BaNES and Wiltshire CAMHS request for service guidance

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).

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.

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.

Description of difficulties

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.
Enter short summary
  • 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.

Description of difficulties
  • 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.
What to do
  • 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.

Description of difficulties

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.
What to do

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

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)

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Page last reviewed: 13 September, 2024