CAMHS Referral information

Overview

CAMHS provides specialist support for severe, enduring, and complex mental health difficulties, which have not been helped by other interventions e.g. school-based counselling or emotional wellbeing interventions.

CAMHS criteria and advice on whether to make a referral can be found here: https://www.awp.nhs.uk/camhs/professionals.

Before Referral

Before referral to CAMHS please see the Mental Health Resources for Children page which has alternative resources that may provide appropriate support for your patient. There is also a section on obtaining advice from CAMHS on this page which can be used if you are unsure if a referral is required.

The majority of queries can be answered by email, however a call-back from a Getting Advice clinician can be requested or may be recommended.

Primary Care Mental Health Specialists (PMHS) service is available although cannot be accessed via GP referral. Parents looking to access this service should discuss with their child's school.

Referrals should not be made until the above options have been tried or considered, unless an urgent referral is required (see criteria below).

Moderate to Severe Mental Health Difficulties

When a frontline intervention such as those above has been tried and problems persist and / or the young person is experiencing severe, complex and enduring mental health difficulties, a routine CAMHS referral should be made.

All referrals must be made using the Single Point of Entry Referral form (see below) and have consent from young person / carer. The young person should recently have been seen by the referrer.

• By moderate we mean, having an impact on a young person’s day to day life and if left untreated are likely to become more severe
• By severe we mean, having a significant impact on a young person’s day to day life, limiting functioning and ability to engage with normal childhood life
• By complex we mean, having an impact on more than one area of a young person’s life, e.g. home , school, hobbies, friendships etc
• By enduring we mean that these difficulties have been present for over 3 months and they’ve been getting worse despite help being tried.

Referrals are reviewed every week day by clinicians in the CAMHS Getting Advice team. A decision is typically made within 24 hours although some require further information or follow-up to make a decision. Routine referrals are passed to the local CAMHS team (based on GP address) and a waiting list letter will be sent to family, GP/referrer. The family will be contacted to offer an initial appointment via ‘opt-in’ letter called a “choice” assessment. At this appointment ongoing CAMHS input will be discussed and planned.

Urgent referrals

When young people present with severe or urgent mental health difficulties an urgent referral to CAMHS should be made using the SPE form (see below). Severe or life threatening conditions include:

• Risk of suicide including attempted suicide and/or frequent suicidal ideation with intent to act with limited protective factors (such as supportive relationships). And/or severe self-harm (requiring medical intervention).
• Low body weight anorexia with continuing food restriction and limited motivation or ability to change.
• Psychotic episode with hallucinations/delusions and severe impact on functioning.
• Severe depressive episode with severe impact on functioning (lack of self-care, loss of appetite leading to weight loss, social withdrawal, extreme hopelessness)

For CYP referrals which may require an urgent assessment (within 7 days) a clinician from the Getting Advice team will contact the CYP/Carer to confirm if urgent assessment required and provide advice in the interim.

If a young person requires same day mental health assessment then CAMHS will provide an assessment in A+E.

Safeguarding

Where there are concerns around risk (suicide, self-harm), please ensure necessary information is shared with parents/carers/guardians and safety advice is given (see CAMHS Emergency Helpline). Risk trumps confidentiality, even if Fraser Competent.

Emergency Helpline

If you need urgent advice relating to a young person’s risk, you can speak to the CAMHS response line on 0800 9539599

See the CAMHS mental health 24/7 emergency helpline page for details

Referral

The SPE referral form needs to be completed in full. This should also be available as an EMIS template.

Both Consent questions need to be answered. Consent from the parent/carer and young person is required and the relevant box ticked.

In the DETAILS box please include:-

• What the difficulties are and how long they have been present.
• What are the risks (have these been shared with parents, has a safety plan been discussed).
• What impact the difficulties have on the young person’s life.
• What has already been tried in terms of support. Have they accessed first line intervention (OTR etc)?
• What the young person wants from a CAMHS referral.

Insufficient information may lead to the referral being returned or result in a delay in the treatment of the child.

If you are making a referral due to eating issues, please see the Eating Disorder Pathway.

Young people aged 18 or over: For mental health referrals please go to the Primary Care Liaison Service page It may also be appropriate to suggest Off the Record who offer services to young people aged up to 25.

Neurodevelopmental disorders / assessment

If the primary issue is possible/diagnosed neurodevelopmental difficulties such as Autism, ADHD then the referral should be made to Community Paediatrics (using the same SPE form). CAMHS will assess CYP with neurodevelopmental difficulties but only if have significant and co-morbid enduring mental health difficulties.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.