Damien Dalmayne, 17, is autistic. He also battles mental health issues that have left him unable to get out of bed and contemplating harming himself.

Warning: This story contains references to suicide

“There were thoughts of me doing stuff to myself. I never did but there were stages where it would get pretty hard and it really did get to that point that I was really considering it,” Damien says.

His depression spiralled during the COVID lockdowns and when he was 15 he was referred to his local NHS mental health team in Greenwich.

The paediatrician who made the referral recommended that Damien be seen “urgently”.

But Child and Adolescent Mental Health Services (CAMHS) rejected the referral, instead referring Damien and his family to a local social services team.

Damien believes he was rejected because of his autism diagnosis.

“They [CAMHS] think they can’t help people with special needs. They think ‘that’s just a terminal illness’ even though it’s not,” says Damien.

In its rejection letter, Greenwich CAMHS agreed Damien “experiences emotional difficulties”.

But, noting his autism diagnosis, it suggested he see the area’s Children with Disabilities Team, rather than a specialist mental health service.

Crucially, his mother, Emma Dalmayne, says this meant they were unable to access specialist services like therapy to help Damien.

Autism and mental health ‘seen as separate issues’

Ms Dalmayne says a confused social worker called her after Damien’s referral was redirected to their team.

“They said ‘why have we been called?’ I said ‘I don’t know’.”

“CAMHS see autism and mental health as separate for some reason,” says Ms Dalmayne.

“If you’re not well you go to a doctor, you get help. But no, if you’re mentally ill and autistic and go to a doctor, you’re not getting anything. You’re told ‘well we can’t see you because you have a neurological difference’.”

The NHS trust responsible for Greenwich CAMHS said it is unable to comment on individual cases but stressed it does accept referrals for autistic children who have a “severe and enduring mental health need”.

However, it said children may be referred to other services “where referrals do not meet the threshold for CAMHS”.

CAMHS are run by different health trusts throughout the UK.

Ms Dalmayne says she has spoken to other parents with autistic children who have had similar experiences.

She says she knows one mother who is scared to tell her local CAMHS that her son has been diagnosed as autistic because she worries they will stop his care.

“It’s not an inclusive world. We don’t feel included at all,” says Ms Dalmayne, who is also autistic.

Damien believes NHS services don’t think autistic people can engage effectively with therapy.

“It’s not like just talking to a wall. They [autistic children] will end up listening and if they can they will end up talking.”

He says his experience with CAMHS left him feeling “inhuman”.

Damien ended up using his disability benefits to pay for private therapy.

“If I had waited probably six months [longer to get therapy], I probably wouldn’t be here. They [CAMHS] really put my health at risk,” he says.

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Oxleas NHS Foundation Trust, which administers Greenwich CAMHS, said: “Currently, just over 16% of our CAMHS caseload includes children and young people with both an autism diagnosis and a severe and enduring mental health need. This does not include children and young people either waiting for or currently being assessed by an autism diagnostic service alongside CAMHS.

“Should individual circumstances change, re-referrals can be made. CAMHS is just one part of a much larger collection of services delivering emotional health and wellbeing support and services to children and young people.”

People with autism more likely to experience mental health issues

Sky News tried to get a clearer picture of autistic children’s access to CAMHS across the UK, but when we requested data from health trusts, the majority did not disclose the number of referrals and rejections for autistic children.

We did learn of the serious pressure facing services nationally, with data showing total referrals to CAMHS had risen by 60% between 2018 and 2023. Rejections from CAMHS were up by 30% across the same period.

While it’s difficult to get a sense of the number of autistic children accessing CAMHS, autistic people are more likely to experience mental health problems than people who aren’t autistic.

Sky News spoke to one CAMHS nurse anonymously – we aren’t identifying the health trust she works for.

She said nationally it’s a mixed picture in terms of the level of care autistic children receive.

“We [CAMHS] certainly don’t do enough for children that have been diagnosed with autism in terms of their post-diagnostic support.”

She says she has witnessed preconceptions about autism among staff that can lead to autistic children not getting the care they need.

Skills ‘aren’t consistent’ across health service

“Some people [working in CAMHS], sometimes might tend to say ‘well it’s [their issues are] because of their autism’ as opposed to thinking well actually they might be autistic but they can also have a mental health difficulty that can be supported,” says the nurse.

“A child that has autism and mental health needs, that’s not going to be solved by social services, they need mental health support.”

