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by SEN Parent Support Group

(Please share – this will help so many families)

We are seeing a sharp rise in bullying, school‑based trauma, and mental health crises in neurodivergent children as communicated in our group by SEND Parents – and a rise in CAMHS refusing referrals because children “don’t meet criteria”.

Here is what the data shows, what this means for ND children, and what you can do if CAMHS gatekeep.

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Bullying of SEND & Neurodivergent Children – The Reality

FACT – SEND and neurodivergent children are significantly more likely to be bullied than their non‑SEND peers.

Key findings:

• 36% of pupils with SEND experience frequent bullying, compared with 25% of pupils without SEND.
• Disabled and neurodivergent children (autistic, ADHD, learning‑disabled) are disproportionately targeted.
• 19.1% of children aged 10–15 experience online bullying each year.
• 34.9% experience in‑person bullying.
• Many ND children do not report bullying due to masking, communication barriers, or fear of not being believed (source)

Bullying is not “friendship issues”. It is a safeguarding issue and for ND children, it is often chronic, invisible, and minimised.

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2. Trauma in Neurodivergent Children – What It Actually Looks Like

Trauma in ND children is often misunderstood because it doesn’t always look like “classic” trauma.

Common trauma responses include:

• School refusal / EBSA
• Shutdowns
• Meltdowns after school
• Regression
• Panic attacks
• Sleep disturbance
• Eating changes
• Hypervigilance
• Masking until collapse at home

For autistic children especially, trauma can be triggered by:

• Bullying
• Sensory overload
• Repeated restraint or seclusion
• Punitive behaviour systems
• Being misunderstood or punished for communication differences
• Chronic anxiety from school environments

Trauma in ND children is real, physiological, and often mislabelled as behaviour.

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Autistic Inertia – Why Trauma Makes Everything Harder

Autistic inertia is a well‑documented phenomenon where starting, stopping, or switching tasks becomes extremely difficult especially under stress.

Inertia can look like:

• “Refusing” to get out of bed
• “Not engaging” in schoolwork
• “Ignoring instructions”
• Freezing or shutting down
• Being unable to speak or move when overwhelmed

This is NOT defiance. It is a neurological response, often worsened by trauma, bullying, and chronic anxiety.

When CAMHS or schools misinterpret inertia as “won’t” instead of “can’t”, children are denied support they urgently need.

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What CAMHS Should Do

CAMHS are responsible for supporting children with:

• Anxiety, depression, OCD, phobias
• Self‑harm or suicidal thoughts
• Trauma responses
• Severe emotional distress
• Eating difficulties
• Behaviour linked to underlying mental health needs
• Neurodevelopmental concerns (in some areas)

If a child is struggling in daily life – school refusal, shutdowns, meltdowns, panic, self‑harm, or overwhelming anxiety – that IS clinical need.

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When CAMHS Say “Does Not Meet Criteria” – What It Really Means

A refusal does not mean:

• Your child is fine
• Your concerns aren’t valid
• There is no mental health need

It simply means CAMHS have declined to assess or support at this time.

And you are absolutely entitled to challenge that because this is NOT ACCEPTABLE!

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Step‑by‑Step: What To Do Next

Step 1 – Ask for the refusal in writing

Request:

• The exact reason for refusal
• The criteria they believe your child doesn’t meet
• The evidence they used
• The name and role of the clinician who made the decision

This creates a paper trail.

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Step 2 – Respond with a clarification letter

Your reply should:

• Correct misunderstandings
• Add missing context (masking, burnout, bullying, trauma, inertia)
• Attach logs, school reports, or professional letters
• Focus on impact on daily functioning

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Step 3 – Escalate to PALS (Patient Advice and Liaison Service)

PALS can:

• Review whether CAMHS followed correct process
• Challenge inappropriate refusals
• Request a second clinical opinion
• Ensure your concerns are logged and investigated

Include:

• Child’s name, DOB, NHS number (if known)
• Date of referral and date of refusal
• A copy of the refusal letter
• A clear explanation of why the decision is unsafe or inappropriate
• Evidence of impact (school refusal, self‑harm, shutdowns, sleep issues, etc.)

PALS cannot force CAMHS to accept a referral but they can require CAMHS to justify or review the decision.

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Red Flags for ND Children

If CAMHS say:

• “It’s just their autism”
• “This is a parenting issue”
• “School need to deal with it”
• “They’re masking so they seem fine”

These are not clinically valid reasons to refuse support.

Escalate immediately. Currently CAMHS are the only CYP MH Resource available on the NHS. You must escalate!

If PALS are unable to resolve the issue or CAMHS continue to refuse support despite clear evidence of harm, parents should escalate without delay. The next step is to submit a formal complaint to the NHS Trust Complaints Team, outlining the safeguarding concerns, the impact on the child’s daily functioning, and any failures in process or clinical judgement.

You can also request that the case is reviewed by a senior clinician or CAMHS Service Manager. If the situation involves significant risk, school breakdown, or unmet mental health need, parents may escalate further to the Integrated Care Board (ICB) and, in cases of systemic failure, to the Children’s Commissioner for England. Escalation is not confrontational – it is a safeguarding action when a child’s needs are being overlooked.

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BULLYING OR HARMFUL INCIDENT OCCURS
▼
Child shows signs of distress:

• Anxiety / panic
• Meltdowns or shutdowns
• School refusal / EBSA
• Sleep disturbance
• Eating changes
• Regression
• Autistic inertia (freeze, can’t start tasks)
  │
  ▼
  PARENT OBSERVES IMPACT AT HOME
• Logging behaviours
• Recording patterns
• Noting triggers
• Gathering school communication
  │
  ▼
  SCHOOL RESPONSE
• Safeguarding concern raised?
• Bullying recorded or minimised?
• Support offered or refused?
  │
  ▼
  IF IMPACT IS SIGNIFICANT:
  (mental health, functioning, daily life)
  │
  ▼
  CAMHS REFERRAL MADE
  (by GP, school, or parent depending on area)
  │
  ▼
  CAMHS TRIAGE DECISION
  │
  ├──► ACCEPTED
  │ • Assessment
  │ • Therapy
  │ • Psychiatric input
  │ • ND pathway (in some areas)
  │
  └──► DECLINED (“Does not meet criteria”)
  ESCALATE!

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