Managing tier 4 admission
What is CAMHS tier 4?
Child and Adolescent Mental Health Services (CAMHS) support young people experiencing poor mental health and are organised in a tiered system.
- Tier 1 – provides early intervention through schools, GPs, health visitors.
- Tier 2 – provides early help and targeted services, including some CAMHS services e.g. counselling.
- Tier 3 – provides specialist CAMHS services in the community, including eating disorder services.
- Tier 4 – is highly specialised day and inpatient units, where young people with more severe mental health problems can be assessed and treated. This can be voluntary, or as a person who have been detained under the Mental Health Act.
CAMHS Tier 4 Services
CAMHS Tier 4 Services include care that is inpatient, intensive outpatient or day care treatment, which reflects a level of need equivalent to inpatient care.
Travel Expenses
Managing travel costs can be a worry for some families. We have posted some information on this here under ‘Help with travel costs‘.
Helpful info for your child’s inpatient stay
#GettingThrough guides were created by and for families in collaboration with NHS England. They offer useful information for families when their child or young person (CYP) has been admitted to a CAMHS Tier 4 inpatient unit. The #GettingThrough guides can be accessed below.
#GettingThrough guides there are five guides in total.
- Getting through meetings during an inpatient stay
- Getting through family life during an inpatient stay
- Getting through communication during an inpatient stay
- Getting through the first few days: staff guidance
- Getting through the first few days: patient booklet
Guides to help understand CAMHS T4 processes
- CAMHS Tier 4 A Family Survival Guide a comprehensive reference guide written and edited by experienced parents.
- SEND Education Family Survival Guide help for parents to understand the SEND system.
- Crisis Prevention A Family Survival Guide support for families to understand and access local education, health and care services to avoid a potential crisis.
- Jargon Buster guide to common acronyms in Children and Adolescent Mental Health Services.
- Information about the Care Programme Approach (CPA) NHS guide to explain how the care programme approach works.
- Rethink Mental Illness, Care Programme Approach (CPA) at the bottom of the page is a factsheet that you can download.
Human rights and legal rights
Below are some links explaining what your child’s rights are when they are in a mental heath unit.
- Human Rights in CAMHS | British Institute of Human Rights (bihr.org.uk) explaining young people’s rights in inpatient mental health units and human rights law
- Information for 11-18 year olds: your rights (Mind) understanding legal rights for 11 – 18 year olds with mental health difficulties
- Requesting a Child & Family Assessment under Section 17 of the Children Act 1989 – your right to a child and family assessment to assess the needs of the child (and also the carer).
The Mental Health Act and being sectioned
If you are ‘sectioned’, this means that you are kept in hospital under the Mental Health Act. There are different types of sections, each with different rules to keep you in hospital. You can find out more about your rights when you are sectioned below.
- It can be very helpful to know about your rights as a ‘nearest relative’. Nearest relative is a legal term used in the Mental Health Act. A factsheet can be located here: https://www.rethink.org/advice-and-information/rights-restrictions/mental-health-laws/nearest-relative-under-the-mental-health-act/
- The Mental Health Act explains the Mental Health Act, being sectioned and your child’s rights.
- My rights if I’ve been sectioned from Mind.
- Mental Health Act and your child Explain Section 117 of the Mental Health Act, ‘Section 117 Aftercare’
About Care, Education and Treatment Reviews (CETRs)
Care, Education and Treatment Reviews (CETRs) are for young people with learning disabilities or autism and mental health issues who have been admitted to a CAMHS Tier 4 inpatient unit, or for those at risk of admission. Their purpose is to ensure that young people are only admitted if absolutely necessary and for the minimum amount of time possible, and to ensure they have good care at the right time and in the right place.
- The Dynamic support register (DSR) and Care, Education and Treatment Reviews (CETRs) for young people with learning disabilities or autism who are in hospital, or at risk of going to hospital. See below for more information about CETRs.
- Care & Treatment Review, A Family Survival Guide
- My Care Education and Treatment Review Planner and Consent
- Easy-Read – My Care Education and Treatment Review Planner and Consent
- NHS England Care Education & Treatment Reviews (CETRs) to meet the needs of young people with learning disabilities and autism.
- Children & Young People Keyworkers young people with a learning disability and/or who are autistic with the most complex needs will have a designated keyworker.
Your right to a social care assessment
- Requesting a Child & Family Assessment under Section 17 of the Children Act 1989 – the assessment aims to gather information and assess the needs of the child (and also the carer).
For more CAMHS parent information, please check out Good Advice and the Parent and Carers resources.
Page last reviewed: 17 September, 2024