Hi there, I'm Amy Griffiths and I'm one of the journalists in Mags Radio's newsroom. And on this episode of Newscast, we're asking if there's enough support for children with high functioning additional needs on the island, because according to one parent, the answer is no. She's calling for more help to be given to children like hers who struggle in a mainstream school environment. She wants to stay anonymous to protect her son's identity, so for now I'll call her Jane. She's been telling me her story, which contains reference to suicidal thoughts and may be distressing to some listeners. So my little boy, he's eight years old, he's very kind, he's very loving, honestly he's just adorable sometimes, he's so sweet, he's really thoughtful, he's very loyal, he's fiercely protective over his friends, but he has been diagnosed with ADHD and autism aspergers, but they don't diagnose as aspergers anymore, it's under the autistic umbrella. He can go into crisis, which can be very distressing for everyone around him and for himself. He will get aggressive, he fights, he'll punch, he'll kick, but when he's in this crisis he's not quite aware of what he's doing, he's lost all control, his mind has just lost the ability to be able to control himself, and it's a real struggle for him. He struggles on a daily basis, he struggles to manage through a full school day with his autism and his ADHD combined, it's just so confusing for him. He can have meltdowns which can result in violence towards staff. When he has episodes like that, how does that impact the people around him? Is he branded as the naughty child for example? Yeah, he doesn't get invited to parties and things. I think his class have learned to understand him a little bit better now, but there's still instances where other children can be, I don't want to say in danger, but he can throw things and he has to be removed from the classroom, he has to be handled by the teachers, he hits the teachers sometimes, which is quite stressful for them, and then I'll get phone calls to come collect him, and that's purely because he's just not managing the school day, there's so many things going on around him, something can trigger him, sometimes you won't even see it coming because he won't voice that he's struggling, he just keeps it all in. He's not a masquer, so I know some children can mask and they can be able to get through conform through the school day, but then when they get home they have the meltdowns, but that's not what he does, and I suppose in a way that's a good thing because he feels safe in school enough to be able to do that, but the teachers they do struggle, and I feel guilty as well for them because they don't go to work to get hit, and it's tough, but they do the absolute best for him, I don't know how I would have got through without them, they're amazing. What kind of impact does that have on him then, because does he recognise that those sort of outbursts aren't what his friends are doing? Yeah, definitely as he's got older, he's eight now, and when he was younger he wasn't quite aware, but as he's getting bigger he's getting more aware. Just making his self-esteem really low, he's said he wants to harm himself, he has tried to harm himself by holding his breath when he couldn't find anything to hurt himself with, which is, it's really upsetting as a parent, and I felt like there was no support, not from school but from outside sources, there wasn't enough support there for him. Once he got his diagnosis I did ask for work to be done around ADHD and autism to be able to explain it to him, because as a parent we can do our research and we can try and explain the best way what we can, but I think they need to hear it from professionals, so he feels like his diagnosis makes him a bad person because of his behaviours and the way he's acting and his peers don't act like that, so he does, he feels different, and I feel like there was a little bit of education around that for himself, then he'd be able to handle it a little bit better and not feel so low. And what has your experience been like so far with Cams, I know you said you're on the waiting list for, and health services generally here on the island, in terms of the support that you're able to get for him since you've had those diagnoses? At the start, it was brilliant, he was able to go to sessions, and this was before diagnosis and then once we got the diagnosis, he then started ESC, and he was doing two lots of emotional regulation, one at Cams and one at ESC, so I stopped the one at Cams because I felt like it was too much for him, and they said they would leave the door open for me to go back so he could go back and continue that with them if it was needed. It was needed, I asked for some anger management, but I was told that the waitlist was too big and they couldn't provide that for him. How does that make you feel as a parent, trying to get that support and feeling like you're coming up against a closed door? It's frustrating, I mean, I feel like all that gets offered from Cams at the moment is medication and it's extra medication every time there's a crisis. It takes a crisis for something to happen going forward and that usually is just a referral to somewhere else, not to Cams. I've got a referral in for my matters, but I'm still waiting, I haven't heard anything back from them yet, and this was after my son had a crisis at school, and when he couldn't find anything to physically harm himself with, he held his breath for as long as he could. That was just awful, and yeah, like I say, all I got was a referral and I'm still waiting. When we were chatting before this, you said that your son, who's eight years old, he's having suicidal thoughts as a result of all of this, isn't he? Yeah, and that goes down to the self-esteem and the lack of education that he's not being given, so when I asked for some work to be done around the ADHD and the autism, I just