The Child and Adolescent Mental Health Service (CAMHS) are a specialist NHS Service that provides specialist and targeted assessment of young people’s mental health up until their 18th birthday (or 16th birthday for Learning Disabilities).
Children and young people who are experiencing mental health difficulties are usually first identified within Tier 1 services, for example by a teacher, GP or health visitor . Similarly, parents/carers who identify that their child is experiencing difficulties will usually first seek help from services at that level. Children and young people with an identified need may be subsequently referred into specialist CAMH services (falling within Tiers 2–4) for assessment and intervention if necessary.
In Scotland, CAMH services are generally delivered through a tiered model of service organisation, as shown in the diagram below:
Child and adolescent mental health services at Tier 1 are provided by practitioners working in universal services who are not mental health specialists. Children’s mental health and emotional wellbeing is the responsibility of all agencies and they have a duty to respond to any concerns raised about a child or young people. These professionals and agencies include: GPs, health visitors, school nurses, teachers, social workers, youth justice workers, family support workers, and voluntary agencies (this list is not exhaustive).
Tier 1 practitioners are able to offer general advice and intervention for less severe problems. They contribute towards mental health promotion, identify problems early in the child or young person’s development and refer to more specialist services.
NHS Forth Valley has a small team of mental health practitioners working at Tier 2 level who provide a link or bridge between specialist mental health services and universal services. They also work as part of Tier 3 services but also support targeted interventions already offered by others e.g. school counsellors, educational psychologists and counsellors working in GP practices, paediatric clinics, schools and youth services. FV CAMHS PMHT offer consultation to professionals working within Forth Valley who can phone and speak to a member of the team for advice and guidance or to request resources etc. They offer training to practitioners on child mental health generally and have a role to build capacity and confidence of other services to intervene with children’s emotional mental health and wellbeing. As a targetted service, there is some expectation that something has been attempted at Tier 1 or by universal services prior to referral to CAMHS.
At this tier, FV CAMHS offers specialist diagnostic assessment and the provision of specialist psychological, systemic and/or pharmacology therapy. Intervention is provided to children and young people who are experiencing moderate mental health difficulties which are having a significant impact on daily psychological /social/ educational functioning. We would expect children to be experiencing pervasive difficulties or that their difficulites are proving a barrier to education. In these circumstances we expect children to be on some form of staged intervention and or have their own education plan and would encourage the Team Around the Child or Named Person to make the CAMHS referral on completion of the Children’s Plan Form 2A. Referrals completed in this way also ensures that services are working in a coordinated way to ensure children receive the right help at the right time.
Tier 4 encompasses essential tertiary level services such as intensive community treatment services, day units and inpatient units. Within FV these are generally services for the small number of children and young people who are deemed to be at greatest risk (of rapidly declining mental health or serious self harm) and/or who require a period of intensive input for the purposes of assessment and/or treatment. NHS Forth Valley have no access to day units or have their own inpatient units therefore they aim to deliver wrap around care to those most in need which usually involves several members of the T3 team. A Consultant Child and Adolescent Psychiatrist or Clinical Psychologist is likely to have the clinical responsibility for overseeing the assessment, treatment and care for each Tier 4 patient and often these young people require a multi disciplinary team.
Who Can Refer
We accept referrals from any agency working with children, but all non-health referrers must inform the child or young person’s GP of the referral and complete Child’s Plan paperwork. We are unable to accept urgent referrals from schools or non health professionals and request that these services contact the family GP or A&E.
How to make a referral
All children and young people should be seen by the referrer prior to the referral. The referral should be fully discussed with the child or young person and with their carers. Where appropriate referrers should consider the motivation of children / young people and their families to participate in therapeutic work. For referrals of eating problems please provide current weight and height, and the speed and amount of any changes in these.
All referrals should be addressed to the team rather than to any individual professional. The referral route for health professionals and other professionals are slightly different:
|Health Professionals: GPs and those who have access to SCI Gateway||Non-Health Professionals e.g. Schools, Family Support Workers, Social Workers|
|CAMHS hope to be live on SCI Gateway by April 2016. Until then a letter referral can be accepted including the option of completing Request for Assistance Form-see Appendix 2||Complete and send Child’s Plan Forms 1, 7 and 8 alongside an appropriate assessment form ie 2, 3 or 6 which will enable CAMHS to progress Requests for Assistance.|
|Referrals should indicate level of urgency. If you think that the problem may be urgent (e.g. self harm, suicidal ideation, hallucinations or severe eating disorder) then please telephone the relevant CAMHS team to discuss, in the first instance.
