NHS Tayside Child _ Adolescent Mental Health Service

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					      NHS Tayside Child & Adolescent Mental Health Services
                 Referral Criteria and Guidance

Summary
This guidance note has been written for professionals preparing to refer patients to NHS Tayside’s
Child and Adolescent Mental Health Service (CAMHS).

It describes:
•    What CAMHS is, what it does, and what it doesn’t do
•    Who can refer
•    Who can make urgent and emergency referrals
•    Responsibilities of referrers
•    Which patients to refer
•    How to refer (i.e. what information to include)


Contents
      1        Introduction
      2        Who we are, what we do, and what we don’t do
      3        Who can refer
      4        Responsibilities of referrers
      5        Who to refer
      6        Emergency and urgent referrals
Appendix A     Common Presentations and Referral Guidance
Appendix B     How to write a good referral letter
Appendix C     What happens with (non-urgent) referrals
Appendix D     Referral form

________________________________________________________________________

1     Introduction

1.1    This document gives advice to professionals wanting to refer children and young people to
       NHS Tayside’s Child and Adolescent Mental Health Services.

1.2    In this document, when we say “child” we mean someone who is under 18 and who is still on
       a school roll.

1.3    In this guidance note we describe:
        Who we are, what we do, and what we don’t do
        Who can refer
        Responsibilities of referrers
        Who to refer
        How to refer (what we need to know)


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Referral Criteria and Guidance                                                                 Page 2 of 16

        Who can make urgent and emergency referrals


2     Who we are, what we do and what we don’t do

2.1    We are the clinical speciality which provides specialist clinical assessment and treatment for
       children and young people who have, or who are suspected to have mental health problems.
       We also provide psychological treatments for children with physical health problems and
       disabilities.

2.2    Because we are a specialist service we expect that children and young people who have
       common behaviour problems (such as with temper, arguing and disobedience) will have
       support with these problems from other, more local agencies.

2.3    We don’t provide services for children and young people living in difficult social situations if
       they don’t have a mental health problem.

2.4    We don’t see children or young people where the main problem is drug or alcohol misuse.
       Children and young people who misuse drugs or alcohol may have a mental health problem
       as well, and we would see them if the mental health problem was severe enough to need
       treatment or help from a specialist service.

2.5    We don’t provide primarily social care (for example emotional or practical support to
       parents/carers who have difficulty in parenting or caring as a result of their own difficulties).

2.6    We don’t investigate situations where children or young people are thought to be being
       abused or neglected by parents/carers. If you have concerns that a child or young person is
       being abused or neglected you should follow the child protection procedures which are
       relevant to your agency.

2.7    We don’t provide assessment or remediation of primarily educational difficulties such as
       dyslexia or dyscalculia.

2.8    The NHS does not pay for assessments of children which are needed for legal purposes,
       such as tribunals or Court proceedings. We may accept these referrals but require that they
       are made by lawyers who are representing one of the parties in the case and that
       arrangements are made to fund these.


3     Who can refer

3.1    We accept referrals from any professional (including paid staff working for voluntary
       agencies) who is currently involved with the care, health, education or welfare of the child or
       young person.

3.2    We expect that the referrer will always have seen the child or young person and have talked
       to them.


4     Responsibilities of referrers

4.1    To write a referral letter or fill in a referral form (attached as Appendix D). We are happy to
       accept referrals as letters or, where referrers have access to this, through the NHS Referral
       Management System. But we know that some referrers prefer to have a referral form so we
       provide one for those who wish to use it.

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Referral Criteria and Guidance                                                                  Page 3 of 16




4.2    To ensure that the referral letter contains enough information so that we can ensure the
       referral is appropriate, i.e. that the child has signs or symptoms of a mental health problem
       (see Appendix A). It is not acceptable to write a referral letter to advise that we contact other
       professionals to get enough information to decide whether the referral is appropriate. We
       describe the important points that you need to cover in a referral letter in Appendix B.

4.3    Referrals which are inappropriate (or which are not detailed enough to work out whether they
       are appropriate) will not be accepted for allocation.