got, "Well, you need to wait for Jenny Court," and I know Jenny is the only person on Ireland who deals with the autism. She has a massive wait list, she's absolutely brilliant, but there needs to be more trained to people that can help her, that can help the children, help the parents, the schools, the teachers. They're amazing. The school that my son's at, I am very lucky to have all the support that I have. I feel like it's one of the best on the island for additional aged children, but if there was more education and more support there, then my child wouldn't be feeling like this, he wouldn't be feeling so low because he wouldn't feel different to everybody else. He would have the information to be able to process it and there'd be resources for him to take himself away. In our school, we have two rooms, one that has toys and stuff in for therapy, and another one has just been turned into when the child's in crisis, so they just have teddies in there. My son suggested to the school, actually, to pad the room out. It's just so that it's safe, so when these children are in crisis, there's nothing that they can hurt themselves with, they can't hurt anybody else with. That's your eight-year-old son's just a child. He recognises he knows when he's in a crisis, and he's starting to be remorseful afterwards, but it's really difficult for him. MagsCare has announced that it's going to be investing £4 million into hopefully getting the waitlist down for the camp service, and also to try and be more proactive rather than reactive to situations like this in terms of the way they actually help children. What was your reaction when you heard that news? I mean, that's brilliant news, and I hope it all goes to plan because then these children who do need additional support and therapy and things like that, then hopefully they've got enough staff to be able to do that instead of just medicating, because these children that need the therapy, they need extra support, yeah, I think it will be great. For you, and with your experience with your son, what do you think would be the best thing that the island can do to support your son and other children like him? He goes to ESC, they've been brilliant, they've offered extra support, but that's only for one or two terms, and they don't have the facilities to take a lot of children, so I feel like there's probably so many more parents out there struggling and not getting the help and support that they need, because there's just nowhere for these children to go, they're too high functioning for units, but they're just not coping in the mainstream school. I feel like they need more staff in the schools to be able to just modify their timetable, so that they can do something different with them, so they're not just having to sit in the classroom for all that amount of time, because some children just can't conform, some children don't do well on the playgrounds and things out on lunchtime, I know that's one thing that my son struggles with, but then if you've not got the staff in the school to be able to take away and do the one-to-ones and do something else with them, then that's not going to be able to happen, so I feel like that's a problem to be understaffing, and I feel like that's where a lot of the stuff will happen as well on the playground and then your child gets in an incident and they get sent home, so it's lack of staff, that's a major issue, so if we had more support in the schools. And we've talked a lot about your little boy and the effect that this has on him, what about you, how are you, and how do you cope with all of this? I think I'm just in autopilot mode, to be honest, there isn't any support for families out there who've got diagnosis, I've joined the autism page and I often see parents writing on there that they're struggling, they're getting hurt by their children, they're just at their wit's end, but there isn't anywhere for parents to get support, and also for the siblings to get support as well, because I know my daughter, she's on the crossroads weightless, but I think she's been on there about a year and a half, they keep the same children on there until a child leaves, then another one can be accepted, so maybe that can be a better system in place so that these siblings are also getting the support as a family, as a whole. And again though, that's charity support, that's not support from government. Yeah, there is no support from government, there's just a complete lack of understanding, I mean, they all say that years ago this wasn't a problem and it only became a thing now where I feel like it's always been there, there's just more awareness for it now, but there's still a lot more needs to be done to educate people around autism and ADHD as well, but certainly autism, because I know before my son got diagnosed, I would think of someone with autism, I think you'd be able to see it, but it's not visible to everybody, every autistic person is different, every autistic person has different troubles and struggles in life, there's a saying once you've met one autistic person, you've met one, yeah, then there needs to be some more support around that. For parents and teachers as well, as well as the wider public, because I've had messages before where my sons hurt someone, or I have actually been quite lucky, but whereas the parents have dealt with this sort of thing before, so they've kind of got a bit of knowledge, but it still doesn't stop and not get invited to parties and things, because some parents just don't know that they're just naughty and they don't want their child to be associated with them, and it's quite sad because he's come home in tears before, because he's literally been one of two people that haven't been invited to a party, and that happened on two occasions. The number of children and young people on the island with a high functioning additional need is on the rise. In fact, of the 1,200 who were waiting