This case study discusses the challenges faced by Lydia, an 18-year-old female. She has long-standing depression and anxiety issues, self-harming behaviour, and Autism Spectrum Disorder (ASD). She sought help from the Child and Young Person’s (CYP) Primary Wellbeing Practitioner (PWP).  After being unable to attend her first webinar and scoring within the severe range on both PHQ9 and GAD7.

Lydia struggled to transition from Child and Adolescent Mental Health Services (CAMHS) to adult mental health services as she felt the abrupt end to psychological support. She had been self-harming and struggling with depression and anxiety symptoms for a long time. During her conversation with the PWP, Lydia disclosed that she had been groomed and raped four weeks before. As a result, she experienced flashbacks, nightmares, and intense anxiety when outside her house.

1. A referral to Hillingdon Improving Access to Psychological Therapies (IAPT) service was unsuccessful as adult mental health services were supporting her. However, the adult mental health service could only offer psychiatric consultation for medication management, not psychological support.
2. She was referred to the London Survivors Gateway for specialised support following the rape. Still, she was denied support due to her high risk of self-harming behaviour and was encouraged to be referred to a home treatment and crisis team instead.
3. Lydia had previously worked with the crisis team immediately after reporting the incident to the police. Her risk decreased after several days of support, and she was discharged.
4. Lydia was then referred to Solace Women’s Aid. Still, she was informed that she would need to wait four months for the initial assessment. The was also a possible delay of an additional eight months for psychological support due to the high demand due to the Covid-19 pandemic.
5. Lydia was encouraged to continue attending HYPT wellbeing webinars, but due to being excessively distressed, she found it challenging to engage in the sessions.

Lydia’s experience highlights several important areas for consideration. Firstly the lack of continuity of care during the transition from CAMHS to adult mental health services. The rigid risk-related criteria leads to young persons being deemed too high risk for some services while the insufficient risk for others. Plus, the need for procedures to be in place to manage potential risk and safeguarding-related issues. Despite the challenges, Lydia was supported by HYPT and continued to receive ongoing support.