4.4    To clarify that there is an appropriate consent for the child or young person to be seen by a
       mental health professional. Scottish law1 is fairly straightforward:

           If the young person is 16 or over they must consent (agree) to the referral. Young
            people over 16 cannot normally be referred without their agreement even if their
            parent/carer wants this. There are three exceptions to this rule:

            a.   If the young person may need to be detained in hospital under the Mental Health
                 Act. This is rare and should be discussed on the phone by a healthcare
                 professional with a clinician at CAMHS.

            b.   If there is an order under the Adults with Incapacity legislation (for example if the
                 young person has a severe disability)

            c.   If there is a legal authority to compel specific mental health care (such as an order
                 from a Court)

           If in the opinion of the referrer the child is able to understand the reason for the referral
            and the consequences if they refuse referral, then only the child can consent.

           If in the opinion of the referrer the child is not able to understand the reason for referral
            and what this entails than a person who has parental responsibility under the Children
            (Scotland) Act 1995 needs to consent.


5     Who to refer

5.1    The child or young person should be 16 or under. We accept referrals of young people who
       are older then 16 if they are still on the roll of a secondary school. We don’t accept referrals
       if the young person is at College.

5.2    The child or young person should normally live (or be at boarding school) in Tayside (i.e. in
       the local authority areas of Angus, Dundee City or Perth and Kinross). Exceptionally we will
       accept children or young people who live in other areas of the UK but we expect referrers to
       say why they are not referring the child or young person to a more local service.

5.3    Finally, the child or young person’s presentation must be suggestive of a mental health
       problem. By this we mean a disturbance of psychological, emotional or behavioural
       functioning which is more than transient and significantly interferes with their day to day life.
       We give more detailed descriptions of the kind of presentations we would expect to see in
       Appendix A.


1
 Age of Legal Capacity (Scotland) Act 1991
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Referral Criteria and Guidance                                                                Page 4 of 16


6     Emergency and urgent referrals

6.1    We only accept emergency and urgent referrals from General Practitioners or Hospital
       Doctors.

6.2    Other professionals should make referrals through normal NHS routes for getting urgent
       healthcare. These are:
        By arranging an emergency appointment with the child or young person’s General
           Practitioner
        Through NHS 24 (telephone 08454 242424)
        By taking the child to an Accident and Emergency Department
        By calling an ambulance

6.3    Emergency referrals will be seen on the day they are made.

6.4    Urgent referrals will be seen within a week. All referrals labelled “urgent” will be read by a
       senior mental health professional and if they are not thought to be clinically urgent this will be
       fed back to the referrer.

6.5    An emergency referral should be made when there is a serious and relatively immediate risk
       to the life or limb of the child or young person as a direct result of a mental health problem.

6.6    Behavioural problems, aggression or violence in children or adolescence which constitute an
       immediate and serious risk to the life or limb of someone else should be handled by the
       police in the first instance. The first priority is to establish safety before any assessment or
       treatment can be considered. While aggression and delinquency in childhood may be a
       consequence of a mental health problem they do not in themselves constitute a mental
       health problem in the sense used here.




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Referral Criteria and Guidance                                                                                 Page 5 of 16


APPENDIX A
                           Common Presentations and Referral Guidance

                   Description                      What this might be                  What to do
 The child (or more usually, the                    Suicidal thoughts   If the child repeatedly contemplates
 teenager) persistently thinks about killing                             suicide and has a plan about how to do
 themselves and often has a plan about how to do    Self-injuring        this they should be referred to CAMHS.
 so.                                                behaviour            (Also see paragraphs 6.1 and 6.2)
                                                                        Children who repeatedly injure
 The child hurts or injures themselves in some                           themselves because they are distressed
 way, for example: cutting themselves repeatedly;                        should be referred to CAMHS.
 taking overdoses of medications; putting ligatures                     Self-injury (or self-decoration) motivated
 round their neck.                                                       by child or teenage culture should not be
                                                                         referred to CAMHS.
 Some apparent self-injuring behaviour may be a
 part of teenage culture, for example scratching
 “LOVE” or the name of a girlfriend or boyfriend on
 the arms with a paperclip.
 The child has excessive worries or fears which     Anxiety disorder          Referral is appropriate if anxiety interferes
 interfere with their day-to-day life. Sometimes                              with the child’s life and the problem has not
 children show they’re anxious or worried through                             improved with straightforward advice.
 repeated minor physical complaints such as sore
 heads, sore tummies or nausea. Often anxious
 children avoid some activities that are enjoyed by
 most children.