to be seen by the Child and Adolescent Mental Health Service, or CAMS, the vast majority are said to be waiting for an ADHD or autism assessment. Just a couple of weeks ago, a £4 million investment into CAMS was announced, hoping to reduce waiting times and switch from a reactive approach to a proactive one. But how exactly will that help? I asked Head of Integrated Mental Health Services at ManxCare, Ross Bailey. "It's tremendously exciting to ultimately get the funding that we're so desperately in need, so we can really transform CAMS and our services for children and young people, and really the focus is twofold really, so we can address the current waiting list, which is significant, but also transformed away with deliver services with a much more of a focus on intervening earlier. So we know that mental health conditions are no different to physical health conditions. The earlier you do something about it, the better the prognosis, the better the outcomes. So that's the really, our focus in terms of this transformative approach. It's intervening earlier, and one of the ways we're going to believe that is embedding professionals in school settings, which we're working closely with colleagues in education to build and something we're really excited about." And that's something I'm going to pick up on in a minute, but I think looking at the numbers, 1,200 children currently waiting for support from CAMS, and I think to people listening, that is going to sound like a really high number. But why is it that that is so high? Why aren't mental health services so in demand from our young people here? "Historically, we've probably not invested enough resource, money, time and energy into those early interventions. So those kind of community-based interventions where we can be more proactive in treating people who present with a myriad of problems and challenges. Very few tend to be mental illness, typically they can mix up common mental health disorders, such as anxiety and low-level depression. And what we've, I think, failed to do historically is have those interventions and those services more upstream, so within school settings, within community settings, so we can intervene earlier. So that's the whole model that we're looking at shifting. So we've designed a CAMS service that really historically has been developed for people with civilian, jury, mental illnesses, for quite chronic and acute conditions, and this isn't established or delivered in a way to cope with the more lower levels of anxiety, common mental health problems, which people experience." It's obviously something that is a big problem. I mean, looking at the numbers here, case loads have gone up by 90% in three years, 13% of all 4 to 17-year-olds are receiving or awaiting some kind of treatment. Currently waiting lists are 48 weeks, with the hope of this money helping get them down to 18 weeks, is £4 million actually going to be enough to try and address some of these issues for mental health service provision here. I think it's an incredible start for us, and it's an enormous opportunity, and it's one of the huge leap having the money secured, which is wonderful. The real work starts now in really sort of radically changing how we deliver services. So that's the real work starts now. So as I've said, if we can develop a model and we've got clear laid out plans, and how we're going to do this, the first thing we need to do is pull some additional staff again on a temporary basis to focus on those waiting, to get those waiting times down to the 18-week target that we want and improve upon that in due course. But that's not enough, what we really need to do is sort of shift our focus on to intervening earlier within people's lives. We know all the research indicates that the 50 cent of mental health problems are established by the age of 14 and 75 percent by the age of 24, and that's that's researched by the mental health foundation. So we know the more we invest in children, young persons, mental health, the better the outcomes throughout their adult lives. So I think the £4 million certainly gives us a fantastic footing in which to shift our focus on to be in a more proactive service intervening much earlier rather than the reactive service that we are, I think historically at the moment where we wait for someone to become unwell, and then we try to do something about it. What we want to do is when we see these emerging mental health problems, particularly in school settings, only community settings, that we intervene there and then it's a much more proactive approach rather than the reactive model of delivery that we'll launch on at the moment. And you talk about wanting to make sure it's a more proactive approach, and is that purely from the research suggesting that that is then more effective, or has that come from a potential disparity between what CAMs has actually historically provided and what people think it should be and what they think that they're entitled to from the service? I think people are entitled to a service that's got a sound evidence base that's reactive to their needs and is based upon their needs, not necessarily a diagnostic criteria. So I think that's an entirely reasonable expectation. What we're planning or what we're proposing in terms of the services going forward for children and people is built on a sound evidence base. So some of the work we're looking at about has been rolled out and in the UK and internationally it's got some excellent outcomes, particularly the work that we intend to undertake in school settings, absolutely in partnership with those schools. So we're looking at having a dedicated full-time meal of food practitioner for every one of the secondary schools on the island and including UCM, and we certainly want to build on that. Going forward, we want to develop a service where a single point of access where there's one way into the service, and punch and families