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She says skills aren’t “consistent” across the health service and that autistic children can be at a disadvantage if their behaviour means more traditional forms of talking therapy aren’t appropriate.

The nurse continues: “I’ve known it happen where people say ‘oh this person is not engaging’ so they get discharged.

“Sometimes therapy is not always helpful, then it’s about different, more holistic ways to support children and support behavioural changes.

“I do think there’s a need to increase skills within CAMHS absolutely. [Staff] recruitment and retention has been difficult across the board.”

Ms Dalmayne is campaigning for better access to CAMHS for autistic children, her biggest fear is that autistic children and adults are hurting, and even killing themselves, if they can’t access mental health support.

“It makes me feel we’ve got to do everything we can to change it,” she says.

Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK

There was one clear, united message from today’s virtual meeting of leaders – that they rejected Vladimir Putin’s “yes, but” approach to a ceasefire.

The “coalition of the willing” – the 27 leaders, plus NATO and the EU led by Sir Keir Starmer and Emmanuel Macron – want the Russian president to mirror Ukraine’s pledge for a 30-day pause in fighting, in order to hammer out a sustainable peace deal.

Sir Keir made that very clear, and suggested the attendees at the meeting were behind this approach.

Ukraine war latest: Putin’s ceasefire conditions ‘not good enough’

The prime minister said: “Volodymyr [Zelenskyy] has committed to a 30-day unconditional ceasefire, but Mr Putin is trying to delay, saying there must be a painstaking study before a ceasefire can take place.

“Well, the world needs action, not a study, not empty words and conditions. So my message is very clear. Sooner or later, Putin will have to come to the table.”

There are two reasons for this challenge – an immediate end to fighting is a goal in itself, but many of those in today’s call, including Sir Keir, do not trust Mr Putin to uphold promises on peace and are trying to convince US President Donald Trump to be more clear-eyed about the Russian approach.

Challenging the Russian leader to follow the US request for a ceasefire and watching him refuse is designed to send a message to the White House as well as the Kremlin.

There were, however, bigger unknowns left hanging.

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One of which was the clear signal from Sir Keir that he is still relying on a US security guarantee in order to bring on board a “coalition of the willing” who might be able to provide troops to Ukraine.

There are, however, many that don’t think that that US security guarantee is coming in any substantial way, based on the noises coming out of the US.

That is a big problem for the PM, as government sources tell me that the scope and the remit of any potential peacekeeping force is determined by what protection the US might be able to provide.

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The second issue that is being sidestepped by Sir Keir is what any peace keeping might be able to do in practice.

UK troops, like those of any NATO country, cannot engage directly with Russia in combat for fear of triggering a much bigger conflagration.

So if not that, then what is their purpose – a question repeatedly asked by experts like the former national security adviser Lord Ricketts.

I put exactly this to the PM, but did not get an answer. He suggested that we were a long way away from getting an an answer, even though military chiefs also appear to be meeting to “operationalise” plans on Thursday.

How can they operationalise a plan that does not, and currently cannot, have a remit?

Today Sir Keir heralded the participation of Canada, Australia and New Zealand on the call, as part of the effort.

But if the remit of the coalition of the willing isn’t clear, how can it truly be effective?

Military chiefs from around the world will meet next week to discuss the “operational phase” of protecting Ukraine as part of a peacekeeping force, Sir Keir Starmer has announced.

The prime minister hosted a virtual meeting of the “coalition of the willing” on Saturday, which involved leaders of 26 nations, including Ukraine, plus the EU and NATO, to discuss ending the war in Ukraine.

Speaking after the 90-minute meeting, Sir Keir revealed military chiefs from the group of Western nations would meet on Thursday as they move “into an operational phase”.

He said they would draw up plans to help secure Ukraine “on the land, at sea and in the sky” if a peace deal can be agreed with Russia.

Ukraine war latest: We must be prepared to defend peace deal

The day before, Ukraine President Volodymyr Zelenskyy accepted a proposal for a 30-day interim ceasefire as Russia agreed to an end to fighting, however, President Vladimir Putin said “lots of questions” remain over the proposals.

Notably absent from Saturday’s call was US President Donald Trump, but Sir Keir reiterated any peace deal requires a US backstop.

He said the UK is talking to the US “on a daily basis” and there is a “collective resolve” to end the war, which has been shown by the “momentum we’re building up now” by the many allied countries being “on the same page” both politically and militarily.

