When CAMHS fails, the classroom becomes the front line

It was when the student walked slowly behind me that I felt most intensely afraid. We were almost through the lesson; it wasn’t a particularly exciting lesson, that’s true, but that wasn’t any reason to act like this. The student had closed his book a few moments before and pushed it away from himself on the desk. He then stood, silently, slinging his bag over his shoulder. He was static for a second, as if listening for something no one else could hear. This young man had not been formally diagnosed but had all the behaviour patterns of schizophrenia with paranoia.

Schizophrenia is a label that can still strike alarm. Newspaper headlines scream it freely, then sell copies on the back of stories about yet another stabbing in the street. It’s an alarming diagnosis. Imagine a doctor telling you that about yourself. Imagine you’re confused by what is going on. People are looking at you and talking. They must be plotting against you. Everyone wants to hurt you, even the doctors. And inside a voice is telling you to act, or something terrible will happen.

The fear that stirs in you then is bound to force anger to the surface, anger that is always a secondary emotion to help us keep powerlessness or fear or shame at bay. The teacher is right there; the focus of the room. He’s the target now. The teacher knows that someone suffering with such a problem is most of all dangerous to themselves. But right here in this classroom, this situation is undeniably dangerous to me.

The rest of the class is confused by the sudden outburst. I keep calm, so the students stay calm. The situation, although still unfolding, must be ok if the teacher is calm. After all, the teacher sets the weather in the room. And the teacher is right there, sitting at the desk and speaking calmly and slowly and clearly as the disturbed young man towers over him and then stalks slowly behind his chair, having already issued his out-of-the-blue threats.

I know this young man has a history with knives and assault. He’s clearly not well. Every person in that room has to be careful, with their cue coming from me.

A teacher’s role is an odd one. I’ve had to stand between fighting teenagers, both stronger than me. I’ve been squared up to by young people who’ve gone on to kill, been sworn at, screamed at and blamed.

As a result, I’ve asked the questions such an experience must raise. Why was he there in the classroom at all? Why was he not receiving help? It’s simple. CAMHS is creaking under the weight pressing down from outside.

It’s sometimes said that the true measure of any society is how it treats its most vulnerable members. I was vulnerable as that young man threatened me. More importantly, my students were vulnerable too, even if they were not aware. But the most vulnerable person of all in that room was the young man himself. His illness was affecting us all. Because what each of us does affects all of us. That, in a nutshell, is why some of us are teachers, doctors, nurses, police officers or mental health care professionals, because we know that what we do can affect the whole.

When our young people are allowed to carry on without the treatment they need, it inevitably affects others. When that turns into something more violent, it might hit the headlines. But most of the harm – self-directed, silent, and hidden behind the closed doors of too many ordinary homes – will never ever be known. What should be hitting the headlines and causing a scandal but does not is the shocking paucity of our society’s impoverished approach to CAMHS.

My student’s mother is scared. She is watching her son decline, desperate for help. The social worker or mental health worker has a ridiculous caseload, all of them urgent, and paperwork piling up. More than half a million young people in our country are waiting for mental health help and assessment. The wait to be seen can be a lingering hell of months or years, even. What happens to such young people while they’re waiting? If they remain in education at least something is ok, so they can’t be such a priority, it seems to be thought. So the buck is passed and down the triage list they slip. But in an emergency, sometimes you have to look for the silent ones first. Someone screaming is still breathing. So what about those who are not crying out, but suffering in silence still? Do we wait for them to start screaming too? That will be way too late.

I got over the encounter in the classroom in about twenty minutes, albeit with a few days off later in the week. In the immediate aftermath, a cup of tea and supportive colleagues put me back on my feet. For the young man involved, a cup of tea isn’t really going to do the trick.

Who will piece back together the shards of his shattered soul?

The heroes working in our system are up against the odds. Years of cuts, decades of neglect, misunderstanding, dismissive social attitudes even, have left their services buckling and young people suffering. That should be in bold headlines on the front page. Instead, that young man is back at home now. Hidden away in his room and out of education again. His mother remains scared for him and of him, and afraid for her other children too.

The measure of our society must remain how it treats its most vulnerable members. Ask any teacher who those vulnerable people are; every one of us could show you a few.