 The child is continuously sad for long periods          Depressive illness   Children like this should be referred to
 (several days at a time), it is very difficult to cheer                      CAMHS.
 them up and they have great difficulty getting
 pleasure or enjoyment out of things they usually
 enjoy. Sometimes children will feel guilty, even
 though there’s no reason to be, there may be an
 alteration in their sleep and appetite from its usual
 pattern, and they can feel hopeless.


 The child has had a very frightening experience A disorder                   Children like this should be referred to
 (such as being in a Road Traffic Accident, a house associated with           CAMHS if their signs and symptoms have
 on fire, being the victim of physical violence or  traumatic stress.         not settled down one month after the
 sexual abuse) and there is an alteration in their                            frightening experience.
 usual state. Children may have trouble stopping
 themselves thinking about the frightening
 experience, see it in their mind’s eye over and
 over again, have nightmares, or be very easily
 startled. Sometimes children avoid anything that
 reminds them of the frightening experience.




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Referral Criteria and Guidance                                                                             Page 6 of 16

                   Description                     What this might be                  What to do
 The child has frequent tempers or tantrums, often Childhood behaviour Generally these problems should be handled
 argues with adults and does not conform to        problem             by support to the parents or family by local
 reasonable rules.                                                     community agencies.

                                                                          Referral to CAMHS is appropriate:
                                                                           If the child has a mental health or
                                                                            developmental problem in addition to this
                                                                            behaviour, described somewhere else on
                                                                            this grid
                                                                           If these problems start suddenly and are
                                                                            not how this child usually behaves
                                                                           Where the child’s parent/carer has had
                                                                            significant support from community
                                                                            agencies, which they have co-operated
                                                                            with and used well and the child’s
                                                                            behaviour has not improved.


 The child has serious behaviour problems such as Severe behaviour        Generally these problems should be handled
 repeated vandalism, is physically violent, is away problems              by support to the parents or family by local
 from school for long periods without permission,                         community agencies.
 commits crimes, is sexually aggressive, cruel to
 animals or repeatedly sets fire.                                         Professionals should consider a referral to
                                                                          Social Work and/or the Children’s Reporter
                                                                          rather than CAMHS.

                                                                          Referral to CAMHS is appropriate:
                                                                           If the child has a mental health problem
                                                                             in addition to this, described somewhere
                                                                             else on this grid
                                                                           If these problems start suddenly and are
                                                                             not how this child usually behaves.
                                                                           Where the child’s parent/carer has had
                                                                             significant support from community
                                                                             agencies, which they have co-operated
                                                                             with and used well and the child’s
                                                                             behaviour has not improved.



 The child has serious difficulty concentrating on Attention Deficit      Referral is appropriate where these
 things he or she wants to do, is easily distracted, Hyperactivity        behaviours are noticeable both at home and
 disorganised and forgetful. The child may be           Disorder (ADHD)   at school and significantly interfere with the
 restless, fidgety, “on the go”, over talkative and act                   child’s life or mean that they need a lot of
 or speak before they think. These behaviours are                         support and supervision from adults.
 noticeable both at home and school and
 significantly interfere with the child’s life, or mean                   Some children with these types of problems
 that they need a lot of support and supervision                          can be helped enough by supportive adults
 from adults                                                              at school and home.




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Referral Criteria and Guidance                                                                                Page 7 of 16

                   Description                          What this might be                 What to do
 These children have great difficulty with imagining,   Autism, or another  School-aged children who are suspected
 pretending and understanding what other people         disorder on the      of having an autistic disorder should be
 are thinking. They may have great difficulty           autistic spectrum    referred to CAMHS.
 “reading between the lines” in verbal                                      Preschool children who are suspected of
 communication. They may not be interested in                                having an autistic disorder and where
 making friendships or relationships. They may                               their parents/carers want an assessment
 have very unusual or restricted interests.                                  for this should be referred to a
                                                                             paediatrician at the child development
                                                                             centre.
                                                                            Children who have been diagnosed with
                                                                             an autistic spectrum disorder and who
                                                                             have problems with their behaviour or
                                                                             emotions or mental health can be
                                                                             referred to CAMHS.

