CAMHS request for service guidance – BaNES and Wiltshire

This page provides guidance in relation to the decision-making process used by CAMHS to determine whether or not to accept a request for service.

In Swindon we are not commissioned to deliver Getting Help services and these are delivered by TAMHS, please see the separate page for Swindon here.

For referrals for under-5s, please discuss with Health Visitor (who can consider the need in relation to the Infant Mental Health Pathway).

To download this guidance as a PDF, click here.

How we determine whether a child or young person needs a specialist mental health service

Each request for service received by the CAMHS service is screened carefully to check whether the child or young person requires a specialist mental health assessment. This reflects the fact that all children and young people are different, so we need to look at each individual circumstance to determine the best course of action.

There are three key areas which we consider when we make this decision: Impact/Intensity, Duration and Context.

Specialist mental health services like CAMHS work with children and young people whose mental health difficulties are having a significant impact (usually on several areas of their lives) – for example, at school, socially and at home.

These difficulties are also likely to be significant in their intensity or severity. If difficulties are only in one area or are not too severe then we may advise that other local services and self-care options are tried first as often these are sufficient to resolve the issue.

CAMHS usually work with children and young people whose difficulties have been impacting on their life for a significant amount of time. This is usually about three months or more.

Often support from other local services and self-care options are able to resolve an issue which has only been affecting a child or young person for a shorter time.

However, if there has been a sudden change in behaviour or the young person is posing a significant risk to themselves or others then a referral to CAMHS is may be necessary.

CAMHS considers the circumstances experienced by each young person at the time as these often provide important context to the issues they are experiencing.

This might include current or recent major events such as bereavement, physical illness or family breakdown (which may be appropriately supported by other agencies but which may not be indicative of a mental health disorder).

They also look at the support the young person is already receiving (from their school, their family, social care etc) and what impact this has had.

The CAMHS referral pages contain a pre-referral questionnaire which helps to consider the three key areas described above. You can fill in the questionnaire here:

CAMHS referral pre-questionnaire

How to support a child or young person experiencing difficulties

Below is a general guide to help you to consider what might be a helpful next step for a child or young person.

Green – experiences that most young people will have from time to time

Difficulties which:

  • are specific to a situation or last only for a short time.
  • have a limited impact on daily functioning (e.g. just affect a child or young person’s ability to enjoy a hobby or spend time with friends).
  • have a limited impact on the child or young person’s physical or emotional wellbeing
  • most children and young people experience as part of growing up.
  • Access the self-help resources on the CAMHS website: Good Advice
  • Talk to friends and family
  • Access support at school or from a youth organisation
  • It is unlikely that a referral to CAMHS will be required

Amber – challenges that some young people experience and may need some help with

  • Common worries or difficulties which are causing more distress than would be expected.
  • Distress which is greater than would be expected given the situation / event / incident.
  • Episodes of worry, sadness, anger or distress which are frequent or last longer than you might expect.
  • Impact on functioning across all areas of a child’s life which lasts a few weeks. This might affect the child or young person’s ability to cope at school, spend time with friends or enjoy their hobbies. It could also incorporate the impact on their physical health including their eating and energy levels.
  • Follow the steps described in the green category.
  • Explore the support the child or young person could get at school/college.
  • Consider the options for support from community organisations, youth groups and counselling services.

Red – difficulties that have significant impact and duration which may require a specialist mental health intervention by CAMHS

Difficulties which:

  • have persisted, despite trying the strategies outlined in green and amber.
  • are severe and enduring (this usually means they have lasted for three months or more).
  • have been present for a shorter timeframe but result in emotional difficulties which are severe.
  • are causing significant distress to the young person and/or their family network.
  • are causing significant disruption to daily life and functioning. This might significantly affect the child or young person’s ability to cope at school, spend time with friends or enjoy their hobbies.
  • cause the young person to present a risk of harm to themselves or others (for example, presenting with self-harming or self-injurious behaviour).
  • have an impact on the child or young person’s physical health.

Make a referral to CAMHS – either by visiting the GP or through self-referral.

Get support in BaNES and Wiltshire

The list below is intended for guidance purposes only – it is not a definitive list and decisions will vary based on individual circumstances.

If you are worried about a child or young person, please contact the Single Point of Access (SPA). SPA clinicians will be able to assist you in identifying the needs of the child and young person and selecting the best source of support to meet their needs.

Some examples of mental health conditions we work with if the issue is consistent with the amber or green criteria described above:

  • Anxiety
  • Depression
  • Eating Disorders
  • Obsessive Compulsive Disorder
  • Post-Traumatic Stress Disorder (including Complex Post-Traumatic Stress Disorder)
  • Self-harm
  • Suicidality
  • Psychosis
  • Attachment disorders
  • Body dysmorphic disorder
  • Severely challenging behaviour in the context of ASD/LD
  • Bipolar Disorder
  • Somatisation syndrome (with severe impact on functioning)

 

Conditions unlikely to be supported by CAMHS

The below mental health conditions are unlikely to be supported by CAMHS unless accompanied by a comorbidity (another mental health condition). Please click any you are concerned with to see alternative advice and guidance.

Avoidant and Restrictive Food Intake Disorder (unless low weight or medically compromised)

ARFID Awareness offers a range of information for parents/carers and schools, including webinars, coping strategies and suggested professionals who may be able to offer support.

