

I do feel that the transition to adult mental health services is difficult. It felt strange that as soon as I turned 18 I could not be seen any more unless I went somewhere else. This felt really scary, and it would be good if there were more support in place or if the transition was slower and more gradual.

Anonymous, children’s mental health services

I work in CAMHS and we are massively underfunded. As well as this a lot of third-sector organisations that used to look after young people’s wellbeing have been cut or shut, which means we cannot refer people elsewhere if they don’t meet our threshold. I have been working with CAMHS for many years in a range of different areas. The biggest challenge is demand v capacity. There’s massive expectations on staff to deliver but with very limited resources. That’s one of the biggest frustrations because we are here to help young people and sometimes feel we simply cannot do our job. It feels like the NHS is being slowly deconstructed and staff morale is so low.

We do sometimes have to turn people away we should see because we get so many referrals, and this means the threshold for who we can help keeps changing. What we can now deliver is care for those in acute need. There are now a lot of young people who are left to struggle until it gets to the point of acute crisis. They don’t receive help early enough.

From a staff perspective, we feel frustrated and under a great deal of pressure. The systems we use are slow, clunky and inefficient. CAMHS does care about young people and does want to provide the best service, but people’s expectations are unrealistic as they don’t understand the stress we are under. It’s not that we are not interested or not working hard enough, we simply don’t have the capacity.

Abby, 19, west Sussex

I first sought help about three months before my 18th birthday, but because of my age CAMHS refused to see me. They said that by the time my referral was processed I would be an adult. The first – and only – time I saw a CAMHS worker was in hospital after I’d tried to kill myself two weeks before my birthday.

There should be something in place to help people who are not quite old enough for adult services, but deemed too young for children’s ones. For example, if someone was 17 and a half years-old at the time of their first assessment, they could be referred to adult services instead of CAMHS. I think this would prevent people like me from falling through the net.

Now I am an adult, I have a wonderful GP who is hugely supportive and proactive in fighting my corner and making sure I get the help I need.

Tina McGuff, 46, Dundee

I work in finance but do mental health support voluntarily after setting up my own charity. My charity is for young people and I help families try to access services. I also give talks about my experiences with mental illness in schools and universities to raise awareness and break the stigma. I want to help children get seen before they reach crisis point.

When I was younger, I was sectioned under the Mental Health Act with anorexia and I nearly died. I also ended up having a psychotic episode in my 20s and suffered from orthorexia until my mid 30s. I am now fully recovered and have published a book about how we have to help each other and lift the lid on these problems.

I visit parents who need advice in helping their children, offering them support and a shoulder to cry on. I also try to put them in touch with other experts who might be able to help. The most common problem they have is not being able to get an appointment with CAMHS quickly. In one instance a girl tried to kill herself in January but wasn’t seen until June. That is just unacceptable.

We need ring-fenced resourced money to fund mental health services in this country and more support in schools. I talk in schools and this can make a huge difference. Often kids will come and talk to me afterwards and tell me about their own issues. The school can jump in and help that individual. Early intervention is key and if we as a society can talk about mental health openly then it will help save lives.

Anonymous, 39, North Yorkshire

My son is 14 and was referred to CAMHS last year with anxiety and intrusive thoughts. His issues gradually appeared – it started with him having nightmares, and then he got upset over minor things. Soon it developed into daily panic attacks at school. These issues came after a particularly difficult year with seven deaths in the family and a divorce between myself and his father. We also moved four times in six months, so this could have contributed to his stress.

We went to the doctor and they immediately referred him, but it was eight weeks before he was assessed. In this time, he was offered no support and I was surprised by how long it took. Luckily, he didn’t decline too much during this period, but it was still a battle to get to school, and he worked out that if he said he was sick then he would be sent home.

After his assessment, he was seen once a week and offered cognitive behaviour therapy as well as mindfulness techniques etc. It has really improved his anxiety but he still suffers from intrusive thoughts. He believes he is worthless, a burden and that everyone hates him. This aspect isn’t really being dealt with and now it’s time for him to be discharged. He has been told essentially that he has a certain amount of time to recover and if that doesn’t happen then tough. He will leave the service without some issues being appropriately handled.

Anonymous worker, mental health social worker

One of the issues is the lack of hospital beds and specialist units. Often the situation you get is that on a national scale, children will be shifted around the country because there aren’t enough beds on a local level. Where I work, for example, children end up far away from their family after assessment. I recently saw a child who was placed miles away and they were detained in hospital for their own protection, against their will. They spent nearly a month away from home and then stayed in hospital for treatment. These children are isolated from their families, from services and professionals local to where they live. He was away from school and friends in a little private hospital. It wasn’t even an NHS bed – and it’s not uncommon for the NHS to pay private hospitals in this way.