 The child is so worried about their weight or body Eating disorder         Children like this should be referred to
 size and shape that they reduce their food intake (Anorexia Nervosa        CAMHS. They should also be seen by a
 severely and lose a lot of weight in a short time. or Bulimia Nervosa)     General Practitioner or Hospital Doctor if the
 Alternatively the child eats huge amounts of food                          referral has not been made by a doctor.
 in short periods and then makes themselves
 vomit. They do this repeatedly.


 The child has a very restricted range of food that     Feeding disorder    Children like this should initially be seen by
 he or she will eat and is not gaining weight                               community or hospital dieticians. They can
 properly.                                                                  be referred to CAMHS if the problem does
                                                                            not resolve with help from the dietician.
 The children hears or see things that other people Psychosis (serious      This is extremely rare in children before
 aren’t able to (hallucinations), or has unusual     mental illness)        puberty and fairly unusual in adolescents.
 beliefs for her or his age and culture (for example                        Children who may be psychotic should be
 – the prime minister is watching her or him at all                         referred to CAMHS.
 times through the TV screen, her/his mobile
 phone is transmitting all her/his thoughts to the
 head teacher). Children with these problems are
 usually distressed by them.

 The child feels that they have to repeat an action Obsessive           Children like this should be referred to
 (such as hand-washing, repeatedly touching or      Compulsive Disorder CAMHS if these repeated actions or
 tapping objects) in order to prevent a feeling of                      thoughts interfere in their day-to-day life (for
 severe discomfort, distress or anxiety. Some                           example by taking up a lot of time) or cause
 children think the same though over and over                           significant distress to the child.
 again to prevent a feeling of distress or anxiety.




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Referral Criteria and Guidance                                                                               Page 8 of 16

                    Description                    What this might be                 What to do
 The child has unusual, repeated movements (like Tics                  Tics are common in children and usually
 grimaces, eye-blinking, twitches or jerks) and/or                      don’t cause any problems. You may be
 unusual repeated vocalisations (such as repeated                       able to reassure the child/parents using
 throat-clearing or other sounds), which happen in                      information on the
 clear consciousness or which the child finds hard                      www.NHSInform.co.uk website.
 to suppress.                                                          Where the tics significantly interfere with
                                                                        the child’s day-to-day life or cause
                                                                        significant distress to the child this would
                                                                        be an appropriate referral.
                                                                       If there is doubt about whether the
                                                                        movements are tics, the child should be
                                                                        seen by a GP or hospital doctor before
                                                                        referral to CAMHS is considered.




 The child drinks too much alcohol too often or     Alcohol or drug         Children who use drugs or alcohol in
 uses too many illicit drugs too often.             misuse                   risky ways should be helped by more
                                                                             local community agencies and projects.
                                                                            If the child has a mental health problem
                                                                             which is described elsewhere on this
                                                                             grid, as well as their use of alcohol or
                                                                             drugs, referral may be appropriate.
                                                                            In the very rare event of children
                                                                             becoming dependent on alcohol or drugs
                                                                             (which would mean they were using
                                                                             drugs or alcohol nearly every day),
                                                                             referral would be appropriate. These
                                                                             children would need to be assessed by a
                                                                             GP or hospital doctor first.




 The child is generally slow to develop and learn   Learning disability  Learning disability by itself is not a
 the skills that most children learn.               (sometimes called         sufficient reason to refer to CAMHS.
                                                    intellectual disability  However children with learning
                                                    or mental handicap)       disabilities are especially vulnerable to
                                                                              mental health problems and we do
                                                                              accept referrals of children with learning
                                                                              disabilities with the kinds of mental
                                                                              health problems described elsewhere on
                                                                              this grid, or who have significant difficulty
                                                                              controlling their behaviour.




