Download Referrals are considered on children and adolescents

HOUNSLOW DEPARTMENT OF CHILD & ADOLESCENT MENTAL HEALTH
REFERRAL CRITERIA
Referrals are considered on children and young people up to the 18th birthday.
The service accepts referrals for direct assessment/intervention, or for consultation or advice to
professionals. Senior professionals are available daily to discuss potential referrals and telephone
discussion prior to referral is welcomed, particularly if an urgent response may be needed.
Any professional can refer, although referrals from schools require the support of the Educational
Psychology Service, Behaviour Support Team or BEST team mental health worker except in the case of an
emergency. Self-referrals cannot be accepted. Guidance on how to make a referral and what information
to include are available separately.
For telephone discussion of a potential referral, or to request referral form/guidelines please call
020 8630 3237.
The following categories are used to determine clinical priority:
Level 1 –Emergency.
As a general guide we regard patients who are actively suicidal or are exhibiting life threatening selfharming behaviour or are acutely psychotic as emergencies. Staff are very willing to discuss whether or
not cases should be considered as emergencies, and would encourage referrers to phone to discuss
particularly in the case of self-harm.
Level 2 – Priority.
Children and adolescents with symptoms suggestive of significant psychiatric disorder are considered as
priorities. In addition, consideration is given to the level of risk, distress, impairment, symptom severity
and other contextual factors in determining priority.
Significant psychiatric disorders include:
 Psychotic disorders.
 Major depressive disorder.
 Deliberate self-harm not deemed to be an emergency.
 Obsessive compulsive disorder.
 Eating disorders.
 Severe anxiety.
 Severe or prolonged adjustment difficulties e.g. abnormal grief reactions or post-traumatic stress
disorder.
Level 3 – Routine.
Referrals in this category include: Attention deficit hyperactivity disorder.
 Autistic spectrum disorder (autism, Asperger’s Syndrome and other pervasive developmental
disorders).
 Tourette’s Syndrome.
 School attendance difficulties where there is likely to be a clear mental health problem.
 Mental health difficulties associated with chronic physical illness.
 Physical symptoms thought likely to arise from psychological causes.
Consultation Service.
Referrals for consultation to professionals rather than for direct assessment/intervention are welcomed.
Appropriate cases may include those where a mental health perspective will compliment work already in
progress elsewhere, where there is professional anxiety, or uncertainty whether referral to specialist
CAMHS is appropriate, or doubt about whether the family will engage.
Problems and disorders not regarded as first line work of the specialist CAMHS team.
The following is a list of some of the problems that are not regarded as first line work of the specialist
CAMHS team. These referrals would normally only be considered when, despite the involvement of other
professionals and agencies, specialist mental health in-put still appears to be indicated. In some cases a
prior consultation with the CAMHS team may be useful to clarify whether referral would be appropriate.
Typical problems not considered first-line work of the specialist CAMHS service include: Isolated anger outbursts.
 Oppositional and/or defiant behaviour.
 Feeding problems.
 Sleep problems.
 Difficulties presenting exclusively in a school setting.
 Soiling and wetting.
Presentations not normally suitable for referral.
These include: Normal reactions to stress or bereavement.
 Specific or global learning difficulties as an isolated problem.
 Truancy.
Other important factors taken into account in determining the appropriateness of referral to the specialist
CAMHS service and the priority given to individual referrals include the following: Severity
 Duration
 Complexity
 Time sensitivity
 Likelihood of response to available treatments.
 Likelihood of engagement (if this is highly unlikely consultation may be a suitable alternative to
direct referral).
The above is intended as a guide. The ability of the service to respond to non-urgent referrals may
fluctuate depending on resources available.
APRIL 2007
Chnon-pat/referralstocamhsaugust2004