Damien Dalmayne, 17, is autistic. He also battles mental health issues that have left him unable to get out of bed and contemplating harming himself.
Warning: This story contains references to suicide
“There were thoughts of me doing stuff to myself. I never did but there were stages where it would get pretty hard and it really did get to that point that I was really considering it,” Damien says.
His depression spiralled during the COVID lockdowns and when he was 15 he was referred to his local NHS mental health team in Greenwich.
The paediatrician who made the referral recommended that Damien be seen “urgently”.
But Child and Adolescent Mental Health Services (CAMHS) rejected the referral, instead referring Damien and his family to a local social services team.
Damien believes he was rejected because of his autism diagnosis.
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“They [CAMHS] think they can’t help people with special needs. They think ‘that’s just a terminal illness’ even though it’s not,” says Damien.
In its rejection letter, Greenwich CAMHS agreed Damien “experiences emotional difficulties”.
But, noting his autism diagnosis, it suggested he see the area’s Children with Disabilities Team, rather than a specialist mental health service.
Crucially, his mother, Emma Dalmayne, says this meant they were unable to access specialist services like therapy to help Damien.
Autism and mental health ‘seen as separate issues’
Ms Dalmayne says a confused social worker called her after Damien’s referral was redirected to their team.
“They said ‘why have we been called?’ I said ‘I don’t know’.”
“CAMHS see autism and mental health as separate for some reason,” says Ms Dalmayne.
“If you’re not well you go to a doctor, you get help. But no, if you’re mentally ill and autistic and go to a doctor, you’re not getting anything. You’re told ‘well we can’t see you because you have a neurological difference’.”
The NHS trust responsible for Greenwich CAMHS said it is unable to comment on individual cases but stressed it does accept referrals for autistic children who have a “severe and enduring mental health need”.
However, it said children may be referred to other services “where referrals do not meet the threshold for CAMHS”.
CAMHS are run by different health trusts throughout the UK.
Ms Dalmayne says she has spoken to other parents with autistic children who have had similar experiences.
She says she knows one mother who is scared to tell her local CAMHS that her son has been diagnosed as autistic because she worries they will stop his care.
“It’s not an inclusive world. We don’t feel included at all,” says Ms Dalmayne, who is also autistic.
Damien believes NHS services don’t think autistic people can engage effectively with therapy.
“It’s not like just talking to a wall. They [autistic children] will end up listening and if they can they will end up talking.”
He says his experience with CAMHS left him feeling “inhuman”.
Damien ended up using his disability benefits to pay for private therapy.
“If I had waited probably six months [longer to get therapy], I probably wouldn’t be here. They [CAMHS] really put my health at risk,” he says.
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Oxleas NHS Foundation Trust, which administers Greenwich CAMHS, said: “Currently, just over 16% of our CAMHS caseload includes children and young people with both an autism diagnosis and a severe and enduring mental health need. This does not include children and young people either waiting for or currently being assessed by an autism diagnostic service alongside CAMHS.
“Should individual circumstances change, re-referrals can be made. CAMHS is just one part of a much larger collection of services delivering emotional health and wellbeing support and services to children and young people.”
People with autism more likely to experience mental health issues
Sky News tried to get a clearer picture of autistic children’s access to CAMHS across the UK, but when we requested data from health trusts, the majority did not disclose the number of referrals and rejections for autistic children.
We did learn of the serious pressure facing services nationally, with data showing total referrals to CAMHS had risen by 60% between 2018 and 2023. Rejections from CAMHS were up by 30% across the same period.
While it’s difficult to get a sense of the number of autistic children accessing CAMHS, autistic people are more likely to experience mental health problems than people who aren’t autistic.
Sky News spoke to one CAMHS nurse anonymously – we aren’t identifying the health trust she works for.
She said nationally it’s a mixed picture in terms of the level of care autistic children receive.
“We [CAMHS] certainly don’t do enough for children that have been diagnosed with autism in terms of their post-diagnostic support.”
She says she has witnessed preconceptions about autism among staff that can lead to autistic children not getting the care they need.
Skills ‘aren’t consistent’ across health service
“Some people [working in CAMHS], sometimes might tend to say ‘well it’s [their issues are] because of their autism’ as opposed to thinking well actually they might be autistic but they can also have a mental health difficulty that can be supported,” says the nurse.
“A child that has autism and mental health needs, that’s not going to be solved by social services, they need mental health support.”
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She says skills aren’t “consistent” across the health service and that autistic children can be at a disadvantage if their behaviour means more traditional forms of talking therapy aren’t appropriate.
The nurse continues: “I’ve known it happen where people say ‘oh this person is not engaging’ so they get discharged.
“Sometimes therapy is not always helpful, then it’s about different, more holistic ways to support children and support behavioural changes.
“I do think there’s a need to increase skills within CAMHS absolutely. [Staff] recruitment and retention has been difficult across the board.”
Ms Dalmayne is campaigning for better access to CAMHS for autistic children, her biggest fear is that autistic children and adults are hurting, and even killing themselves, if they can’t access mental health support.
“It makes me feel we’ve got to do everything we can to change it,” she says.
Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email [email protected] in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK
