Under-nourishment and clinical risk: two concerns of CAMHS clinicians

Abstract

The concern of this study is a blindness to risk assessment of mental health and safety issues for children and young people by Child and Adolescent Mental Health Services (CAMHS) teams when they are insufficiently emotionally contained. The need for social worker membership of CAMHS teams is suggested but not developed, as the focus is unconscious processes that debilitate required thinking by CAMHS about risk. A case example allows discussion of various ways in which primitive anxieties within CAMHS teams lead to paucity in thinking about risks. Located at the beginning of life, primitive anxieties are contained through nourishment. It is suggested without nourishment, and its consequent provision of a containing boundary for these anxieties, teams can dangerously dysfunction in primitive infantile states. These persecutory mental states are traced as the cause of a depleted thinking capacity, which may inadvertently place patients at increased risk through errors and oversights.