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Referral Criteria and Guidance                                                                               Page 9 of 16

                     Description                      What this might be                   What to do
 The child has difficulty learning a specific         Specific learning    Children should not be referred to
 academic skill (reading, writing, spelling, maths)   difficulty (such as   CAMHS for this type of problem.
 which cannot be explained by generally low           dyslexia or           Assessments of specific learning
 intelligence.                                        dyscalculia)          difficulties are done by educational
                                                                            specialists such as special needs or
                                                                            learning support teachers or Educational
                                                                            Psychologists. We will not accept these
                                                                            referrals even if school staff have
                                                                            refused to do this assessment.
                                                                           The voluntary agency, Dyslexia
                                                                            Scotland, have a very good website at
                                                                            http://www.dyslexiascotland.org.uk/ The
                                                                            Scottish Government has published a
                                                                            website aimed at teachers about
                                                                            dyslexia at
                                                                            http://www.frameworkforinclusion.org/As
                                                                            sessingDyslexia/
 The child or teenager has trouble with motor skills, Dyspraxia            Children like this should not be referred to
 for example handwriting, using a knife and fork,                          CAMHS. Assessments of motor skills are
 doing buttons and zips, or seems generally                                done by the paediatric occupational therapy
 clumsy.                                                                   service.


 Children who are upset because of family conflict Family conflict          CAMHS should not be used to provide
 such as continuing domestic violence or disputes                            emotional support to children in
 between parents/carers in the context of divorce                            situations where parents/carers need to
 or parental separation.                                                     resolve their disputes or problems. More
                                                                             appropriate support can be obtained
                                                                             from other agencies.
                                                                            However if the child has signs or
                                                                             symptoms of a mental health problem
                                                                             described somewhere else on this grid,
                                                                             he or she can be referred if this is
                                                                             appropriate.

 The child passes faeces into their underwear or      Enuresis or          Children like this should initially be seen by
 outside the toilet. The child urinates into their    encopresis           community paediatricians in the first
 underwear or outside the toilet.                                          instance because constipation is frequent
                                                                           and needs to be ruled out and/or managed.
                                                                           CAMHS referral is appropriate if paediatric
                                                                           management does not resolve the problem.
 The child has a physical health problem or           Emotional or         If straightforward advice and support from
 disability (such as diabetes, cerebral palsy,        psychological        the clinical team treating the child doesn’t
 chronic fatigue, cystic fibrosis) and is having      problems linked to   resolve the problem, refer to CAMHS.
 difficulty adjusting to this or managing the care    physical illness
 needed for their physical disorder.




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Referral Criteria and Guidance                                                                          Page 10 of 16

                     Description                      What this might be                 What to do
 The child will not to go to school.                  School refusal      Children like this should be referred to
                                                                           CAMHS after a significant effort to
                                                                           resolve this by education support
                                                                           services has been ineffective.
                                                                          However if there is good reason to
                                                                           believe that the child or young person
                                                                           has a mental health problem, described
                                                                           somewhere else on this grid, then it
                                                                           would be appropriate to refer them.


 Children under 5 who:                                Common behaviour  Preschool children with these types of
 - Have temper tantrums or other behaviour            or development       behaviour problems will not be seen in
   problems                                           problems in          CAMHS. Early years parenting support
 - Or who are developing slowly or acquiring skills   preschool children   from family centres or other community
   (talking, walking, eating, sleeping, using the                          supports should be used
   toilet) slowly                                                         Concerns that young children are
                                                                           developing slowly or have trouble
                                                                           acquiring skills should be addressed by
                                                                           health visitors and/or paediatricians.

 The child has experienced the loss of an important Bereavement            Grief is normal in children. Support
 person in their life, for example through death, and                       services such as CRUSE should be used
 is sad and unhappy                                                         in the first instance.
                                                                           CAMHS referral is appropriate if, despite
                                                                            other support, the child’s day to day
                                                                            functioning is significantly compromised
                                                                            or they are severely distressed.




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Referral Criteria and Guidance                                                                Page 11 of 16
APPENDIX B
                                    How to Write a Good Referral Letter

When making a referral we need the following information to help the child or young person get the
most appropriate service:

1.   Identify the child: by:
        Name
        Address where they are living
        Date of birth
        CHI number, if you are a health professional in NHS Scotland
        The name and address of the child’s General Practitioner (if you’re someone else).