I see this happen often. This year, in terms of the assessments I’ve made on children, it’s happened a lot. It hinders recovery because young people need to be in a local hospital, where they have local community teams feeding in. They also need to be discharged as soon as possible to maintain a normal school and family life.

Kerry-Mae Doogan, 21, Wigan

I was first referred to CAMHS aged 14 by my family GP. At the time there was a waiting list of up to a year for help, and in the end I waited for more than seven months to be assessed. Once I was seen by CAMHS I was moved between workers and my regular appointments were often cancelled without warning. In the end I discharged myself from the service because it was doing me more harm than good. Instead I went to a local charity counselling service which I found much more helpful.

I experienced delays before and after the initial assessment. In that time my health got worse, although I was fortunate I was able to cope during this period.

My experience would have been improved by not being shuffled between various workers who made me repeat my background information over and over again.

I have been in recovery for two years now and I no longer use medication or have much contact with mental health services. When I was 18, I got involved with the Royal College of Psychiatrists as a young adviser to their quality networks for inpatient and community CAMHS. I am working with them to improve standards of child mental health services. I don’t want other children to be let down the way I was.

Natalie Milner, 22, Leeds

I had panic attacks during school several times before I finally asked my mum to help me. We made an appointment with the doctor about one or two months after the first attack.

The doctor seemed convinced I thought the attacks were heart attacks, which she brushed off, by saying: “You know you didn’t have a heart attack don’t you?” I never mentioned a heart attack – I didn’t know what was going on with my body. She suggested next time it happened to just carry a paper bag around with me and ventilate into it. She never told me what a panic attack was and never gave any thought to me having anxiety issues.

My mum eventually pushed for a referral and, after a six-month wait, I received cognitive behavioural therapy through CAMHs. I continued to have panic attacks more and more frequently during the waiting period. I remember it making me feel scared to be in public and made me more and more isolated from my friends. No one really understood what I was going through. I once had a panic attack in front of my best friend and she said, “Oh please don’t”. I didn’t have help or a diagnosis, so to everyone else it seemed like I was acting out.

I feel my age was definitely the reason why I wasn’t taken seriously. I felt like they all thought, “What do you have to worry about – you’re just at school”. Everyone believed it was all my control and that I could choose not to have panic attacks and choose not to be depressed. My mum wouldn’t let me tell my grandparents as she didn’t think they’d understand.

I remember asking adults, teachers and my doctor every week and I never got the answer to what this was (a panic disorder). I found out what a panic attack was on the internet late at night and finally it all made sense. I can now control my panic attacks if they resurface thanks to the help of the CBT I had when I was a child. I just wish I had been taken more seriously from the start.

Anonymous, 47, Monmouthshire

Last year, my child, who had been having suicidal thoughts for at least two years, was diagnosed with severe depression and anxiety disorder. She was 15 at the time.

We were lucky she had enough of a self-preservation instinct to see a school counsellor who got her to see the GP. We were told there was at least a nine-month wait to be treated by the CAMHS in south Wales. Even though she was feeling suicidal, because she hadn’t actually self-harmed she wasn’t enough of a high-risk patient to make her a priority, so she had to wait. During this time I watched my compassionate, funny, lovely daughter disappear before my eyes. She became angry, sad, lonely and despairing. Her social life was non-existent and her grades got worse as her anxiety grew. She was referred to a private psychologist who saw her for seven months twice a month. It cost a fortune, but we had no choice.

Gradually she improved but the psychologist thought medication would be useful. In order to get this prescribed she had to see a consultant psychiatrist, which happened within six weeks of a second referral to CAMHS.

Since then she’s been on a low dose of medication and has agreed to do some group therapy to deal with her anxiety. CAMHS and the NHS have been great now she’s in the system, but I don’t want to think what would have happened if we hadn’t got her help privately in the long wait to be seen. During that wait she has battled with her feelings of despair and studied for GCSEs. It was an incredibly stressful time for her.

Our experience would have been greatly improved if she’d been referred more quickly. By the time a child asks for help they are already quite unwell. Initial help needs to come within a couple of weeks. It’s very hard to ask for help and the longer mental health issues go on, the harder they are to resolve.

• In the UK and Ireland the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here.

Children"s mental health in crisis – readers share their stories