and caregivers and children who have a certain age can self-refer, they can do that by phone, they can do it by email. So we're not reliant on people having to go to their general practitioners or to our health professionals to come into the service. We want to really increase our capacity for delivering sort of low to moderate psychological therapy for children as well. So these approaches really differs from the kind of historical model. And if we're looking into a bit more of the specifics of things, so within the 1,200 children waiting for CAM support, it said that an overwhelming majority of children waiting are waiting for autism and ADHD assessment. So what is the root cause of that? Is that actually more of an increased awareness in those particular conditions or is it actually something else that's causing that increase in demand? I think it's a significant, I think people's awareness and understanding of kind of the neurodevelopmental conditions, you know, is far, far better than it has been ever. So it's much more in the public conscious. I think that people are recognising professionals, families and communities are recognising that some of these conditions will often come with some real strengths, do present some challenges for children and do impacts on the way that they manage and cope at home and in school settings. And there's some fantastic treatment options out there, not just relying on medication but psychological treatments as well. So I think the absolute thing is an increased awareness. We're not, you know, we're saying there's 1,200 children on the way to this 7,800, I think of those children, or waiting for neurodevelopmental assessments. Now not all of those will be assessed as a kind of diagnostic criteria for ADHD or autism. So I think time will tell as we work through that way to this, we can be able to see the prevalence levels. But I think anecdotally, what we see is higher levels of prevalence of the neurodevelopmental ADHD and autism on the island that we see in the general population, you know, we're not clear why that is. This would be a huge amount of research required to unpig that, but what's most important for our communities is that we're able to see and assess and treat those children in a much more reactive, responsive than we have been able to do previously for the resources available to us. And part of the way you're hoping to do that is £500,000 of this £4 million is going to hopefully be used to recruit six more people to help get through those waiting lists and help get through those assessments. And how many currently are there who are able to do these sort of assessments? We're looking at bringing some additional staffing in to release our existing staff who are really very, very skilled to take in these assessments. So it's an extremely challenging sort of recruitment market out there, and attracting people to the island's healthcare professionals and social care professionals and professionals across the board is challenging because of how competitive the market is. But what we want to really do is utilize the fantastic resources we have within our teams. We've got incredibly skilled professionals who are able to undertake these assessments. And what we want to do is bring colleagues, camps professionals in so we can release our highly trained staff to undertake these assessments and focus on these assessments. This waiting is of £1,200. So we're not essentially bringing staff in to undertake them. We've got suitably qualified and skilled professionals do that, but we need to bring staff in to backfill them so they can be released to undertake that function. Given those global issues of recruitment, I've spoken about multiple times with various people from Mankscare, given the timelines of everything, when do you think the people are actually going to see a noticeable difference within the service? And not the quality of the service that they get, but just the time it takes to be able to get that service. When do you think people will actively see that difference? Well, we're in the process of actually recruiting now, so it's, you know, I suspect we're not going to get six professionals landing on our doorstep within the initial recruitment phase. I suspect that we're going to be tripped for you in there. But I'm expecting to see a enormous difference in the next 12 months in terms of both the volume of people waiting and the time they are waiting. I ask for an interview with the Education Minister, Daphne Kane, but were sent a statement instead. It says the department is committed to an inclusive education policy whereby measures are implemented to ensure that each pupil can access the curriculum regardless of their needs or personal circumstances. This involves implementing suitable arrangements for pupils who have additional and complex educational needs. Following the recommendations, looking at how our schools are funded, we hope to carry out a review of additional educational needs. During this review, consideration would be given to best practice within and outside the island, taking into account the following areas. The development of dedicated facilities for children with complex needs, allowing for the concentration of specialist resources and expertise while ensuring inclusivity of the curriculum by supporting focused and structured access and improving equity of offer. The use of alternative resource centres to support the delivery of provision for pupils with less complex needs, but who otherwise have difficulty accessing mainstream on a permanent basis. The role of alternative provision within schools, including the role of online provision, as well as on-site and off-site provision, and the function of each. And finally, the role of other agencies in working together to deliver improvements for children with additional educational needs. A timeline for this review has not yet been given. [MUSIC] [BLANK_AUDIO]
