Child and Adolescent Mental Health Services (CAMHS)

This guideline relates to the Children & Family Health Devon Services (excluding Plymouth).

For Plymouth area please see Livewell Southwest CAMHS

For patients registered with a Torbay GP please see here

CAMHS will see children with the full range of mental health difficulties including those with coexistent mild learning disabilities.

Problems which should be referred elsewhere include:

  • ADHD in the absence of another comorbid mental health difficulty - this should be referred to the community paediatrician (except in North Devon where currently all ADHD should be referred to CAMHS),
  • Behaviour issues judged to be predominantly due to parenting capacity rather than the child's mental health - further information is available in the assessment section relating to this.
  • An uncomplicated grief response to a life event such as bereavement or divorce
  • Disturbances where the predominant problem is regarding drug use or dependency – in this case you can access Drug services via YSMART who can be contacted via their website Y-SMART

If you are unsure about anything, you can access a duty CAMHS clinician for discussion via the single point of access.

Assessment

To help us make the right decision about where the child or young person is best supported it is important that you include information about severity, complexity and duration of their difficulties. This should include the impact on the child's life and whether there are multiple risk factors present.

Prior to referral (except red flag cases - see below) specific areas that might be tried first would include school counselling, on-line counselling accessed via Kooth or support from other universal services e.g. a school nurse.

Where there are behaviour issues that have a parenting component these referrals should initially be referred to an early help behaviour intervention such as Incredible Years, Webster Stratton, Solihull Approach or Triple P. The Devon community directory is a good source of information as to which groups are available in your area.

Alternatively the child's school or the local children's centre may be able to advise on local resources, or the Early Help Coordination Centre which is run by Devon County Council may be able to help.

Another useful national resource is MindEd which has helpful information for both parents and professionals.

Red Flags

Problems which need to be sent in urgently would include Eating Disorders, Severe Depression, Self-Harm with Suicidal Ideation or Psychosis.

Investigations

Children exist within a support network that includes home, school and other social settings and it is really helpful for us to have as much information about this as possible to help assist us in making decisions about what to do with your request.

As mentioned earlier we would expect to see evidence at the point of referral of what has already been tried. A guide to what might be considered can be found under Section 2 of the request for services form which can be found under 'Documentation Required'.

Children should have been seen before they are referred. If you are unable to see the child or young person please indicate why. Ideally you should at least speak to another professional who is regularly involved in the child's life. Families and children where appropriate should give consent to the referral and have some understanding of the service to which they are being referred to.

Management

Even after making a referral, you retain clinical responsibility for monitoring the referred young person until you have had confirmation from our services that we have seen them. Please put any necessary safeguards in place for example regular review appointments, or ensuring that relevant responsible adults are aware of the young person's needs. Please also remain in contact with us as to any significant changes in the young person's presentation that might alter our view of the urgency of their need.

Referral

Anyone can refer to CAMHS including parents, young people themselves, school staff and other agencies. The person or agency who has the most information may be the most appropriate to make the referral. For eating disorders cases GPs should be involved in the case at the point of referral. When referring a young person with an eating problem please ensure you include a note of their current weight and height.

Use the Children & Family Health Devon website to guide you to what information needs to come in with a referral.

Please could all referrals be made using the request for services form. This form is available on some GP systems; we are rolling access out to all practices across Devon.

This helps you think about why you are referring and what outcomes are desired for the child you are referring and their family. It also ensures that you pass on the correct information about the child.

A consent form should also be included with the referral form if possible.

Forms that do not have sufficient information in them to allow us to undertake effective clinical screening will be returned to the referrer, the parent or another suitably placed person to provide this. This can delay processing a referral.

If you are unsure about anything you can phone into the Single Point of Access for support on making a referral:

Emergency out-of-hours advice and assessment under the mental health act by CAMHS is available from 5pm to 9am Monday to Friday, at the weekends and on bank holidays. The service is accessed via the Council Emergency Duty Services:

  • For Devon via the Emergency Duty Team on 0345 600 0388
  • For Torbay via the Emergency Duty Service on 0300 456 4876

The CAMHS service is led by CAMHS practitioners with Consultant Psychiatrists available to undertake Mental Health Act Assessments as required.

Supporting Information

Pathway Group

This guideline has been signed off by Devon CCG.

Publication date: December 2019

 

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