A2A - The parents' story

30.04.2025

Parents of a neurodivergent teenager, who self-harmed and threatened to end his life, have endorsed an innovative new centre for young people in crisis.

They outlined the fantastic work done by BCUHB’s Child and Adolescent Mental Health Service (CAMHS) team members but also the frustration of being unable to access those professionals at the times they needed them.

The Alternative to Admission (A2A) facility, in the grounds of the Royal Alexandra Hospital, Rhyl, was officially opened on Valentine’s Day this year. However, it has been operational since just before Christmas and so far more than 220 appointments have taken place, helping more than 90 children, families and carers.

Funded by Welsh Government, the trial is looking to reduce attendances from young people in crisis at hospital Emergency Departments, which are acknowledged as being inappropriate places in those circumstances. It is also hoped it will reduce the need for Section 136 orders, by offering earlier and more appropriate interventions.

The parents, whose names we have changed to protect the identity of their son, were present at the official opening of A2A and welcomed the move.

Mr and Mrs Jones (not their real names) first noticed issues with their son around the age of 13 and they struggled to find the right help for him after various behavioural problems in school and difficulties maintaining relationships with his peers.

Mr Jones praised the work of CAMHS clinicians in general but pointed to the difficulties of getting his son in front of them. It is a familiar refrain from parents and carers of young people who are neurodivergent, as clinical capacity is often outstripped by demand.

Mr Jones said: “Once he was with a clinician or a person who dealt with young people, they could identify and they could then work with him. But getting to those people is the difficult bit. The problem is getting in and if the alternative is the emergency department, yes, this A2A idea is fantastic.”

Access to A2A is via the CAMHS single point of access or by referral from crisis colleagues working with Glan Clwyd Hospital’s emergency department (ED). Young people can also be referred from the hospital’s paediatric ward if no medical treatment is needed, to reduce any stay. Previously, admission to the Children’s Ward was the only choice for many, while they waited for an assessment by a professional.

Mr Jones explained how their son eventually built up a rapport with a clinician, after being given a passport which suggested he had autism spectrum disorder (ASD). However, their early optimism was dashed when the clinician left and he was discharged from the service. They were referred to a centre which provided support but it didn’t help.

Mr Jones said: “The guy there (had) been doing the job a long time, and was very good. But I think it had an impact on our son because he felt he wouldn’t understand, because he’s too old. It shook his faith in all authority…and it had a massive impact in school.”

Mrs Jones continued: “It was difficult. Initially, we were still managing it reasonably well, between the three of us and school. But he was self-harming. While he was at the new centre there was no real interaction with school.

“Our son really struggled with the lack of exit strategy and transition from having a trusted clinician, to having nothing other than a letter of discharge.

“It made future engagement very difficult – his perceived lack of trust, rejection, feelings of being let down by adults, powerless to exact any changes, etc. Young people with mental health issues and neurodiverse challenges need to be included at every step, it is so important they feel part of the process.”

They had withdrawn their son from his local school and he was sent to one in another county. He was given an advocate, which his parents found hard to deal with. Mr and Mrs Jones’ differing views were seen as “control” by their son.

The parents surrendered to the advice of psychiatrists. However, it seemed their son was continuing to deteriorate, culminating in one weekend when he left them a long note after threatening to take his own life.

Mr Jones said: “I rang CAMHs but there was no one available. I was on the phone to the Samaritans for about two hours…listening to me. It’s those feelings of what do you do? I didn’t know where he was.”

On another occasion Mr Jones saw his son riding his bike late at night after disappearing again but he rode straight past him and refused to talk. It was then they contacted the police. Thankfully, they found him and the family drove home together.

Mrs Jones continued: “It was that fight or flight feeling. He was always on edge. If he wasn’t fighting with us, he was fleeing.”

Mr and Mrs Jones felt having something like A2A to refer to would have helped them all, especially their son.

Mrs Jones said: “I think (the A2A building) would have put him at ease. This environment is so much better for young people.”

Mr Jones recalled how he was advised to take his son to ED but he said he knew it was not the right environment for him.

Mr Jones said: “On one occasion I was asked if our son would kill himself. I didn’t feel qualified to answer that…I’m his dad. I was then told he could go to ED. The idea of him going there to be assessed by a psychiatrist to possibly keep him in…he would have just erupted.

“If the alternative on the phone had been to bring him here (to A2A), it would have been great. I think that would have helped him greatly because he could have sat and spoken to somebody. He needed someone who could understand his perspective.

“We obviously couldn’t. We were too close. We were too emotionally involved. We were just crying out really.”

They eventually received a diagnosis when their son was aged 16 and he was placed with a clinical psychologist. Things improved, even though he stopped taking his prescribed medication. However, his father still feels that intervention, had it come earlier, would have helped.

Their son is now living independently and is “managing”, according to Mr and Mrs Jones. The future looks better but they revealed it has been a tough road for all of them.

Cindy Courtney, head of nursing for regional CAMHS crisis specialist services, said: “As this real story illustrates, getting the right service for young people, at the right time, in the right environment, is critical.

“We are committed to continually listening to and learning from young people, families and carers. Only then can we really understand how to transform services to provide the care and compassion we do so well, in a way that is accessible - and in a welcoming, calm, safe and comfortable space.

“I would like to thank Mr and Mrs Jones for sharing their experiences and for being part of our A2A journey. The vision is that A2A Rhyl is just the start. We are dedicated to providing these spaces for children and young people across North Wales.”

*Alongside A2A in Rhyl, there have been more positive developments, with early interventions and strong links into schools. CAMHS crisis services across North Wales have extended their hours, with clear pathways from the NHS Wales 111 press 2 mental health triage service to prompt help and support.

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