2.   Describe the signs and symptoms (behaviours, thoughts and feelings) for which you are
     referring the child or young person. Tell us how long these have been going on and how often
     they happen. Be specific and descriptive. Use ordinary language rather than jargon which is
     open to misinterpretation. Examples of such terms are:
         social communication difficulties (this isn’t a standardised term and doesn’t have a
          generally agreed meaning)
         “attachment issues” (this isn’t a standardised term and doesn’t have a generally agreed
          meaning)
         “mental health issues” (Think about this – if the child had black teeth and cavities would
          your letter to their dentist saw “dental health issues”?)
         “concerns about mental wellbeing”
         “concerns about emotional wellbeing”
         “self-harm” (this can be anything from skin-picking to serious overdoses of drugs)
         “bizarre behaviours” (this tells us you think the behaviour is bizarre. But we want to know
          what the behaviour is).

3.   You can get this information from:
        Talking and listening to the child or young person
        Talking to other people who know the child (such as their parent/carer)
        Reading reports or notes that others have written about the child or young person
        Your observation of the child from when you have seen them.

4.   Remember - you must have personally met the child or young person who you intend to refer.

5.   If you can, tell us about the child or young person’s general health and any treatment they are
     having - for example:
      “He has epilepsy which is treated with Lamotrigine and receives care from the paediatric
          epilepsy team. His epilepsy is well-controlled.”
      “She is generally well apart from the normal childhood illnesses.”
      “He sees the speech and language therapist because of difficulty with pronunciation.”

6.   Tell us something about the child’s development if you can. For example:
         “He is reading and writing at about the level we expect for a child of this age”
         “Although she is 14, she isn’t able to talk in sentences, feed herself independently or find
          her way about the school without help. We think she is doing work at about the level of a
          child in nursery.”

7.   Tell us who the child or young person lives with, and if relevant (perhaps because they are in
     foster-care) how long they have been living there.



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Referral Criteria and Guidance                                                                Page 12 of 16
8.   Tell us about any difficult social circumstances or other stresses which the child or young
     person is having to live with or which you think may be relevant to their presentation. For
     example:
         Physical or mental illness or disability in a parent or carer
         Alcohol or drug misuse in a parent or carer
         Overcrowding at home
         Major conflict or violence between parents or carers
         Bullying or harassment at school or in the neighbourhood.

9.   Tell us about any risks the child or parent/carer may present to healthcare professionals.

10. Tell us about any special arrangements that we may need to make to see the child or young
    person. For example:
     “16-year old Janie tells us that these emotional problems started after she had a
          termination of pregnancy. She does not want her parents to know that we are referring
          her. Please could you send the appointment to her ℅ the School Health Nurse who will
          ensure this is passed to her?”
        “Billy’s parents have trouble reading and writing. If you send the appointment letter to
          their support worker at ……. this will help them get to the appointment.”

11. Finally, if there is any ambiguity, make sure we are clear that there is an appropriate consent
    for the referral (see paragraph 4.4 above).

12. Send the referral to us at:

                                                     Intake
                                             NHS Tayside CAMHS
                                             Centre for Child Health
                                              19 Dudhope Terrace
                                                    Dundee
                                                   DD3 6HH

                                        Safe Haven Fax 01382 346555




Want to know about children’s mental health and wellbeing?? click www.handsonscotland.co.uk
For high-quality information on health – visit www.nhsinform.co.uk
For the low down on children who need extra help in education – go to www.enquire.co.uk
NHS Tayside Child & Adolescent Mental Health Services
Referral Criteria and Guidance                                                                Page 13 of 16


Here’s an example of a referral letter which is well-written, complete and which we would accept.
It’s fictitious but not too far removed from reality.



                                      LEARNWELL PRIMARY SCHOOL
                                            Spelling Street
                                             Numbertown

                                              0156446 9876455366

Dear CAMHS

Hamish McFlannery DOB 51-99-87
16 Shyness Road, Numbertown, XY1 1AB

Please could you see 7 year old Hamish who is in our P2 class. The problem for which I am
referring him is that he is too anxious to be able to talk at school. Also he is very worried when he
has to change in front of the other children for gym and we have arranged for him to get changed
in the head teacher’s office. He tends not to play with the other boys and girls in the playground
and prefers to play by himself. He does chat happily to the learning support teacher when she
sees him by himself. This problem has been going on since he started at the school (he transferred
here from another school about 6 months ago). I have talked to his mother and she says he is a
chatty, cheerful boy when he’s at home but he’s quite shy with family members he doesn’t know
well, like his distant cousin.