Referrals can be made for a child or young person up to their 18th birthday (up to 16 years for Learning Disability CAMHS).
Before making a referral, the agreement of the family and/or the young person should always be obtained and the child should be seen.
Urgency will be decided by the multi disciplinary team based on the severity of the symptoms, their context and chronicity.
Severity – the mental health difficulties presenting need to have a significant impact on a number of areas of functioning. Interventions for single symptom presentations (e.g. sleeping difficulties, minor eating problems, toileting or behaviour difficulties) should be provided at universal or targeted services (e.g. primary care, Local Service teams) in the first instance.
Context – consideration will be given to systemic or complex risk factors such as parental mental health, history of abuse, child on Child Protection Register. Understandable or time limited reaction to external stresses (eg bereavement, family breakdown, physical illness) should be directed to universal or targeted services as above.
Chronicity – where symptoms have been present for less than 6 months, an intervention at universal or targeted level of service should be tried first (which may include advice or consultation from Specialist CAMHS). However, sudden unexplained change in behaviour that may be indicative of a significant mental disorder should be assessed as a priority.
Emergency criteria is defined as significant and immediate risk to self or others related to mental health/behaviour of child, young person and will be seen within 48 hours:
Urgent Referrals: referrals categorised as urgent will be responded to as appropriate, normally within 4 weeks. Children referred who are currently on the Child Protection Register will be prioritised their referrals categorised as urgent, however the team will require access to all relevant assessments completed and the current Child Protection Care Plan.
Routine Referrals are all other referrals or Requests for Assistance and will be seen within target timescales
NHS Forth Valley CAMHS Team
The Team have 2 bases and most staff work across both teams.
|North CAMHS||OPD 3, Stirling Community Hospital, Livilands, Stirling, FK8 2 AUfirstname.lastname@example.org|
|South CAMHS||The Manor, Brown Street, Falkirk, FK1 4PXemail@example.com|
|Primary Mental Health Team||OPD3, Stirling Community Hospital, Livilands, Stirling FK8 2 AUfirstname.lastname@example.org|
|There is an out of hours answer phone on both sites
Please note that we cannot respond to email or by email to members of the public
Primary Mental Health Team Advice Line
CAMHS Primary Mental Health Workers provide a telephone/email advice service to child care any professional working within Forth Valley.
Phone: 01786 454546
Response time is within 48 hours, Mon-Thurs 9-4.30, Fri 9-3.30. If engaged aim to return your call within 1 hour.
When you call please let staff know where you can be reached during this hour.
Please feel free to download and display our poster.
Self Help Resources
There are lots of Self-help publications that can be accessed on line and via Internet searches. It is also considered good practice for charities and organisations, including the NHS, to provide accessible information to people about their condition and treatment.
Self-help materials and interventions have been thought helpful as a psychological intervention in their own right as well as a good starting point to those delivered by clinicians. Such interventions have been referred to as ‘psychoeducation’ which is a general approach involving the provision of therapeutic information, written/video or web based materials as well as support and advice from professionals. Many self help materials use a cognitive, behavioural or problem-solving approach which many young people have found have helped them, and they don’t feel the need to attend CAMHS- whilst for others it has provided information and is a good starting point.
We have attached a copy of our Self Help Resources. All information here has either been recommended to us by young people or parents who have used the material, or is from a reliable source. However please note that this should never replace mental health assessment and if you are concerned about any deterioration or worsening of a child or your person’s mental health then please continue to refer.
CAMHS are also developing their own localised SafeSpot App which is available for Android and IOS systems. More information can be found on the App/download infor etc at www.safespot.org.uk and we will update this page when more information is available.
CAMHS Waiting Times
The team are working hard with other departments and services to achieve the target set by the Scottish Government of 18 week Referral to Treatment for all children and young people referred to CAMHS, and once achieved aims to sustain timely access for those children and young people that need it most. CAMHS have produced a Referral Criteria Document that is available.
As FV CAMHS is a specialist and targeted service for children with mental health difficulties, many children and young people may experience difficulties with their emotional health and wellbeing. All agencies have a role to play in supporting children, young people and their families when there are concerns about emotional and mental health needs.
This is further strengthened by Getting it right for every child (GIRFEC) which aims to improve outcomes for all children and young people through a shared approach between all services that; builds solutions with and around children and families, enables children to get the help they need when they need it, supports a positive shift in culture, systems and practice and involves working together to make things better. Therefore you may want to discuss concerns with the child’s Named Person.
For more information on GIRFEC see below: