When the Child Speaks

Not long ago I wrote a post here called The System That Waits for Crisis. It was built on a study by Dr Emma Ashworth and colleagues that asked 300 parents of autistic children what it was like to seek mental health support from CAMHS. The parents described watching their children accumulate harm on a waiting list until things reached crisis point — and only then, sometimes, did help arrive.

That post spoke in the voice of parents. It had to. Parents were the ones who had been surveyed, and parents see things a child in distress often can't name from the inside: the slow slide, the months of waiting, the letter on the noticeboard.

But there was always a voice missing from it. The child's own.

In March 2026, the same research team submitted written evidence to Parliament — to the inquiry on children and young people's mental health — and this time the young people speak for themselves. Alongside 300 parents, 36 autistic young people aged 11 to 18 described, in their own words, what CAMHS was actually like to sit inside. This post is a companion to the first. Read together, the two complete a picture that neither could hold alone.

What the young people said

The pattern across the accounts is hard to look away from. When asked to pick an emoji for their overall CAMHS experience, the largest group chose a neutral face — but the next largest, more than a third of them, chose very unhappy. Very few chose happy. And the reasons they gave were specific, concrete, and entirely fixable.

Before they even arrived

Most said they weren't offered a choice between, say, an online or a face-to-face appointment — and the overwhelming majority felt they should have been. One described how being seen over the phone left her crying alone in a school room while someone across the country listened, and how much she'd have preferred to be met in person. Nearly two-thirds said they simply didn't know enough about what was going to happen before they walked in. A short video, a recorded introduction, a note about who their therapist would be — small things, and they asked for them plainly.

The room itself

Almost half didn't like the waiting area, and almost half didn't like the appointment room. Not as a vague complaint — they told us exactly why. Too bright. Too noisy. Chairs too far apart and scratchy. One young person described a bare, cold room with strip lighting, a doctor balancing a laptop on his knees, and pandemic-era social distancing posters still on the wall. Another found the hardest part was watching other children leave their sessions visibly distressed while they waited for their own.

When asked what they'd want instead, they were clear and reasonable: somewhere quiet, comfy chairs, softer lighting, something to fiddle with, the option to wait in the car rather than a crowded room. None of this is exotic. All of it is the difference between a nervous system that can settle and one that spends the whole appointment in alarm.

Being talked to like a person

This is the part that stayed with me most. Half of the young people didn't like how their CAMHS worker communicated with them, and the words they used were patronising, dismissed, not listened to. Talked to like a baby. Talked about, over their heads, to their parent. One said a worker joked about her coat and her school, spoke too loudly, and made her feel fat. One said, simply, that everything on offer was talking — and talking was the thing they found hardest.

And then, threaded through, the accounts of what happened when it worked — because it sometimes did. One young person described a worker who didn't jump straight into what happened, and understood that they needed to build trust before telling him everything. Another called their psychiatrist "one superhero… who went above and beyond to ensure my voice was heard." The good experiences weren't about clever techniques. They were about being met as a person: given time, given trust, given a choice about how to share — whether that's talking, drawing, writing it down, or bringing something from home.

How it ended

The endings were, for many, the sharpest wound. Support that stopped abruptly. A psychologist who left the service with no one to replace them, and a young person signed off by email. Being passed between an eating disorders team, a child team, an adolescent team and a neurodevelopmental team inside a single year. And, most painfully, a child who deliberately hurt themselves in the office so they wouldn't have to come back.

Why hearing both voices matters

Here is the thing I most want to say, and the reason I've written this as a companion piece rather than a standalone. The parents' study and the young people's evidence each see what the other cannot.

Parents can see the shape of the whole ordeal from outside — the referral that was refused, the months of waiting, the diagnostic overshadowing, the slow accumulation of harm. They can name the timeline a child in distress has no vantage point to see. That's what the first study gave us.

But parents were not in the appointment room. They didn't feel the strip lights on their own skin, or the specific humiliation of being spoken to like a toddler, or the flood of relief when one worker — just one — took the time to build trust first. Only the young people can tell us that. And in this evidence, they do.

Put them side by side and something clicks into place. The parents described a system that waits. The young people describe what it's actually like to be the person waited upon — and then, too often, mishandled once the waiting ends. Neither account is complete without the other. A policy response built only on the parents' view risks fixing the pipeline while leaving the room unbearable. A response built only on the children's view risks improving the room while leaving them waiting years to reach it.

And it's why the single most neuroaffirming act in all of this may simply be making sure the young person is in the room, and heard, when decisions about them are made.

I work the way I do — low-demand, creative, led by the young person in front of me — precisely because of accounts like these. Not because they're rare, but because I've sat on the other side of them: as a parent who watched the waiting, and as a therapist who sees where it leaves a young person. The young people in this evidence weren't asking for the impossible. They were asking for quiet, for kindness, for a choice, and to be spoken to as though they were there. When we build rooms and relationships around that, we don't just avoid harm. We make room for the child to finally be heard — which, more often than not, is where the healing actually begins.

And if you're a practitioner reading this and recognising your own service, or your own practice, in some of these accounts — that recognition is a good place to start, not something to feel defensive about. It's the reason I built The Neuroaffirming Therapy Room, my CPD training for therapists and other professionals who want to make their practice genuinely accessible to autistic young people. Much of it is simply learning to do, deliberately, the things these 36 young people were asking for.

Reference: Ashworth, E., Bray, L., Hanlon, C., Pavlopoulou, G., Moore, D., Kirkby, J., & Tebble, G. (2026). Accessible and equitable mental health support for autistic children and young people. Written evidence submitted to the UK Parliament (CYM0146), March 2026. Liverpool John Moores University, Edge Hill University, and Anna Freud/University College London. The parents' study referenced throughout: Ashworth et al. (2025), Autism. doi.org/10.1177/13623613251335715. With thanks, as ever, to the research team and the young people and families who shared their experiences.