CAMHS Tiers

Why might it be of interest?

CAMHS work with children and young people up to the age of 18.  When a young person is approaching 18 there should be a transition plan in place – but make no assumptions.  If no plan is in place with referrals being made the young person’s care defaults back to their GP.

Tier1

Universal mental health services provided by professionals who do not specialise in mental health.  This can include early intervention and prevention services, usually provided through schools, children’s centres, health visitors, school nurses, GPs, youth services, helplines and wellbeing websites offering general emotional wellbeing, online therapeutic support and self-help services.

Practitioners can offer general advice and treatment for less severe problems, contribute towards mental health promotion, identify problems early in their development and refer to more specialist services.

Tier 2

Mental health services provided by professionals who do specialise in mental health, working in the community, such as GP practices, schools and youth services, paediatric clinics and can include, for example:

• Early help and targeted services
• Community counselling
• counselling or mentoring in schools
• educational psychologists
• education support centres
• targeted youth support teams
• family support
• primary mental health workers

Tier 3

Specialist CAMHS services.

Services are made up of multidisciplinary teams of child and adolescent psychiatrists, psychotherapists, family therapists, psychologists, nurses, primary mental health workers and allied health professionals such as occupational therapists, art, music and drama therapists.

Usually working in a community mental health clinic or child psychiatry outpatient service, Tier 3 is for children and young people with more severe, complex and persistent disorders.

Services are offered to children and young people with:

• Symptoms at the point of referral which suggest major mental illness and other psychiatric disorders, such as psychosis, depression, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), anxiety disorders, eating disorders, that is, those with an identifiable mental illness
• Complex neurodevelopment and neuropsychiatric disorders, such as attention deficit hyperactive disorder (ADHD), autistic spectrum disorders, Tourette’s syndrome, tic disorders, co-morbid epilepsy, complex cases with co-morbid developmental disorders for specific neuropharmacological intervention, or who require a multi-disciplinary assessment or treatment, as opposed to having less complex developmental problems
• Severe emotional difficulties and severe functional impairment arising from child abuse and/or neglect. They’re also likely to have severe attachment disorders, complex care and parenting needs, and to be ‘looked after’
• Complex conduct disorder or oppositional defiance disorder with an additional mental health disorder requiring treatment as part of a co-ordinated multi agency package of care

• Inpatient needs: those who’re being cared for in a general hospital setting (inpatient and outpatient) and require specialist mental health services, for example, those admitted with self-harm, those with chronic illness, such as asthma, HIV, terminal cancer, diabetes, who need to be cared for in a biological, psychological and social model.

Who can refer:

• GPs
• Social workers
• Health professionals, including paediatricians, school nurses and health visitors
• Adult mental health services
• Schools, via the educational psychologist, special educational needs co-ordinator (SENCO), or behaviour support team
• Tier 2 multi-agency teams.

Tier 4

Inpatient / highly specialist services

Services for children and young people with the most serious problems

Links:

Kingston:  https://swlstg.nhs.uk/kingston

Richmond:  https://swlstg.nhs.uk/richmond/

Hounslow, Ealing, Hammersmith & Fulham:  https://www.westlondon.nhs.uk/our-services/child-and-adolescent/camhs/about-camhs/camhs-services-borough

Wandsworth:  https://swlstg.nhs.uk/camhs

Richmond Borough Mind:  https://www.rbmind.org/

RB Mind offers support for young people (8-25), adults and carers

Support is offered through activity groups, peer support, recovery hubs, counselling

Rethink:  https://www.rethink.org/

Rethink have a lot of fact sheets about conditions, symptoms, treatment and support

They do run groups – activity and therapy groups but it doesn’t appear that they do anything in our immediate area