Tics and Tourette’s
  • HCRG – a diagnosis for simple Tics/Touretes syndrome can be attained by assessment at the HCRG group.
  • Great Ormand Street Hospital (GOSH) provides a wide range of information on Tourette’s/Tics, how you can go about getting it diagnosed and how the different ways in which it can be treated.
Chronic Physical Illness & CFS
  • Please ensure all concerns have been discussed with your GP who may be able to refer you onto specialist services for an assessment and therapeutic support.
  • Consider referral to the School Nursing service via https://wiltshirechildrensservices.co.uk/our-services/
  • On Your Mind provides local counselling services for initial talk-based therapy support.
Conduct Disorder & Oppositional Defiant Disorder

Parenting support:

Please also discuss with your child’s school.

Tics and Tourette’s
  • HCRG – a diagnosis for simple Tics/Touretes syndrome can be attained by assessment at the HCRG group.
  • Great Ormand Street Hospital (GOSH) provides a wide range of information on Tourette’s/Tics, how you can go about getting it diagnosed and how the different ways in which it can be treated.
Obesity / Binge Eating Disorder
  • Dietitian – we would recommend that you speak to your GP to see if they can refer onto a dietician, they can give support and guidance on healthy eating and achieving a healthy lifestyle.
  • Beat is a charity offering support and guidance to help with recovery for eating disorders, with resources to help children/young people and parents to understand about eating disorders, and a national helpline that runs 365 days a year where you can get further advice from their helpline staff.
Behavioural difficulties
  • Action For Children offers parents/carers advice on how to set boundaries, effectively use rules and rewards and how to cope with challenging behaviours.
  • Family Lives looks at managing children’s difficult behaviours including aggression, it also offers a video looking at teenagers and older children.
  • Young Minds offers parents/carers advice on coping with challenging behaviours and gives you links to further support.
Bedwetting / toileting issues
  • Eric the Children’s Bowel & Bladder Charity has some great resources for parents and children, including information and advice on encopresis, also known as faecal soiling (the soiling of underwear by no fault of their own, with stool, by children who are past the age of toilet training and are at least 4 years old or older).
  • RCPsych offers advice and guidance for parents whose children are soiling and/or wetting themselves.
ASD/ADHD assessments

Referral information:

  • A professional referral is required; this is best completed by school based on Wiltshire Children’s Services requiring a report from school which needs to include factors such as academic level strengths and weaknesses, behaviour during structured and unstructured parts of the day, relationships with peers and adults, details of any interventions tried and any reports from other professionals.
  • Information can be found on: https://wiltshirechildrensservices.co.uk/our-services/spa/

The National Autistic Society offers advice and guidance for people on the autistic spectrum and their families.

ADHD resources

Bereavement

Cruse offers online counselling with specialist grief counsellors and also offers an helpline for immediate help. Please visit the website for your nearest branch for more information about the support and services offered, as well as a full list of towns and villages covered by each branch. Local services include:

  • Bath 01761 417250 bath@cruse.org.uk (Covering Bath, Chippenham, Trowbridge, Devizes, Warminster, Frome, Melksham and Warminster)
  • Salisbury 01722 411938 salisburybranch@cruse.org.uk (Covering Salisbury, Amesbury, Fordingbridge, Netheravon, Tidworth, Downton and Shrewton)

We Hear You provide free professional counselling to anyone affected by cancer or a life threatening condition, at any time. From diagnosis to bereavement including children who themselves have cancer or a life-threatening condition.

  • Age 4 upwards for face to face. Virtual 12+. Provide up to 16 sessions.
  • We support children, young people and adults and work across Wiltshire, Somerset and B&NES.
  • Working in Matravers School (Westbury) Frome College, Selwood and Oakfield (Frome), The Hubb in Trowbridge (for referrals from Trowbridge schools) –
  • Can also offer virtual support outside of the above areas for YP aged 12+
  • Referrals are from individuals, schools, GP, cancer nurse specialists and community organisations.
  • Tel: 01373 455255
  • Email: info@wehearyou.org.uk
Refusal to go to school or college
Substance or alcohol abuse
  • Motiv8 – Wiltshire – help to support young people who are using drugs and/or alcohol. Phone on 0800 169 6136 or email info@dhimotiv8.org.uk
  • Project 28 – BaNES
  • FRANK provide confidential information and advice for anyone concerned about their own or someone else’s drug or solvent misuse. Visit the website or freephone 0800 77 66 00 (24 hour service, provides translation for non-English speakers)
Gender identity/dysphoria

GIDS the Gender Identity Development Service is a highly specialised clinic for young people presenting with difficulties with their gender identity.

Mermaids offers support and guidance for transgender, nonbinary and gender-diverse children and young people. It offers support for children and their families up till their 20th birthday.

Sleep difficulties

Calm App

  • Calm is a meditation, sleep and relaxation app, available in both the App Store and Google Play store.
  • Calm creates unique audio content that strengthens mental fitness and tackles some of the biggest mental health challenges of today: stress, anxiety, insomnia, and depression.
  • Some in app purchases are available.

Headspace App

  • This app offers a 10 days beginners course of meditation and mindfulness. Alongside offer sleep session.

Better Sleep

  • This app helps you to understand and improve your sleep, with the use of sleep trackers, sleep trackers, sleep sounds, sleep stories and meditations.
  • You can set a bedtime reminder and your own playlist of audio to help your relax and distract your mind.

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Page last reviewed: 28 February, 2023