Despite this he is working well and his reading, writing and number work are at the level we’d
expect although his spelling isn’t great. He lives with his mum, dad and baby sister Anastasia who
he dotes on, according to his mum. He used to see the speech and language therapist when he
was at nursery and this seems to be because he had trouble pronouncing some words. His mum
tells me he has asthma and uses a blue inhaler.

His mum is keen to get help and she has told me that he would like to be able to talk to the other
children at school. He has told the learning support teacher that he could go to Cubs if he was
better at talking to other children.

Yours sincerely

Mrs E Leader
Head Teacher

Copy to:         Dr Caringdoc, Numbertown Medical Centre




Want to know about children’s mental health and wellbeing?? click www.handsonscotland.co.uk
For high-quality information on health – visit www.nhsinform.co.uk
For the low down on children who need extra help in education – go to www.enquire.co.uk
NHS Tayside Child & Adolescent Mental Health Services
Referral Criteria and Guidance                                                                Page 14 of 16


APPENDIX C

                             What Happens with (Non-Urgent) Referrals

We welcome non-urgent referrals to CAMHS from any professional who knows the child.
Make a referral using this process:



                                       The child seems to
                                      have a mental health
                                            problem




                                        Is referral to CAMHS
                                             appropriate?

                                     (See referral criteria and
                                       guidance if not sure)




              No                                  Yes                    Not Sure

  Do not refer to CAMHS               Write a letter or use NHS    Talk to a Primary Mental
                                         referral management            Health Worker
                                      system or use the referral
                                            form provided.
                                       Send to CAMHS with a
                                        copy to the child’s GP


                                      Send all referrals to:
                                      Intake
                                      NHS Tayside CAMHS
                                      Centre for Child Health
                                      19 Dudhope Terrace
                                      Dundee
                                      DD3 6HH

                                   Safe haven fax 01382 346555

Appendix D
Want to know about children’s mental health and wellbeing?? click www.handsonscotland.co.uk
For high-quality information on health – visit www.nhsinform.co.uk
For the low down on children who need extra help in education – go to www.enquire.co.uk
NHS Tayside Child & Adolescent Mental Health Services
Referral Criteria and Guidance                                                                Page 15 of 16


                         Tayside Child & Adolescent Mental Health Service

                                              REFERRAL FORM

    You can use this form if you don’t want to write a referral letter.
    Please complete this form in conjunction with the NHS Tayside Child and Adolescent Mental Health
     Service Referral Criteria and Guidance

 Name of Child:


 Current Address:


 Date of Birth (and CHI number if you know it):

 Telephone Number:

 Name of GP:

 GP Address:


 When did you last see the child?

 Describe the signs and symptoms (behaviours, thoughts and feelings) for which you are referring the
 child. Please be specific and descriptive.

 For how long have these problems been going on?


 How often do they happen?


 Tell us about the child’s general health, development and progress at school or nursery.




 Who does the child live with?




 Tell us about any relevant social circumstances.

Want to know about children’s mental health and wellbeing?? click www.handsonscotland.co.uk
For high-quality information on health – visit www.nhsinform.co.uk
For the low down on children who need extra help in education – go to www.enquire.co.uk
NHS Tayside Child & Adolescent Mental Health Services
Referral Criteria and Guidance                                                                Page 16 of 16




 Tell us about any risks to professionals.



 Have you obtained appropriate consent?

 From the child: *Yes/No

 From the Parent/Guardian: *Yes/No

 Are the parents/guardian aware of this referral? *Yes/No


 Are there any special arrangements that we need to make to see the child? *Yes/No


 If Yes what are they?


 Name of referrer

 Job title

 Employing organisation

 Address


 Phone number

 Date                                              Signature




Want to know about children’s mental health and wellbeing?? click www.handsonscotland.co.uk
For high-quality information on health – visit www.nhsinform.co.uk
For the low down on children who need extra help in education – go to www.enquire.co.uk

				
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