CAMHS

Making a successful referral

What senior leaders can do

Establish a protocol with CAMHS in your area to clarify referral and joint working procedures. This may include:

• Agreeing how you might access advice and consultation. Many specialist CAMHS teams are happy to offer school staff and other professionals advice about potential referrals, which can save time and simplify the process.
• Finding out and documenting who can refer to specialist CAMHS. Some areas have an ‘open’ system of referral (which means that family members, children and young people, teachers, counsellors, social workers etc. can refer). Others have a system where only certain professionals can make a referral (e.g. schools nurses, GPs etc.).
• Finding out and documenting how children and young people are referred. Some specialist services have a single doorway (or point of access called a SPA/SPOA) or an initial screen system (called triage) to determine whether a child or young person’s needs are best met through a specialist CAMHS service.
• Agreeing an information-sharing protocol so that schools and families can work together and complement any treatment a child or family might be receiving.
• Agreeing a clearly documented partnership approach for helping support a child or young person to maintain progress and ‘step down’ from specialist help when it ends.
• Exploring opportunities for joint training with CAMHS to develop partnership working and to problem-solve more effective support for local children. 

 What education staff can do

• Document evidence of the symptoms or behaviour that are causing concern. Daily monitoring diaries, which include information about time, place and duration of symptoms are useful for this.
• When making a referral from a school (or supporting another professional with a referral), keep information relevant and focus on the things that specialist CAMHS teams need to know, including:
  • How much a child or young person’s difficulties are interfering with day-to-day life and progress.
  • How long a child or young person has been struggling with symptoms/difficulties. Use your daily monitoring diaries to describe how mental health needs and behaviours affect daily functioning and learning.
  • How many other difficulties and risks a child and family is facing.
  • How much a child or young person’s safety may be compromised by their mental health difficulties.
  • Whether any other school-based or community support has been tried. For example, for behaviour difficulties this will mean thinking about whether parents have been helped with strategies to support their children.
• Carry out a strengths and difficulties questionnaire at an early stage. Both school staff and parents can complete one. Although not a diagnostic tool, it provides a useful way of working out the nature and severity of a child or young person’s needs and what next steps to take. The results of this questionnaire should also be combined and considered together with parents/carers, the child or young person’s own experience and school staff observations. Information gathered from this tool can also give school staff, parents/carers and mental health services a common language, understanding and reference point.

What happens if a referral isn't accepted?

Specialist CAMHS are designed to meet the needs of around 2% of children in your local area.

If they don’t accept a referral, they should provide a clear reason for their decision and give advice about what to do next, including:

• what other local services might best support a child, and
• the most effective things the school and family can do to support them.