He said Thursday’s meeting of military chiefs “is very much an operational planning meeting”.

The PM added the “coalition of the willing” had increased in size since leaders met for the first time just under two weeks ago at Lancaster House in London.

Italian Prime Minister Georgia Meloni was the most notable addition after reports she would “shun” the meeting because she is “not convinced” by the Anglo-French plan to send European peacekeepers to Ukraine.

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PM dodges what rules of engagement would be

Answering a question from Sky News’ deputy political editor Sam Coates on what the rules of engagement would be for troops on the ground as part of a peacekeeping process, Sir Keir said the meeting will set that out.

He said he has already indicated he wants the UK “to play a leading role” in the provision of troops and air power, while other countries will have different capabilities.

But, he said a peace deal needs to be achieved first, which requires more pressure on Russia.

“If there’s going to be lasting peace, there’s going to have to be security arrangements,” the PM said, noting that Putin has previously broken a peace deal with Ukraine.

‘World needs action, not a study’

Sir Keir also said on the call that the gathering of leaders rejected Mr Putin’s “yes, but” approach, in reference to the Russian president saying he would agree to a ceasefire but there must be a “study” into how that would look.

The prime minister said: “The world needs action, not a study, not empty words and conditions. So my message is very clear. Sooner or later, Putin will have to come to the table.

“So this is the moment that the guns fall silent, that the barbaric attacks on Ukraine once and for all stop and agree to a ceasefire now.”

The PM revealed seizing Russian assets was discussed in the meeting but said it was “a complicated question”.

Despite striking US absence, progress was made

Amanda Akass

Political correspondent

@amandaakass

While Sir Keir Starmer’s coalition of willing world leaders weren’t standing literally shoulder to shoulder at this morning’s meeting, their united presence still sent a powerful message of support to the Ukrainians after another tumultuous week.

It was clearly important to make a united statement of conviction that the Ukrainians are the “party of peace”, willing to sign up to a ceasefire without conditions, and the Russians, therefore the de facto party of war, delaying a ceasefire and continuing with their “barbaric attacks”.

But what of the “concrete commitments” Sir Keir said he wanted to secure from the meeting?

While the PM said new commitments had been made, he gave no specific details beyond insisting the coalition would be moving into an “operational military planning” phase, with a meeting of military leaders to be held in the UK.

He had no detailed answer to Sky News’ deputy political editor Sam Coates’ question about what power any troops deployed as part of the coalition of the willing would actually have to police any deal, arguing he was willing for UK forces to play a leading role but that operational capabilities will be discussed on Thursday.

Today’s messages were directed at both Russia and the US. Starmer insisted Russia would be forced to the table sooner or later – by the increased military support given to the Ukrainians and through the threat of greater economic sanctions. The long-held hope of seizing frozen Russian assets was also discussed, he said.

And as for his audience in the White House, the PM was demonstrating again that Europe and its allies have been listening to his calls to do more to shoulder the burden of defending Ukraine – and themselves.

But his argument that no peace deal can be secure and lasting without American security guarantees is unchanged. He reiterated all this needs to be done “in conjunction with the United States” and said his team are in daily talks with Washington.

For all the political power assembled online today, the absence of the US is as striking as ever. Despite that, progress continues.

Zelenskyy accuses Putin of lying to everyone

President Zelenskyy revealed he addressed the meeting and told them the path to peace “must begin unconditionally” and if Russia does not want to do that “then strong pressure must be applied until they do”.

He said the 30-day ceasefire proposal from the Americans negotiating in Saudi Arabia with the Russians has been on the table since Tuesday but accused Mr Putin of “lying to everyone” about the situation on the ground and about how a ceasefire is “supposedly too complicated”.

The Ukrainian leader pleaded with the West to “define a clear position on security guarantees” and for European nations to invest in defence so the continent has “its arsenals and the capability to produce the most advanced weapons”, and to strengthen air defence.

Mr Zelenskyy suggested another coalition of the willing meeting will be held in a week’s time.

Who is part of the ‘coalition of the willing’?

The leaders involved in Saturday’s call were from: Australia, Belgium, Bulgaria, Canada, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Italy, Latvia, Lithuania, Luxembourg, Netherlands, New Zealand, Norway, Poland, Portugal, Romania, Spain, Sweden, Turkey, Ukraine and the UK.

NATO Secretary General Mark Rutte, EU Commission President Ursula von der Leyen and EU Council President Antonio Costa also joined.